©2002 Learning Zone Express 1 Eating Disorders Louanne Kaupa, RD, LN.

©2002 Learning Zone Express 2 Quick Facts An estimated 7,000,000 women & 1,000,000 men in the U.S. suffer from eating disorders. 41% of high school students suffer from an eating disorder. Of all psychological diseases, eating disorders have the highest mortality rates. Men and women, both young and old, rich and poor, all minorities, suffer from eating disorders. Eating disorders are more common in women than in men.

©2002 Learning Zone Express 3 What is an eating disorder? The term “Eating Disorder” is used to describe a variety of eating patterns which are considered abnormal and potentially harmful. These behaviors may be expressed in the following ways… Overeating. Binge eating/eating large amounts of food in a short period of time. Refusing to eat/self-starvation. Compulsive exercising. Overusing diet pills. Overusing laxatives. Vomiting.

©2002 Learning Zone Express 4 Types of Eating Disorders Anorexia Nervosa Bulimia Nervosa Compulsive Overeating For this presentation we will be focusing on Anorexia Nervosa and Bulimia Nervosa.

©2002 Learning Zone Express 5 Anorexia Nervosa Anorexia Nervosa is a serious, potentially live- threatening eating disorder where an individual refuses to maintain a minimally normal body weight by self-starvation tactics. Those who suffer from anorexia nervosa often: Have an irrational fear of becoming fat. See themselves as fat no matter how much they weigh. Strive for perfection and set high standards for themselves. Feel a need for control in their lives. Suffer from low self-esteem. Suffer from depression. Withdraw from social interactions.

©2002 Learning Zone Express 6 Anorexia Nervosa Characteristics Self-starvation with weight loss. Refusal to eat, except in tiny portions. Food preoccupation and rituals. Denial of hunger. Absence or irregular menstrual cycles. Compulsive exercising. Distorted body image. Intense fear of gaining weight. Hair loss. Sensitivity to cold. Lanugo - Light hair covering face and forearms that appears after someone has lost a great amount of weight due to inadequate protein in the diet. Denial of any unusual eating behaviors. Lack of concentration. Some or all of these characteristics may be present.

©2002 Learning Zone Express 7 Anorexia Nervosa Health Effects Lowered body temperature. Decreased heart rate. Iron deficiency. Depressed immune system. Dehydration. Constipation. Low Blood Potassium - this is the most common cause of death in a long-time anorexic as it an contribute to an irregular heart beat. Swelling or puffiness often in ankle and feet. Bloating.

©2002 Learning Zone Express 8 Bulimia Nervosa Bulimia Nervosa is a serious, potentially life- threatening eating disorder where an individual binges and purges, usually in secret, in an attempt to avoid weight gain. Binge - Eating abnormally large amounts of food. Purge - Self-induced vomiting, abuse of laxatives or diuretics or periods of “fasting” to get rid of consumed food. People suffering from Bulimia often: Suffer from depression. Have low self-esteem. Strive for the approval of others. Do realize they have a problem. Have shame and guilt - and mood swings. Withdraw from usual social interactions.

©2002 Learning Zone Express 9 Bulimia Nervosa Characteristics Binge eating, usually in secret. Preoccupation with food. Vomiting after binging. Abuse of laxatives, diuretics, diet pills or drugs to induce vomiting. Feeling a lack of control. Depression/Isolation. Usually normal weight or slightly above normal.

©2002 Learning Zone Express 10 Bulimia Nervosa Health Effects Broken blood vessels in the eyes - a result of the pressure from vomiting. Tooth/gum erosion due to the stomach acid from vomiting. Russell’s sign - scar tissue on the knuckle of finger used to induce vomiting. Swollen salivary glands. Dehydration. Constipation. Low blood potassium. Poisoning. Tears in the esophagus. Ruptured stomach. Ulcers. Serious heart, kidney and liver damage.

©2002 Learning Zone Express 11 Causes of Eating Disorders Generally, there is more than the issue of wanting to be thin that leads to eating disorders. Eating disorders are a sign that deeper personal/ emotional problems exist. Some issues that lead to an eating disorder include: Depression, anxiety, anger & loneliness. Low self-esteem. Feelings of inadequacy or lack of control in life. Troubled family or personal relationship. History of being teased based on size or weight. History of physical or sexual abuse.

©2002 Learning Zone Express 12 Who can help? The most effective treatment of an eating disorder is some form of psychotherapy or counseling in combination with medical concerns being addressed by a physician and dietitian. The team of professionals should consist of: Psychologists Doctors Registered Dietitians Family, friends, and people who have suffered from an eating disorder can also be very helpful members of a treatment team.

