Judith E. Brown Prof. Albia Dugger Miami-Dade College Disordered Eating: Anorexia Nervosa, Bulimia, and Pica Unit 11

The Eating Disorders Symptoms of disordered eating: Self-imposed starvation Feast and famine cycles Binge eating Purging Regular consumption of nonfood substances

Key Terms Purging The use of self-induced vomiting, laxatives, or diuretics (water pills) to prevent weight gain

The Eating Disorders Four types of disordered eating: 1. Anorexia nervosa 2. Bulimia nervosa 3. Binge-eating disorder 4. Pica

Anorexia Nervosa Individuals with anorexia nervosa starve themselves – no matter how emaciated they are, they never feel thin enough Anorexia nervosa An eating disorder characterized by extreme weight loss, poor body image, and irrational fears of weight gain and obesity

Anorexia Nervosa People with anorexia nervosa eat less than 1200 calories a day (below: 562 calories)

Anorexia Nervosa Health effects of anorexia nervosa Dry skin Low or irregular heartbeat Low blood pressure Osteoporosis Infertility Women: irregular menstrual cycles

Anorexia Nervosa 90% of people with anorexia nervosa are women

Female Athlete Triad Three problems occur together in young female athletes with low caloric intakes: Eating disorders that lower estrogen levels Menstrual cycle dysfunction Decreased bone mineral density

Motivation Behind Anorexia Nervosa Overwhelming desire to be thin drives people with anorexia nervosa to refuse to eat, and to exercise intensely Preoccupation with food Low self esteem Social isolation Unhappiness

Motivation Behind Anorexia Nervosa Half of the people with anorexia nervosa turn to binge-eating and purging to lose weight Binge-eating Consumption of a large amount of food in a short period of time

What Causes Anorexia Nervosa? Many different psychological and biological causes may predispose an individual to become anorexic Western society’s expectations of acceptable body weight and shape contribute to low self esteem

Conforming to Expectations

How Common is Anorexia Nervosa? In Western societies: 1% of adolescent and young women 0.1% of young males Certain groups are at higher risk

Treatment for Anorexia Nervosa Few people with anorexia believe they are underweight or need help Generally takes 5 to 7 years of professional help to correct, or partially correct Nutrition and psychological counseling 50% success 3% die within 8 years

Features of Anorexia Nervosa

Bulimia Nervosa Bulimia nervosa Characterized by cycles of dieting and episodes of rapid, uncontrolled eating of large amounts of food in a short time (bingeing) Episodes of binge eating are often followed by purging (vomiting, laxatives, diuretics, enemas) and sometimes exercise

Bulimia Nervosa: Binge Eating

Bulimia Nervosa Characteristics: Preoccupied with eating and weight Tend to be normal weight or overweight Is more common in young athletes, along with anorexia nervosa Major changes in metabolism Teeth may be eroded by stomach acid

Bulimia Nervosa Associated with depression, abnormal food- intake mechanisms, feast-and-famine cycles Restrained eating Purposeful restriction of food intake below desired amounts to control body weight Deprivation and hunger may trigger binge eating

Treating Bulimia Nervosa Break feast-and-famine cycles via nutrition and psychological counseling Regular eating reduces urge to binge Improve self esteem and body image May include antidepressant medication 1/3 relapse within 7 years

Features of Bulimia Nervosa

Binge-Eating Disorder Binge-eating disorder Characterized by periodic binge eating, not followed by purging or excess exercise Average two binges per week for 6 months Tend to be overweight or obese Affects males and females equally

Binge-Eating Disorder Associated with: Stress, depression, anxiety 30-90% of obese people 9-30% of people in weight-control programs Aggregates in families Genetic and environmental origins

Treating Binge-Eating Disorder Nutrition and therapy sessions focus on disordered eating and psychological issues Record food intake, feelings, circumstances Identify triggers and behaviors to avoid them Counseling on normal eating, hunger cues, and meal planning

Binge-Eating Disorder Food Diary

Features of Binge-Eating Disorder Treatment is successful in 85% of women treated for binge-eating disorder

Resources for Eating Disorders Primary care physicians, dieticians, or nurse practitioners can help find a health care team that specializes in treatments of eating disorders Support groups Treatment centers Hotlines

Undieting: Clash Between Culture and Biology Unhealthfully thin body shapes portrayed by models and other popular ideals can lead normal adults to weight dissatisfaction Acceptance of healthy body weight and shape is important to prevent anorexia nervosa, bulimia nervosa, and binge-eating

Movement Toward Size Acceptance

Pica Pica has been observed in many cultures since ancient times Pica Regular consumption of nonfood substances such as clay or laundry starch Mostly in young children and pregnant women

Forms of Pica Geophagia (clay or dirt eating) Craving for taste or smell May relieve nausea Associated with iron deficiency and sickle-cell anemia Problems: Blockage of intestinal tract Parasitic and bacterial infections

Forms of Pica Pagophagia (ice eating) Associated with iron deficiency Common during pregnancy

Forms of Pica Amylophagia (laundry starch or cornstarch eating) Carbohydrate, sweet taste, provides calories Associated with pregnancy Problems: May reduce intake of nutrient-dense foods May contain contaminants

Forms of Pica Plumbism (lead eating) Primarily from paint flakes in old houses Major cause of lead poisoning in young children Lead poisoning Causes mental retardation, death 1.4% of young US children have elevated lead levels

Plumbism

Some Nonfoods Eaten

Other Abnormal Patterns Proposed eating disorders: Nighttime eating syndrome Compulsive overeating Purging disorder Restrained eating Orthorexia nervosa