Abnormal Ch.11 Eating Disorders

Aftermath Bumilia

40% stop / reduce binge-purge 40% moderate response 20% little improvement follow up studies- 75% recover 1/3 relapse within 6 months- 2 years

Treatment Anorexia

- regain lost weight, recover from undernourishment, & eat normally again. - behavioral weight-restoration - clinicians use reward system - more popular: combo of behavioral and cognitive approaches, supportive nursing care, nutritional counseling & high calorie diet. * nurse gradually increases patient diet over weeks to more than 3,000 calories a day (gain weight back 8-12 weeks) -education, psychotherapy, &family approaches (psychological part)

Treatment Binge Eating

-cognitive-behavioral therapy -antidepressant medication - little known about aftermath - 1/3 still had disorder 12 years after hospitalization 36% still significantly overweight

Aftermath Anorexia

90% show improvement menstruate again 25% remain seriously troubled for years occurrence in 1/3 1/2 continue to have emotional problems teens recover better than adults

ventromedial hypothalamus (VMH)

A brain region that depresses hunger when activated.

lateral hypothalamus (LH)

A brain region that produces hunger when activated.

binge eating disorder

A disorder marked by frequent binges but NOT extreme compensatory behaviors. - 2/3 become overwight & obese -25-50% students periodically binge-eat or self induce vomiting

bulimia nervosa

A disorder marked by frequent eating binges that are followed by forced vomiting or other extreme compensatory behaviors to avoid gaining weight. Also known as binge-purge syndrome. - of disordered people 90-95% women - ages 15-21 onset - lasts several years with periodic let up -weight stays within normal range - some become seriously underweight and qualify for anorexia - concerned with pleasing others, being attractive to others, & having an intimate relationship

multidimensional risk perspective

A theory that identifies several kinds of risk factors that are thought to combine to help cause a disorder. The more factors present, the greater the risk of developing the disorder.

binge

An episode of uncontrollable eating during which a person ingests a very large quantity of food. - about a 2 hour period -1-30 binge episodes a week - consume 10,000 calories during an episode - feel overwhelmed by need to eat "forbidden foods" -25-50% students periodically binge-eat or self induce vomiting

enmeshed family pattern

Family members are overinvolved with each other's affairs and overconcerned about each other's welfare. - Salvador Minuchin : enmeshed family patterns lead to an eating disorder. - force child to take on "sick role" & develop an eating disorder - enables family to maintain its closeness

amenorrhea

The cessation of menstrual cycles

weight set point

The weight level that a person is predisposed to maintain, controlled in part by the hypothalamus - weight falls below- LH activated to restore lost weight - weight rises up - GLP-1 activated to remove excess weight.

Compensatory Behaviors : Binge

Vomiting - fails to prevent absorption of 1/2 of the calories consumed during a binge. - leads to greater hunger & more frequent &intense binges.

Perfectionistic

a characteristic that precedes onset.

Anorexia Nervosa

a disorder marked by the pursuit of extreme thinness and by extreme loss of weight. - intensely fear of becoming overweight - distorted view of weight and shape. - of the disorder 90-95% are females - ages 14-18 onset -2-6% become so ill that they die - becoming thin is the goal, but fear provides their motivation -preoccupied with food, think in distorted ways, added psychological problems (depression, OCD, anxiety, low self-esteem)

Misogeny

devaluation of women or that which is feminine.

Lanugo

fine silky hair that covers some newborns - grown by anorexics on their trunks, extremities and faces.

Compensatory behaviors: Bulimia

forced vomiting, laxatives, diuretics, or enemas, fasting or exercising excessively.

binge-eating / purging type of anorexia nervosa

forcing themselves to vomit after meals or by abusing laxatives or diuretics, or eating binges.

Treatments Bulimia

goals: eliminate binge-purge, establish good eating, emphasize education. - cognitive-behavioral therapy / antidepressant drug therapy - keep diaries of eating habits, exposure &response prevention.

Medical problems with anorexia nervosa

low body temp, low BP, body swelling, low bone mineral density, slow HR, - rough, dry & cracked skin - brittle nails - hands & feet are cold & blue

Reverse Anorexia / Muscle Dysmorphia

men who are very muscular but still see themselves as scrawny and small and therefore continue to strive for a perfect body through extreme measures of excessive weight lifting and abuse of steroids. - hisotry of depression, anxiety, self-destructive compulsive disorder -1/3 binge eat

hypothalamus

regulate bodily functions, including eating and hunger.

Restricting- type anorexia nervosa

restricting the intake of food

Metabolic rate

the rate at which the body expends energy

Alexithymic

they have great difficulty putting descriptive labels on their feelings. (psychodynamic factors)

Psychodynamic Factors : Hilde Bruch

view: disturbed mother-child interactions lead to serious ego deficiencies in the child (poor sense of independence or control) and to severe perceptual disturbances that jointly help produce eating disorders. Ineffective parents- feed child at time of anxiety, feed when tired - grow up confused about when to eat.