1. Chapter 9 Eating Disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

2. Eating Disorders Clinical Aspects of Eating Disorders Risk and Causal Factors in Eating Disorders Treatment of Eating Disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

3. Clinical Aspects of Eating Disorders Most common forms Anorexia nervosa Bulimia nervosa © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

4. Clinical Aspects of Eating Disorders Central to both disorders Intense and pathological fear of becoming overweight and fat Pursuit of thinness that is relentless and sometimes deadly © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

5. Body Distortion Image

6. Anorexia Nervosa Characteristics Fear of gaining weight Refusal to maintain normal weight Types Restricting type Binge-eating/ purging type © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

7. DSM-5 subtypes of anorexia –Restricting subtype – limit caloric intake via diet and fasting –Binge-eating-purging subtype

8. Bulimia Nervosa Characteristics Frequent episodes of binge eating Lack of control over eating Recurrent inappropriate behavior © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

9. Bulimia Nervosa Purging type Vomiting Laxatives Diuretics Nonpurging type Fasting Exercise © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

10. Binge Eating Disorder Characteristics Frequent episodes of binge eating Typically overweight or obese No compensatory weight loss behaviors © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

11. Age of Onset and Gender Differences Anorexia nervosa is most likely to develop in 14- to 18-year-olds Bulimia nervosa is most likely to develop in women ages 15-21 90% of anorexics are females © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

12. Prevalence of Eating Disorders U.S. lifetime prevalence of binge eating disorder is around 3.5% in women and 2% in men U.S. lifetime prevalence of anorexia nervosa is around.9% in women and.3% in men U.S. lifetime prevalence of bulimia is around 1.5% in women and.5% in men © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

13. Medical Complications of Eating Disorders Anorexia can lead to Death from heart arrhythmias Kidney damage Renal failure Bulimia can lead to Electrolyte imbalances Hypokalemia (low potassium) Damage to hands, throat, and teeth © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

14. Figure 9.2: Medical Effects of Anorexia © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

15. Medical Effects of Bulimia

16. Course and Outcome Suicide risk is high among anorexics Long-term prognosis for bulimia is relatively good compared to anorexia © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

17. Course and Outcome Anorexia After 21 years: 51% fully recovered 21% partially recovered 10% not recovered 16% no longer alive Bulimia 70% in remission after 11 to 12 years Binge eating 60% in remission after 6 years © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

18. The Long-Term Stability of Eating Disorders People with eating disorders often later develop other eating disorders “Diagnostic crossover” common among subtypes of anorexia Uncommon between binge- eating disorder and anorexia © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

19. Figure 9.3: Diagnostic Crossover in Eating Disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

20. Association of Eating Disorders with Other Forms of Psychopathology Eating disorders associated with following disorders: Clinical depression Obsessive-compulsive disorder Substance abuse disorders Various personality disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

21. Eating Disorders across Cultures Attitudes that lead to eating disorders are more common in whites and Asians than African Americans Eating disorders are becoming a problem worldwide © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

22. Risk and Causal Factors in Eating Disorders Biological factors Sociocultural factors Family influences Individual risk factors Eating disorders multidetermined © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

23. Biological Factors Hereditary tendency Set-point theory Brain abnormalities Serotonin © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

24. Sociocultural Factors Media-related idealized extreme thinness Female internalized ideal Western values toward thinness © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

25. Causes of Bulimia and Anorexia: Media and cultural considerations –Being thin = success, happiness....really? –Cultural imperative for thinness Translates into dieting –Standards of ideal body size Change as much as fashion –Media standards of the ideal Are difficult to achieve

27. Family Influences In what ways do you think families influence anorexia nervosa? © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

28. Individual Risk Factors GenderAgeInternalization of thin idealPerfectionismNegative body imageDietingNegative emotionalityChildhood sexual abuse (debatable) © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

29. Treatment of Eating Disorders Treatment Challenging Hospital commitment © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

30. Treatment of Anorexia Nervosa Common treatments Emergency procedures to restore weight Antidepressants or other medications Family therapy Cognitive-behavioral therapy © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

31. Treatment of Bulimia Nervosa Common treatments Antidepressants or other medications Cognitive-behavioral therapy © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

32. Treatment of Binge-Eating Disorder Treatment Antidepressants and other medication Cognitive-behavioral and interpersonal therapy © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.