2.  About 5 million people in the U.S., mostly females, suffer from the eating disorders anorexia nervosa and bulimia nervosa  http://www.census.gov/main/www/pop clock.html http://www.census.gov/main/www/pop clock.html  (in millions) 314.7 in US / 5 = ~63  So 1 out of every ~63-65 people is struggling with an eating disorder…  Which means in our class of 145, there could be 2 or more people dealing with an eating disorder.

3.  Many more suffer from binge eating disorder or related conditions.  85% of eating disorders start during adolescence; warning signs: › Fear of fatness › Distorted body image › Restrained eating › Binge eating › purging

4.  http://today.msnbc.msn.com/id/4365563 9/ns/today-today_health/t/eating- disorders-stalk-women- adulthood/#.UJjmRIb5Xkc http://today.msnbc.msn.com/id/4365563 9/ns/today-today_health/t/eating- disorders-stalk-women- adulthood/#.UJjmRIb5Xkc

5.  Eating disorder: disturbance in eating behavior that jeopardizes physical or psychological health  Anorexia (without appetite) nervosa (of nervous origin) : › refusal to maintain a minimally normal body weight, self-starvation to the extreme, disturbed perception of body weight and shape

6. Anorexia nervosa

7.  Bulimia nervosa : › Recurring episodes of binge eating combined with a morbid fear of becoming fat; usually followed by self-induced vomiting (purging)  Binge eating disorder: › Similar to bulimia, excluding purging  Cathartic: › strong laxative  Emetic: › causes vomiting

8.  Psychological therapy aimed at changing undesirable behaviors by changing underlying thought processes contributing to these behaviors.

10.  On average, wrestlers, gymnasts, and figure skaters strive to be too thin.  Muscle dysmorphia – a weight gain problem, in which young men with well- muscled bodies falsely see themselves as underweight and weak. › Can lead to obsessive weighing, excessive exercise, overuse of special diets or protein supplements, or even steroid abuse.

11.  Anorexia nervosa: same damage as classic protein-energy malnutrition › Depletes body tissues of needed fat and protein › Young people: growth ceases, normal development falters › Lose so much lean tissue that basal metabolism slows › Blood pressure falls › Heart muscle becomes weak, thin › Electrolytes that help to regulate heartbeat go out of balance; many deaths due to heart failure

12.  Treatment requires a multidisciplinary approach that addresses food and weight and also involves relationships with oneself and others.  1,000 women die each year, mostly from heart abnormalities brought on by malnutrition or from suicide.

13.  The Renfrew Center has 11 facilities in nine states across the country.  http://renfrewcenter.com/ http://renfrewcenter.com/  http://www.addictionresourceguide.co m/listings/renfrewfl.html http://www.addictionresourceguide.co m/listings/renfrewfl.html

14.  Recurrent episodes of binge eating, characterized by both of the following: › Eating, within a 2 hour period, amount of food that is definitely larger than most people would eat over similar time/place › Sense of lack of control over eating during episode (feeling that cannot stop eating or control how much/what are eating)  Recurrent compensatory behavior to prevent weight gain › Self-induced vomiting › Misuse of laxatives, diuretics, enemas, fasting

15.  Binge eating and compensatory behaviors that both occur, on average, at least twice a week for three months  Self-evaluation is significantly influenced by body shape and weight  May be purging type or non-purging  More prevalent than anorexia

17.  A typical binge consists of easy-to-eat, low- fiber, smooth-textured, high-calorie foods

18.  Binge is compulsive, unlike normal eating: › Usually occurs in stages- › Anticipation and planning › Anxiety, urgency to begin › Rapid and uncontrollable consumption  (Whole cake, or bag of cookies or carton of ice cream) › Relief and relaxation › Disappointment › Shame and disgust, followed by purging

19.  Physical and Psychological Perils: › Abnormal heart rhythms › Swollen neck glands › Urinary tract infections › Irritation and infection of the throat › Tears of the stomach and/or esophagus › Dental caries › Shame, guilt

20.  Parents may foster bulimia by example  Families may be controlling, but emotionally unsupportive; this can result in a negative self-image  Criticism of body shape or weight, arguments, especially over dieting  Common factor: family rarely eats together  Sense of not able to get control of life

21.  Plan meals and snacks; record plans  Plan meals that require sitting at table and using utensils  Refrain from ‘finger foods’  Refrain from dieting or skipping meals  Nutrition : Raw fruits, vegs, whole grains, plenty of water  Select foods that naturally divide into portions: one potato instead of pile of rice  Activity