©2002 Learning Zone Express 13 How can you help? Most people suffering from eating disorders do not seek help on their own. Friends and family members are often the first ones to notice signs of an eating disorder If you suspect a friend or family member may have an eating disorder you should talk to a parent, medical professional, or trusted adult for help. You should confront the individual but in a very thoughtful and caring manner. Tell the individual you care about them and are concerned for their health.

©2002 Learning Zone Express 14 Body Image What is body image? Body image is how one sees his or her body. This includes their thoughts and feelings, both positive and negative, regarding physical appearance from height and weight to facial features.

©2002 Learning Zone Express 15 Body Image One’s body image may be affected by: Self- Esteem Family Peers Relationships Media

©2002 Learning Zone Express 16 Self-esteem Self-esteem is defined as how we view ourselves or how we feel about our life. Class Discussion: What are some positive self-esteem feelings? What are some negative self-esteem feelings? How can a person improve their self-esteem? How do people affect other’s self-esteem?

©2002 Learning Zone Express 17 Family Your family has a great influence over your body image. Family values affect the way you see yourself and your body. Ask yourself the following questions: Does your family put great importance on looks and weight? Do members of your family diet regularly? Are you pressured to change your diet by family members? In what ways do you think your family has affected your body image both positively and negatively?

©2002 Learning Zone Express 18 Peers Your friends and classmates may also affect your body image. This is often due to “perceived” pressure we feel from our friends to fit in. Class Discussion: Why might someone feel they need to look a certain way for their friends? Do you care what your friends look like? What might you tell a friend who thinks that you will not be their friend based on their looks? Brainstorm different ways peers can help one another improve each other’s body image.

©2002 Learning Zone Express 19 Relationships Relationships with boyfriends and girlfriends may also affect body image. Again “perceived” pressure to look a certain way in order to feel liked by another may lead to a poor body image. Class Discussion: What characteristics would you look for? What characteristics do you think most guys and girls look for in a boyfriend or a girlfriend? How big a role do you think looks play in dating? How would you encourage someone to “be their own self” when it comes to dating?

©2002 Learning Zone Express 20 The Media Everyday we are hit with thousands of media images which show us the “ideal” male and female looks. However, very few people actually match up to these ideals. Advertisers use body images to promote their products by showing that beauty equals happiness. Class Discussion: How does the media portray the ideal male and ideal female appearance? List several popular commercials. Who appears in the commercials and what do they look like? What is the message the commercial is trying to send? Is the message real? In what ways would you change the media images to help people see a more realistic view of life?

©2002 Learning Zone Express 21 You’re the Expert Your best friend has lost a noticeable amount of weight in the past couple of months. She prefers to eat lunch by herself outside and no longer enjoys some of the activities she used to love to do. You suspect that she might have an eating disorder. Discuss in small groups what you would do in this situation. How should you approach her? What should you do if you speak to her and she tells you nothing is wrong?

©2002 Learning Zone Express 22 Applying What You Know 1. Create a Public Service Ad which gives the public information on eating disorders. Be sure to include statistics, the warning signs of eating disorders, and what you can do if you suspect someone you know has an eating disorder. 2. Interview or research someone who helps people suffering from an eating disorder. (psychologist, dietitian, doctor, etc.) Write a 1-2 page report describing the different treatment methods they use, as well as any current trends in treatment options. 3. Create a poster showing the signs and symptoms of at least three different eating disorders. Be sure to include the health effects, as well as treatment options.

©2002 Learning Zone Express 23 Eating Disorder Quiz 1. Which of the following is not a health effect of anorexia nervosa? a. Lowered body temperature. b. Iron deficiency. c. Increased fertility. d. Dehydration. 2. One’s body image may be affected by______? a. The media. b. Friends and family members. c. Self-esteem. d. All of the above. Choose the best answer to the following questions:

©2002 Learning Zone Express 24 Eating Disorder Quiz 3. What is the light hair that appears on the face and forearms when someone loses a substantial amount of weight called? a. Amenorrhea. b. Lanugo. c. Russell’s sign. d. Fine hair. 4. If you suspect someone you know has an eating disorder what should you do? a. Take them to the hospital immediately. b. Tell the person about your concerns in a thoughtful way. c. Tell a parent or trusted adult. d. Both B and C.

©2002 Learning Zone Express 25 Eating Disorder Quiz 5. What is the most effective treatment for those suffering from eating disorders? a. Counseling. b. Medical/Nutritional + follow-up. c. Support Groups. d. All of the above.

©2002 Learning Zone Express 26 Exploring the Web Here are some suggested sites you and your class may want to investigate for more information on eating disorders. A site for teens with information about eating disorders listed under topic heading “bodies”. Facts and information regarding eating disorders from the National Eating Disorders Association. Eating disorder information geared toward teen girls. Information for teens on eating disorders from the Food and Drug Administration (FDA). National Association of Anorexia Nervosa and Associated Disorders. Teachers: Please note that these addresses are constantly changing and being updated. You may need to revise this list.