Eating disorders Flashcards
Appearance related concerns
Reaching epidemic proportions in the Western society
Body dissatisfaction can occur from 8 years of age
Females report this phenomena more but…increasing in men
Aspects of appearance that concern
Appearance in general including many aspects of the face which are a source of concern to a range of people
Size of abdomen
Body weight
Poor muscle tone
Possible effects of appearance on young people
-ve
Teasing (peak age to cause upset is 7-8yr)
Bullying
+ve
If rated attractive likely to get more attention, be the subject of higher expectations of ability, may ‘get away with things more’
Differences and Body shape
Different cultures see things differently e.g. African American children picked bigger ideal body sizes than white children from random sample of children
Social class – In mid 19thC more weight= more wealth!
Perception of attractive body shape has changed over time eg reclining nude in Manet’s painting Olympia seen as “obscene” – not plump enough to be erotic.1863
Treacher Collins Syndrome
Recessive hereditary
Affects ears, eyes, jaws
‘Bird face’
How to measure body fat
BMI
Skinfold thickness
Waist: hip ratio
Dual energy X-ray absorptiometry (DXA)
BMI
weight/height^2 10-20 underweight 20-25 healthy 25-30 overweight 30-40 obese 40+ morbidly obese
Mental Health problems in children
Prevalence of 1 in 10 from 5-16 years
Press attention +++ to poor C & A mental health services
Funding for Child and Adolescent Mental Health Services, CAMHS, has been dropping in real terms
Diagnostic criteria
DSM –IV criteria (Diagnostic and Statistical Manual of Mental Disorders 4th Edn) are the standard signs which are used to assess /define an eating disorder.
Some people may have a partial syndrome and meet some of the criteria
May be associated with borderline personality disorder
The eating disorders
Anorexia nervosa (av duration 8yr but…)
Bulimia nervosa – in the 1970s (av duration 5 yr but..)
Binge eating disorder (BED)
(DSM says AN,BN and Binge Eating Disorder are the main eating disorders )
Not mutually exclusive and may overlap
7% increase in hospital admissions since 2005
Scoff Test
Sick - make yourself because feel full
Control - worry over loss of in relation to food
One - stone lost in 3m
Fat - see yourself as fat when others don’t
Food - dominates life
Designed in Leeds-Score of 2 or more is a +ve screen for an eating disorder
Eating disorder statistics
More common in females but increasingly in males (NICE - approx 11% affected are male)
Develops between 15-25 years, usually
Can occur in children as young as 8 years
Can be accompanied by other problems e.g. drug use, compulsive shoplifting
Why
Peer/ family pressure Media eg very thin models in fashion magazines Stress Genetic component Role of Serotonin Leptin & ghrelin function
Anorexia nervosa in UK
Prevalence: 1:150 15 year old girl 1:1000 15 year old boys ~1% 16-18 year olds affected Afro-Caribbean, Asian, Hispanic women less likely to have weight concerns than white women
Anorexia nervosa
Fear of gaining weight so eat little 15% below weight for height/age BMI <17.5 Body Image dysfunction Denial of low weight If reproductive years - amenorrhoeic for at least 3 months
Medical consequences AN
Starvation and dehydration - circulatory problems, kidney/ heart failure
Long term - stunting of growth, osteoporosis, possibly fertility problems
5% die
General treatment for AN/BN
Cognitive therapy in improving mental health (but W/L) Individual/ group/ psychotherapy Life skills; nutritional advice Drugs In-px care may be neessary
Specific treatment of AN
Aim to attain viable weight Alter feelings about body image/ food (medical view & px's may not coincide) Family therapy for those <16 years In-px care may be necessary 18year+ care - transitional care?
Prognosis AN
50% recover after treatment 30% retain partial symptoms Approximately: 20% become chronic 5% die – starvation, heart failure or suicide AN has one of highest rates of suicide of all psychiatric illnesses
