1. Eating Disorders Chapter 14
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2. Anorexia and Bulimia ______________:
inability to maintain normal weight, an intense fear of gaining weight, and distorted body perception.
________________:
Eating disorder involving alternation between eating large amounts of food in a short time, then compensating by vomiting or other extreme actions to avoid weight gain.
People with eating disorders struggle to control their disturbed attitudes and behaviors regarding food, and many put their lives at risk.
Differences: Anorexics have distorted body image, bulimics have accurate body image; anorexics significantly below normal weight, bulimic’s weight is average or above-average.
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3. Anorexia Nervosa Anorexia Nervosa
Refuse/unable to maintain ___% of expected weight for frame, height.
Intense fear of gaining weight, though underweight.
Distorted perception of weight or _____________.
Amenhorrhea.
Four symptoms characterize anorexia nervosa.
Amenhorrhea: (for postpubescent females) the absence of at least three consecutive menstrual cycles.
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4. Anorexia Nervosa Effects of Anorexia Nervosa
As self-starvation continues, bodily signs of physical disturbance become more evident.
For example:
Yellowing of the skin.
Impaired organ functioning.
Death (1 in 10).
1 in 10 die as a result of starvation, medical complications, or suicide.
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5. Bulimia Nervosa Bulimia Nervosa _________:
Episodes of eating large amounts of food, characterized by:
in a 2-hour period, eating an amount much greater than others would eat;
feeling _____________ over what or how much is being eaten.
People with bulimia nervosa alternate between eating large amounts of food in a short time, then compensating for the added calories by vomiting or other extreme actions.
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6. COMPENSATING BEHAVIORS
Bulimia Nervosa
Bulimia Nervosa
COMPENSATING BEHAVIORS
_______________ – try to force out of their bodies what they’ve just eaten by
NONPURGING TYPE – try to compensate by ______________________.
vomiting
administering enemas
taking laxatives or diuretics
Some people with anorexia nervosa also engage in compensating behaviors, but their primary symptom is that they starve themselves.
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7. Effects of Bulimia Nervosa
IPECAC SYRUP, if used regularly to induce vomiting, has toxic effects.
_________________.
Enlarged salivary glands.
Skin calluses on hands that brush against teeth in the vomiting process.
Menstrual irregularity is common.
LAXATIVES, DIURETICS, and DIET PILLS also have toxic effects over time.
_____________________ may be permanent.
Also possible: fluid retention in hands and feet; destruction of the heart muscle; collapse of the heart valve.
Effects occur throughout the gastrointestinal, cardiovascular, and nervous systems.
For girls, the highest risk for development of binge behavior is age 16; purging, 18.
42% of bulimic men identify themselves as homosexual or bisexual; 58% anorexic men, asexual.
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8. THEORIES OF EATING DISORDERS
BIOLOGICAL - Altered ____________________________ neurotransmitter systems.
PSYCHOLOGICAL - Turn to food to escape inner turmoil and pain; from cognitive standpoint, over time get trapped in eating patterns.
_______________ - Dysfunctional family functioning and societal obsession with food.
Norepinephrine and serotonin deficiencies are also implicated in mood and compulsive disorders, so it is interesting to note high co-morbidity between those disorders and the eating disorders.
Victims of childhood abuse have higher rates of eating disorders.
Individuals with eating disorders tend to avoid problems rather than resolve them; resort to wishful thinking rather than realistic appraisal; and don’t seek social support even when in serious trouble.
The pursuit of emotional comfort through eating may also be seen as a desperate expression of unresolved feelings of dependency.
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9. TREATMENT COMBINATION OF APPROACHES MEDICATION PSYCHOTHERAPY
Cognitive/Behavioral
Interpersonal Therapy
Family Therapy
multifamily therapy
Given the multiple perspectives on the causes of eating disorders and the evidence to support each, it follows that effective treatment usually requires a combination of approaches.
Medication: Fluoxetine (Prozac) can help control relapse, maintain weight gains, and reduce other symptoms. Regardless of the potential usefulness of medications, though, psychotherapy is clearly needed.
Cognitive/behavioral: Establish good eating patterns; self-monitoring techniques; learn self-control, problem-solving, cognitive-restructuring.
Interpersonal therapy: Therapy focuses on helping the client cope with stress in interpersonal situations and with feelings of low self-esteem.
Family therapy: A review of research indicates that involvement of the parents and the teen is sufficient to bring about positive change.
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10. Eating Disorders The Biopsychosocial Perspective
struggles to control strong urges to act in ways that are destructive or detrimental
fall on an “_____________” that includes other disorders with obsessive or compulsive qualities
In attempting to explain impulse-control disorders, experts have proposed that they fall on an “affective spectrum” that includes mood disorders, substance abuse disorders, anxiety disorders, and eating disorders.
All these conditions share certain symptoms, hypothesized biological mechanisms, and treatments.