Exam 4: Eating Disorders Flashcards
What is characteristic of western society in regards to beauty?
western society equates thinness w/ health & beauty
-thinness has become a national obsession
what are the two main diagnoses of eating disorders?
- anorexia nervosa
- bulimia nervosa
what percentage of anorexia/bulimia cases occur in females?
90-95%
- peak of onset between 15 & 21 years
- symptoms may last for several years w/ periodic letup
symptoms of anorexia nervosa
-despite their dietary restrictions, people w/ this are preoccupied w/ food
- distorted thinking
- low opinion of body shape
- tend to overestimate actual size/proportions
- hold maladaptive attitudes and misperceptions
psychological comorbid disorders of anorexia
-depression, anxiety, low self-esteem, insomnia, substance abuse, OCD patterns, perfectionism, body dysmorphic disorder
medical comorbid disorders of anorexia
amenorrhea, low BP, reduced bone density, metabolic and electrolyte imbalances, poor circulation, body swelling
another name for bulimia nervosa is…
binge-purge syndrome
bulimia nervosa characteristics
- repeated bouts of uncontrolled overeating during a limited period of time (binges)
- inappropriate compensatory behaviors: forced vomiting, misusing laxatives, diuretics or enemas; fasting, exercising excessively
characteristics of binges
- people may have 1-30 binge episodes per week
- binges involve eating massive amounts of food very rapidly w/ little chewing (usually sweet, high-calorie foods w/ soft texture)
- binge usually followed by extreme self-blame, guilt, depression, and fears of being discovered
bulimia: compensatory behaviors
-attempt to undo caloric effects of binge
- vomiting
- fails to prevent the absorption of half the calories consumed during binge
- repeated vomiting affects ability to feel satiated -> greater hunger & bingeing
-over time, cycle develops: purging -> bingeing -> purging
similarities between bulimia & anorexia
- begin after a period of dieting
- fear of becoming obese; drive to become thin
- preoccupation w/ food, weight, appearance
- feelings of anxiety, depression, perfectionism
- distorted body perception (body dysmorphia)
- heightened risk of suicide attempts
differences between bulimia & anorexia
- people w/ bulimia tend to be more sexually experienced and active
- people w/ bulimia are more likely to have histories of mood swings, low frustration tolerance, and poor coping
binge eating disorder
- people engage in repeated eating binges during which they feel no control
- these people do NOT perform inappropriate compensatory behaviors such as vomiting
- 2/3 of people w/ this disorder become overweight/obese
what causes eating disorders? psychodynamic/family theories
- as many as 1/2 of families w/ eating disorders have a long history of emphasizing thinness, appearance, and dieting
- contributes to negative self-judgment based on body shape and weight
- anorexia stems from effort to delay/interrupt sexual maturation
- anorexia reflects passive-aggressive response to conflicts around control/autonomy
- bulimia reflects self-nurturing w/ food in the absence of adequate parental nurturing
do mood disorders set the stage for eating disorders?
- yes, persons w/ an eating disorder have higher rates of major depressive disorder
- close relatives of those w/ eating disorders have higher rates of depressive disorders
- people w/ eating disorders, especially those w/ bulimia nervosa, have serotonin abnormalities
- symptoms of eating disorders are helped by antidepressant meds
what causes eating disorders: biological factors
- the hypothalamus and related brain areas may be responsible for weight set point or weight thermostat
- set by genetic inheritance and early eating practices, this mechanism is responsible for keeping an individual at a particular weight level
- if weight falls below set point: increase in hunger, decrease in metabolic rate -> binges
- if weight rises above set point: decreased hunger, increased met. rate
-dieters end up in a battle against themselves to lose weight
what causes eating disorders: societal pressures
- western standards of female attractiveness may contributes to the emergence of eating disorders
- 9% of college athletes meet full criteria for an eating disorder while another 50% have one or more symptoms
- 20% of gymnasts appear to have an eating disorder
- the socially accepted prejudice against overweight people may also add to the fear and preoccupation about weight
- about 50% of elementary and 61% of middle school girls are currently dieting
gender differences in eating disorders
- some men develop eating disorders as linked to the requirements and pressures of a job or sport; ex: wrestlers, swimmers, body builders
- some men exhibit a new kind of eating disorder: reverse anorexia nervosa or muscle dysmorphia
what are the 2 main goals of eating disorder treatments
- correct dangerous eating patterns
- address broader psychological and situational factors that led to, and maintain, the eating problem
what are the treatment goals of anorexia
promote normal eating behavior, regain lost weight, and recover from malnourishment
what are the treatment goals of bulimia
eliminate binge-purge patterns, and promote normal eating behavior
treatment for anorexia
- most popular weight-restoration technique has been the combination of supportive nursing care, nutritional counseling, and high-calorie diets
- in life-threatening cases, clinicians may need to force tube and intravenous feedings on the patient
- people w/ anorexia nervosa must overcome their underlying psychological problems to achieve lasting improvement
treatments for anorexia (part 2)
in most treatment programs, a combo of behavioral and cognitive interventions are included
- clients monitor feelings, hunger levels, and food intake and the ties among those variables
- patients are encouraged to recognize their underlying feelings
- clients are helped to change their attitudes about eating and weight
positive outcomes of anorexia treatments
- weight gain is often quickly restored, w/ many patients maintaining improvements after several years
- menstruation resumes after return to normal weight
negative outcomes of anorexia treatments
- as many as 25% of patients fail to improve
- initial recover is often not permanent
- anorexic behavior recurs in at least 1/3 of recovered patients, usually triggered by new stresses
- many patients still express concerns about their weight and appearance
- lingering emotional problems are common
treatment for bulimia: cognitive behavioral therapy
behavioral techniques
- eating and purging diaries
- exposure and response prevention (ERP) is used to break the binge-purge cycle
cognitive techniques
- 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
treatment for bulimia: other interventions
- group formats provide an opportunity for patients to express their thoughts, concerns, and experiences w/ one another
- antidepressant meds - may help as many as 40% of patients
treatment outcomes for bulimia
- treatment provides immediate, significant improvement in about 40% of cases; an additional 40% show moderate response
- relapse can be a significant problem, even among those who respond successfully to treatment; relapses usually triggered by stress and more likely among people who had a longer history of symptoms, vomited frequently, had histories of substance use, have lingering interpersonal problems
peak age of onset for anorexia
between 14 and 20 years old
suicide rate of anorexic people
5x the rate of the general population
what did the starvation study in the 1950s find?
people put on a starvation diet were more preoccupied w/ food, talked more about food, dreamt more about food
How many calories do binge eaters consume during an episode?
average of 2,000-3,400, but as many as 10,000
how many people w/ bulimia display characteristics of a personality disorder and which ones?
more than one third
-borderline or avoidant personality disorder
