chapter 11 Eating Disorders

amenorrhea

Absence of menstrual period

anorexia nervosa 350

a disorder marked by the pursuit of extreme thinness & weight loss, "purposely maintains low body weight" may stave themselves to death--restricting type cutting out sweets then eliminating other foods, binge-eating/purging type of anorexia is when they vomiting/use laxatives to prevent weight gain. 95% in females usually starts after a stressful event (divorce/failure) 2-6% die from medical problems/become seriously ill from starvation or suicide. driving motivations are fear of obese, desire to eat and loosing body shape & size associated w/-depression, ocd,anxiety,low self esteem,sleep issues and drugs.

causes of eating disorders (cognitive)

according to theorist these deficiencies of improper labeling of internal needs & sensations contribute to cognitive distortions of negative self judgment based on body shape and weight.

treatments (bulimia)

aims of treatment are to eliminate binge-purge patterns, establish good eating habits, eliminating underlying causes of bulimic patterns emphasizing as much on education as therapy.

medical issues from starvation (anorexia)

amenorrhea,low body temp, hypo tension, edema, reduced body density, slow heart rate, dry skin, brittle nails, poor circulation, lanugo, metabolic & electrolyte imbalences

treatments for bulimia

are helpful behavioral-diaries are useful, exposure & response prevention is used to break the binge-purge cycle, cognitive-help clients recognize and change their maladaptive attitudes toward food, eating, weight and shape, teach individuals to identify and challenge the negative thoughts that precede the urge to binge. if there is no response to this type of cognitive-behavior therapy other types maybe tried, like IPT-to improve interpersonal functioning or psychodynamic therapy or family/group therapy. antidepressant meds help about 40% but are best used with other forms of therapy. If left untreated it can last for years follow-up studies show 75% pt's fully/partially recover. relapse is possible usually due to stress are more likely with longer hx of symptoms, vomiting frequently, hx of substance use or lingering interpersonal problems.

causes of eating disorders (psychodynamic)

argue that the disorder is caused by disturbed mother-child interactions, which lead to ego problems in the child and severe perceptual disturbances, Bruch argues that parents effectively respond-attend to child biological & emotional needs or ineffectively-fail to attend to the needs, feeding when anxious and comfort when tired ect such children grow up confused and unaware of their own internal needs & turn to external guides. research has some support for this theory.

differences in bulimia & anorexia

bulimia-are concerned w/ pleasing others, being attractive and having intimate relationships & sexually active, have mood swings poor coping and frustration, more borderline personality disorders, only half experience amenorrhea but most suffer from purging damage

bulimia nervosa Dx

disorder characterized by inappropriate compensatory behaviors, which mark the subtype of the condition; purging type- forced vomiting,misusing laxatives, diuretics or enemas, non purging type-fast eating, exercising frantically, DX repeated binge eating episodes, repeated performances of forced vomiting, happens weekly for 3 mths, have inappropriate influence of weight & shape on appraisal of oneself, underlying dx is anxiety

eating disorders

disorders where eating & appearance become an issue. western society today equates thinness w/ health & beauty "thinness is a national obsession" there is a rise in dx eating disorders in the past 3 decades "care issue is morbid fear of weight gain" two main dx; anorexia & bulimia & now binge eating disorder

treatments (anorexia)

having two main goals; correct eating patterns, address broader psychological & situational factors that have led to, and are maintaining, the eating problem -often requires family & friends participation, usually aims to regain lost weight, recover from malnourishment and eat normally again, weight restoration technique has been combined w/ nursing care, nutritional counseling and high calorie diets can be achieved in 8-12 wks. People dx must overcome their underlying psychological problems to achieve lasting improvements

bulimia nervose

known as binge-purge syndrome is characterized by binges-uncontrollable eating/eating more than most would at a normal sitting . Typical case is slightly over weight FM but have weight fluctions-(90-95% are fm), usually occurs after a strict diet, peak age is 15 & 21 symptoms last several years w/ periodic letup, some may qualify for dx of anorexia

bulimia nervosa 350

marked disorder where the person goes on eating binges and then purges in order to keep from gaining weight. CAN HAVE 1-30 BINGES WK usually secret

reverse anorexia

new disorder- a negative body image-usually by men "muscle dysmorphobia"

anorexia nervosa dx

purposely intakes little food, resulting in very low/below average body weight, they are fearful of gaining weight despite low body weight, they have a distorted body perception and inappropriate judgments as to the seriousness of low weight, main symptoms;refusal to maintain 85% body weight, fears of weight gain, distorted view of shape & amenorrhea

binge eating disorder DX

recurrent binging, at least 3 of--fast eating, absence of hunger,uncomfortable fullness, shame/secret eating, feeling of self disgust, depression or sever guilt, cause distress, binging happens weekly for 3 mths, absence of excessive compensatory behaviors. usually two-thirds become over weight/obese

binge-eating disorder treatments

similar treatments to bulimia, cognitive-behavioral, psychotherapy and some anti-depressants medsto help reduce/eliminate the eating patterns and change disturbed thinking like concern with weight & shape

causes of eating disorders (social-cultural)

societal, family, and multicultural pressures, men are more likely to exercise and women to diet. develops in FM more than males but if male have it is linked to a job/sport, jockeys,wrestlers, distance runners, body builders, swimmers, for men body image is the key factor

overlapping patterns of anorexia bulimia and obesity 354

some people w/ anorexia binge & purge their way to weight loss, and some obese people binge eat however most people w/ bulimia are not obese and most overweight people do not binge eat

causes of eating disorders (biological)

theorist believe certain genes make people susceptible to eating disorders, low serotonin can be related, relatives are 6 x's more likely to develop disorder, dysfunction of hypothalamus can be related (lateral & ventromedial hypothalamus-areas control eating)-"the weight thermostat"

similarities in bulimia & anorexia

they begin after dieting, fear of obese, drive to be thin, preoccupation w/ food, weight appearance, feelings of depression, anxiety, obsessiveness, has high risk of suicide, substance abuse, distorted body perception, disturbed attitudes toward eating

binge compensatory behaviors

vomiting-fails to prevent absorption of half the calories & repeated vomiting usually causes greater hunger & binging, laxatives & diuretics also fails to reducethe calories consumed, these behaviors temporarily relieve the negative feelings and over time a cycle develops binging leads to purging

binge-eating disorder 350

where people binge eat but do NOT VOMIT/fear weight gain but are marked by other features found in anorexia & (bulimia-RELATED DX) binges are usually feelings of powerlessness & great tension although the binge maybe pleasurable it is usually followed by self blame, guilt, depression, fear of weight gain and being discovered