1. Chapter 12 Eating Disorders

2. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 2

3. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 3 DSM-IV-TR Criteria for Anorexia Nervosa

4. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 4 Restricting type: simply refusing to eat as a way of preventing weight gain. Some might go for days without eating. Binge/Purge type: binging or purging behaviors (e.g., self-induced vomiting or the misuse of laxatives or diuretics). Types of Anorexia Nervosa

5. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 5 Anorexia Nervosa 1–2 % of people develop anorexia nervosa Between 90 and 95% are female Caucasian women are more likely than African American women to develop anorexia nervosa Usually begins in adolescence, between 15 and 19 About half of the those with anorexia nervosa have a positive outcome 10 to 15 years after treatment About half continue to suffer from eating-related problems or other psychopathology, particularly depression Very dangerous disorder (death rate of 5–8%) Serious medical complications

6. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 6 DSM-IV-TR Criteria for Bulimia Nervosa

7. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 7 Nonpurging type of bulimia nervosa: people who use excessive exercise or fasting to control their weight but do not engage in purging are said to have a nonpurging type of bulimia nervosa. Purging type of bulimia nervosa: people who use self-induced vomiting or purging medications. Types of Bulimia Nervosa

8. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 8 Bulimia Nervosa General population prevalence of bulimia nervosa is estimated between 0.5 and 3% Much more common in women than in men, and in Caucasians than African Americans Onset most often occurs between ages 15–29 Death rate among people with bulimia is not as high as among people with anorexia Serious medical complications Tends to be a chronic condition

9. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 9 Binge-Eating Disorder Resembles bulimia nervosa in many ways Exception: binge-eating disorder does not involve regularly engagement in purging, fasting, or excessive exercise to compensate for binges

10. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 10

11. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 11 Variations on Eating Disorders

12. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 12 Eating Disorder NOS

13. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 13 Obesity One of the greatest public health concerns in the United States and many developed countries Defined as a body mass index (BMI) of 30 or over, where BMI is calculated as weight in pounds divided by the square of height in inches Between 1980 and 2002, the prevalence of obesity doubled in adults and tripled in children and adolescents Over one-third of Americans are obese Not designated as an eating disorder by the DSM- IV-TR, but it is clearly a major health hazard

14. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 14 Understanding Eating Disorders Biological factors  Hypothalamus dysregulation  Neurotransmitter levels (serotonin) Social pressure and cultural norms Emotion regulation difficulties Cognitive factors Family dynamics

15. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 15 Athletes and Eating Disorders

16. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 16 Treatments for Anorexia Nervosa Psychotherapy  Individual therapy  Family therapy Biological treatments (hospitalization, stabilization, medications)

17. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 17 Treatments for Bulimia Nervosa Psychotherapy  Cognitive approaches  Behavioral approaches Biological treatments  Medications (antidepressants)

18. Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 12 18 Integration: The Biopsychosocial Model