eating disorders
Anorexia vs. Bulimia
- control. Anorexic is usually already below healthy weight, ,still perceives own weight is unacceptable, attempts to lower weight further by limiting food intake. Bulimic has no sense of control over eating habits. Eat excessively and then attempt to overcompensate for excessive food intake. -weight. a.n. are severly underweight and B.n. are normal or overweight -self thoughts. those with a.n dont see a seriousness in their diorder and those with b.n. have feelings of shame, guilt, and self-deprecation.
what are the two top causes of death in eating disorders
1- medical complications ( malnurtrution, yellowish skin, cold sensitivity, irregular heartbeats) 2-suicde(anorexia nervosa)
family influences on eating disorders
-family DYSFUNCTION, including: rigidity, parental overprotectiveness, excessive CONTROL, and marital discord -parents of patients PREOCCUPIED w/desirability of THINNESS, dieting, physical appearance -family members may make DISPARAGING COMMENTS
BMI (body mass index) that is considered normal is
18.5-24.9
BMI (body mass index) that is overweight is
25-29.9
ghrelin
A hunger-arousing hormone secreted by an empty stomach
what are the body weights of those in the 3 diff eating disorders
AN - markedly low/underweight BN- normal/slightly overweight BED-typically overweight or obese
what are the binge eating eating disorder? which one/s don't
AN - restrictive DOES NOT AN-binge/purge- does BN- yes for both BED-yes
what is the body image disturbances in the eating disorders?
AN- distorted perception BN-overconcerned with weight BED-may be unhappy with body and weight
what eating disorders have a feeling of lack of control over eating
AN-p/b during the binges Both BN has it BED has it also
what are the purging eating disorders which is not
AN-r NO AN-b/p yes BN-p yes BN-nonpurge no BED-no
is there or is there not a fear of weight gain, becoming fat in either eating disorder
AN-yes BN-yes BED-np
BMI (body mass index) that is obese is
BMI over 30
what are the characteristics of bulimia nervosa
Binge eating followed by self-induced vomiting (fasting or laxatives)
treatment of bulimia
First Barrier: Overcome shame and hiding Eat in response to hunger, not emotions Address hidden emotions Professional help Antidepressants
What is bulimia nervosa?
Frequent occurrence of binge-eating episodes accompanied by a sense of loss of control over eating and recurrent inappropriate of behavior such as purging or excessive exercise to prevent weight gain
what are the risk factors for obesity
Genetic predisposition Environmental factors Prepackaged food, fast food, soft drinks, increased portion sizes!! Sedentary lifestyle, lack of physical activity/exercise SES Psychosocial factors (stress, death, they use food to feel better)
what eating disorders are commorbid?
Crossover between an-r and an-bp Crossover between bulimia nervosa and an-bp Crossover between bulimia nervosa and binge eating disorder
what is the theory for why obesity should be consider an eating disorder
In contrast Volkow and O'Brien (2007) suggest that some forms of obesity are driven by an excessive motivational desire for food. They liken such symptoms as the compulsive consumption of food and the inability to restrain eating despite the wish to do so to symptoms of substance abuse and drug dependence. This parallels the view, offered by some, that obesity is a "food addiction" (see Cota et al., 2006). It has also been suggested that obesity and addiction may both concern problems in key brain regions involved in motivation, reward, and inhibitory control. Of course, the idea that obesity is a brain disorder is very controversial.
weight stigma
Negative weight-based stereotypes Juror bias against women with obesity Health care professionals may blame patients who are obese
Treatment of Anorexia
Nutrition therapy to gain cooperation and trust to increase oral food intake. 2-3lb per week weight gain. Psychological and related therapy: treatment of underlying emotional problems.
