2 Introduction What are Eating Disorders? Bulimia Nervosa – 1.)eating in secrecy any amount of food that is a larger portion than a normal person would eat. It usually lasts less than two hours. There is a lack of control of eating during the episodes. The person is literally unable to stop eating or control what is eaten and how much is consumed. Continual snaking throughout the day is not considered would not be considered binging.2.) The person induces vomiting in order to prevent weight gain. Along with vomiting one may also misuse laxatives, diuretics, enemas, or others medications. They may also fast or do an excessive amount of exercise.3.) In order to qualify for diagnosis one must engage in the behaviors for at least twice a week for 3 months
3 IntroductionBinge Eating: Consumption of large amounts of food in a short period of timeOther: mainly Anorexia Nervosa but there have been more forms classified lately.
4 How do I know if someone has an eating disorder? Signs of Bulimia:Dramatic weight loss in a relatively short period of time.Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss.Obsession with weight and complaining of weight problems (even if "average" weight or thin).Obsession with calories and fat content of foods.Isolation. Fear of eating around and with others.Unusual Food rituals such as shifting the food around on the plate to look eaten; cutting food into tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or spoon); chewing food and spitting it out, but not swallowing; dropping food into napkin on lap to later throw away.Hiding food in strange places (closets, cabinets, suitcases, under the bed) to avoid eating (Anorexia) or to eat at a later time.Hair loss. Pale or "grey" appearance to the skin.Dizziness and headaches.Low blood pressure.Loss of menstrual cycle.Constipation or incontinence.Bruised or calluses knuckles; bloodshot or bleeding in the eyes; light bruising under the eyes and on the cheeks.Perfectionistic personality.
5 Warning Signs Cont. Binge Eating Disorder Fear of not being able to control eating, and while eating, not being able to stop.Isolation. Fear of eating around and with others.Chronic dieting on a variety of popular diet plans.Holding the belief that life will be better if they can lose weight.hiding food in strange places (closets, cabinets, suitcases, under the bed) to eat at a later time.Vague or secretive eating patterns.Self-defeating statements after food consumption.Blames failure in social and professional community on weight.Holding the belief that food is their only friend.Frequently out of breath after relatively light activities.Excessive sweating and shortness of breath.High blood pressure and/or cholesterol.Leg and joint pain.Weight gain.Decreased mobility due to weight gain.Loss of sexual desire or promiscuous relations.Mood swings. Depression. Fatigue.Insomnia. Poor Sleeping Habits.
6 DSM-IV Diagnostic Criteria Bulimia Nervosa:Defined by recurrent episodes of binge eatingSelf induced vomitingOccurs at least twice a week for 3 monthsSelf- evaluationDoes not occur exclusively during episodes of Anorexia Nervosa
7 DSM-IV Diagnostic Criteria continued Purging type:Self induced vomiting or misuse of laxatives or other medicationsNonpurging type:Person fasts and exercises excessively and does not partake in self- induced vomiting or misuse laxatives or other medicationsPurging type: After one has a binging episode which would generally consist of sweets and high calorie foods. The episodes are distinguished by the irregularity in the amount of food consumed than the type of food. One, then, has reoccurring episodes in which the person uses self induced vomiting or uses laxatives or other medications to get rid of what they just ate.Nonpurging type: during this type the person will use inappropriate behaviors such as fasting or doing an excessive amount of exercise. The person will not be regularly engaging in self induced vomiting or using laxatives or any other type of medications.
8 Prevalence Rate-About 1 in every 181 in the US are affected by bulimia nervosa-Binge eating disorder affects 0.7-4% of the general population-Binge eating usually occurs during or after a period of dieting
9 Environmental Causes Family Dynamics Social Factors Cultural Pressures The Media
10 Genetic CausesEating Disorder behaviors are a symptom of underlying emotional distress.Parents can add a lot of pressure on a child to excel by setting high standards and negative emotions are taught to be suppressed. In keeping with these high standards, people with eating disorders strive to be model students and lead perfect lives.Biological factors that are associated with clinical depression can lead to the development of bulimia nervosaStudies have shown an increased frequency of eating disorders if they are present in first degree biological relatives
11 Societies Impact Thought to be around middle and upper classes Not completely true—increasing numbers of cases are seen in all types of classesA studies results showed that Anorexia Nervosa was predominant in higher classes while bulimia was distributed consistently throughout all classesMost prevalent in industrialized countriesWestern Vs. NonwesternMedscape's General Medicine 6(3) 2004, prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects.Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing, presumably because of the influence, at least in part, of Western media: movies, TV shows, and magazines. Researchers conclude that the prevalence of eating disorders in non-Western countries is lower than that of Western countries, but it appears to be increasing.
12 Unrealistic Expectations Average WomanBarbieStore MannequinHeight5’4”6’0”Weight145 lbs101 lbsN/ADress Size11-1446Bust36-37”39”34”Hips40-42”33”Waist29-31”19”23”
13 Diversity: RaceOver the past few years there has been increasing evidence of disordered eating occurring among racial and ethnic minorities in the U.S. Contrary to the persistent belief that eating disorders affect only young white women. A study found that dieting was associated with weight dissatisfaction, perceived overweight, and low body pride in all ethnic groups.African American girls may be especially vulnerable to develop a binge eating disorderAfrican American girls age scored higher on the Eating Disorder Inventory than most white females. This scale measures features commonly associated with eating disorders.A telephone survey found that African American women were just as likely as white women to report binge eatingStudies have also shown binge eating to be the most severe in Hispanics
14 Diversity: Age2-3% of females affected by the illness are late adolescent to early adulthoodLifetime prevalence in females is 1-3%Incidence and prevalence has increased in all age groupsPrevalence is increasing among pre-pubertal girlsA study has shown that 70% of sixth grade girls first became worried about their weight at age 9Eating disorders mainly affect people in their teens and twenties, but studies have reported children as young as 6 and individuals as old as 76!As baby-boomers in the U.S. grow older, there seems to be an increase in incidence of middle-aged women with an eating disorder, possibly because this group has consistently considered image to be of major importance.In the U.S. the lifetime prevalence of bulimia is reportedly 3%. Bulimia Nervosa affects about 6% of adolescent girls and 5% of college women.
15 Diversity: GenderPrevalence of bulimia nervosa in females is 1.1 to 4.2%The prevalence rate in males is one tenth of that of females5-15% of cases of eating disorders involve men in the US85-95% of cases of eating disorders are among women in the USBinge eating is prominent in females to males with a 3:2 ratio
16 The Good, the Bad, the Ugly PositivesInitial weight loss can improve athletic performanceTemporary positive feedback from friends, coaches, and family.Gives a false sense of controlGives temporary relief to anxietyNegativeHeart problemsThreat of Female TriadMuscle deteriorationImbalance electrolytesDehydrationKidney ProblemsMood swingsDepressionIsolationDeath………..and the list goes on and on
17 TreatmentThe treatment team that usually consists of a Dietitian, Psychiatrist, and a PhysicianThere are also treatment facilities available but good ones are hard to find around the U.S.***One of the major ongoing debates with treatment of an eating disorder is that most insurance will not cover it. This puts families in a hard position if they cannot afford the treatment****
18 Community Programs Get Help! There are MANY treatment facilities in AlabamaThe Medical Center in Auburn University
19 Recovery With treatment 60% fully recover40% still struggleWithout treatment, up to 20% of people with serious eating disorders die. That number falls to 2-3% with treatment!!!
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