Eating Disorders�����Module 69

Eating Disorders

• Anorexia nervosa - drop significantly below weight, irrational fear of gaining weight and distorted body image
• Bulimia nervosa - characterized by binges of extreme overeating followed by self-induced purging such as vomiting, laxatives
• Weight fluctuations within normal ranges
• Binge-eating - disorder characterized by recurring episodes of binge eating without purging followed by remorse.

Men’s & Women’s Body Images

According to surveys on body image, people in our society are much more dissatisfied with their bodies now than they were a generation ago. Women are still more dissatisfied than men, but today’s men are more dissatisfied with their bodies than the men of a generation past.

Body Image Survey DIRECTIONS

1. First look at the drawings for your gender, choose the number below the figure that best illustrates (A) how you think you currently look (that is, the figure that best represents your actual size).
2. Then choose the figure that illustrates (B) how you would like to look (your ideal figure).
3. Choose what you think is attractive for the opposite sex.
4. Choose what you think the opposite sex would choose as attractive for your gender.
1. The numerical difference between your views of how you think you look and how you would like to look (A - B) represents your self-ideal discrepancy.
2. Finally, rate how ashamed you are of any body image discrepancy from 0 (not at all) to 5 (extremely). If you have a shame score of 3 or more, you should consider talking to a close friend or counselor about these feelings.

Body Image Survey

Women Body Images

Many U.S. women students tend to idealize—and misperceive men as idealizing—a body shape considerably thinner than their actual shape

Anorexia Nervosa�Key Features

1. Refusal to maintain a normal body weight
2. Intensely afraid of being overweight.
3. Suffer from delusions of being overweight.
4. Denies there is a problem.
5. Intensely concerned with how others perceive them
1. Usually in adolescent females
2. May put themselves on self-starvation regimens
3. May become dangerously underweight

Other Qualities - Anorexia

• Unhealthy way to cope with emotional problems, perfectionism, and a desire for control.
• Often equate self-worth with how thin you are. You are never thin enough.
• Most deadly of all psychological disorders. Malnutrition does permanent damage to body organs, leading to death.

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Anorexia - Symptoms

• Physical Symptoms
• Abnormal blood counts, fatigue, brittle nails, thin and breaking hair, no menstruation, constipation, dry skin, always cold, irregular heart rhythms, low blood pressure, dehydration, osteoporosis, dizziness or fainting
• Emotional or behavioral symptoms
• Refusal to eat, denial of hunger, excessive exercise, flat mood, difficulty concentrating, preoccupation with food, denying the seriousness of low body weight

Anorexia - Red Flags

• Skipping meals
• Making excuses for not eating
• Rigid eating rituals, like cutting food into small pieces, or counting food
• Weighing food
• Cooking for others but not eating themselves
• Repeatedly weighing self
• Wearing baggy or layered clothes
• Complaining about being fat

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Psychological Explanation

• It is a way to control a portion of one’s life, particularly when other parts of life seem out of control.
• There is self hate – prevents person from seeing
• May have OCD traits that make it easier to stick to diets and forgo food even when hungry.
• May have extreme drive for perfectionism, so they are never thin enough.

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Biological Explanation

• Possible genetic predisposition, especially with traits towards perfectionism, sensitivity, and perserverance – all associated with anorexia.
• Brain scans reveal high levels of serotonin in brains of anorexics.
• Serotonin hinders appetite.
• Serotonin may help deal with anxiety.

Socio-Cultural Explanation

• Western culture promotes thinness.
• Success and worth are equated to being thin.
• This is true for actors, dancers, models, athletes, and generalized to most jobs.
• Our society discriminates against overweight people.
• Peer pressure – kids can be cruel.

Family Environment

• Mothers who focus on their own weight and their daughter’s weight as well
• Highly competitive, high achieving, overly protective

Complications

• More than 5% diagnosed die.
• Death can occur suddenly from heart arrhythmias, failure or electrolyte imbalance.
• Bone loss
• Lung problems resembling emphysema
• Kidney problems
• Every organ sustains damage, including the brain, when severely malnourished. Damage is not fully reversible.

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Bulimia Nervosa

• An eating disorder characterized by episodes of overeating – binge eating (usually high calorie foods)
• Overeating is followed by purging - vomiting, using laxatives, fasting, or excessive exercise
• Usually stay within their normal weight.
• Usually recognize they have an eating disorder.

Bulimia – Other Qualities

• Common to live in a world of secret shame and self-disgust.
• Feel trapped by the addition and relationship with food.
• Eat until it’s painful then purge.
• Eventually teach body to purge easily with small amounts of food.
• No-purging bulimia uses fasting or over exercising.

Bulimia - Symptoms

• Physical symptoms
• Damaged teeth and gums, swollen salivary glands, sores in throat and mouth, bloating, dehydration, fatigue, dry skin, irregular heartbeat, knuckles with cores, scars or calluses, puffy cheeks
• Emotional and behavioral symptoms
• Constant dieting, binge eating alone, eating to discomfort, going to bathroom after eating, hoarding food, depression, anxiety, disappearing food

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Biological Explanation

• Genetic links
• Abnormal serotonin levels (probably not enough) - connected to food intake

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Psychological Explanation

• Low self-worth and perfectionism
• Trouble controlling impulsive behavior
• Trouble managing moods or expressing anger
• Families my have higher-than-usual incidence of childhood obesity & negative self-evaluation
• Families of people with bulimia may have more conflicts, criticism, and unpredictability
• Sometimes history of sexual abuse

Sociocultural Explanation

• Society promotes thinness
• Success and worth associated with being thin
• Peer pressure – especially among girls
• Similar risk factors to anorexia

Binge Eating �Disorder

• Compulsive overeating – consuming huge amounts of food while feeling out of control and powerless to stop
• Typically last 2 hours or on and off all day
• Gorge themselves as fast as they can barely realize what they are eating or tasting
• Feel extremely distressed after binging
• No attempt to make-up for the overeating

Binge - Other Qualities

• Struggle with feelings of guilt, disgust, depression
• Worry about their bodies knowing they have no control with eating
• Desperately want to stop but can’t.
• It’s a food addiction.

Binge - Complications

• Type 2 diabetes
• Gallbladder disease
• Heart disease
• Certain types of cancer
• Sleep apnea
• High cholesterol, blood pressure
• Gastrointestinal problems

Pica�Strange but True!

• Hippocrates the first to describe the disorder
• People display a compulsive craving for inedible substances such as clay, dirt, laundry starch, chalk, buttons, paper, dried paint, burnt matches, ashes, sand, oyster shells or broken crockery.
• Seen most often in pregnant women or nursing women but also with people with severe mental disorders.
• Could be a behavioral response to stress.
• Usually caused by malnourishment. Body craves what it needs.