what are some comorbid diorders with eating disorders
depression, ocd, personality disorder, substance abuse,
what are the psychological features of anorexia nervosa
distorted thinking ( bones define who we really are let them show ) patients deny having a problem those also show efforts to conceal their thinness by wearing baggy clothes/drinking an excessively large amounts of water to increase their weight temporarily
what personality disorder are more typically associated with bulimia nervosa
dramatic, emotional, or erratic (cluster b) problems including boderline personality disorder
the restricting subtype of anorexia nervosa is characterized by
every effort is made to limit the quantity of food consumed, caloric intake is tightly controlled, patients often try to avoid eating in the presence of other people. when they are at the table, they may eat excessively slowly, cut their food into very small pieces, or dispose of food secretly
anorexia nervosa is defined by
an intense fear of gaining weight or becoming fat combined with a refusal to maintain adequate nutrition and with severe loss of body weight
if a person who binges or purges also meets criteria for anorexia nervosa, what diagnosis would be made ? (anorexia nervosa(binge eating/purgin type) or bulimia nervosa
anorexia nervosa because it trumps the bulimia nervosa diagnosis since there is a far more greater mortality rate
what are the first and second highest mortality rate eating disorders
anorexia nervosa has a high mortality rate; second is bulimia
age and gender differences for the three eating disorders
anorexia nervosa is most likely to develop in 16-20 year olds. bulimia the age group is highest risk in young women from 21-24. binge eating disorder it is around 30 to 50 years of age -eating disorders are more common in women;but homosexual men are at risk as well
what personality disorders are found in those with anorexia nervosa and bulimia nervosa
anxious-avoidant cluster ( c)
biological factors in eating disorder
genetics-may be hereditable brain abnormalities- hypothalamus plays an important role in eating set point-individual bodies prefered weight serotonin- neurotransmitter that haS been implicated in obessionality,mood disorders, and impulsivity reward sensitivity-
Leptin
hormone that signals the hypothalamus and brain stem to reduce appetite and increase the amount of energy used
what is the most common form of eating disorder
binge eating disorder
BMI (body mass index) of underweight is
bmi below 18.5
How is obesity defined?
The condition of having elevated fat masses in the body. Obesity is defined as having a body mass index of 30 or higher
family therapy treatment for eating disorder is
Treatment of choice, three phases In the refeeding phase, the therapist works with the parents and supports their efforts to help their child (typically a daughter) to eat healthily once more. Family meals are observed by the therapist, and efforts are made to guide the parents as a functioning support team for their daughter's recovery. After the patient starts to gain weight, the negotiations for a new pattern of relationships phase begins, and family issues and problems begin to be addressed. Later, in the termination phase of treatment, the focus is on the development of more healthy relationships between the patient and her parents
58% of women with eating disorders may have
a personality disorder
Morbid obesity is defined as a body mass index that is:
above 40; or 100 pounds overweight
the binge eating/purging subtype is characterized by
in addition to restrictive eating they also either binge eat OR purge or both
treatment for obesity
lifestyle modifications(diet, exercise, and behavioral therapy) medications bariatric surgery
sociocultural factors of eating disorders
media-related idealized extreme thinness, female internalized ideal, western values toward thinness
the point when excess weight begins to interfere with basic activities such as walking and creates many health problems is
morbid obesity; bmi above 40 or 100 pounds overweight
what is the cause for eating disorders
no cause, it more so reflects the complex interaction between genetic and environmental factors. biological, sociocultural, family, and individual variables likely all play a role
what eating disorders are not commorbid?
no crossover between an-r to bulimia nervosa no crossover between binge eating disorder and anorexia nervosa restricting subtype
Is obesity an eating disorder?
no it is not considered an eating disorder in the DSM 5
eating disorders in general are characterized by
people with eating disorders show disturbed patterns of eating that impair their health or ability to function well
individual risk factors for eating disorders
perfectionism negative body image body dissatisfaction in females dieting negative emotionality childhood sexual abuse
what are the two types of anorexia nervosa
restricting type and binge-eating/purging type
binge eating disorder
significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging, fasting, or excessive exercise that marks bulimia nervosa
eating disorders differ from other types of disorder because
there is a significant amount of diagnostic crossover/comorbidities
how are eating disorders best conceptualized
through a diathesis stress model. where genes render some people more susceptible to enviormental pressures and hence to the development of problematic eating attitudes and behaviors
treatment of binge eating disorder
Antidepressants and other medication, cognitive behavioral and interpersonal therapy.
what is the evolutionary explanation of obesity
Humans have evolved to be able to store surplus energy as fat. This has obvious advantages: It serves as a hedge against periods of food shortage and makes survival more likely during times of famine. But in our modern world, access to food is no longer a problem for millions of people. The food supply is stable, and large amounts of energy-dense foods are readily available. Not surprisingly, most of us are getting heavier. For some people, the problem becomes even more extreme and results in obesity. Considered in this way, obesity can be regarded as a state of excessive, chronic fat storage
CBT treatment for bulimia
The "behavioral" component of CBT for bulimia nervosa focuses on normalizing eating patterns. This includes meal planning, nutritional education, and ending binging and purging cycles by teaching the person to eat small amounts of food more regularly. The "cognitive" element of the treatment is aimed at changing the cognitions and behaviors that initiate or perpetuate a binge cycle. This is accomplished by challenging the dysfunctional thought patterns typically present in bulimia nervosa, such as the "all-or-nothing" or dichotomous thinking described earlier
what eating disorder use nonpurging methods to avoid weight gain? which dont?
all eating disorders use nonpurging methods besides BED
what eating disorder accounts for more morbidity and mortality than all other eating disorders combined
obesity
