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Eating Disorders

Anorexia Nervosa. Refusal to maintain body weight at or above a minimally normal weight for age and heightIntense fear of gaining weight or becoming fat, even though underweightDisturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weightIn postmenarcheal females, amenorrhea is present (A woman is considered to have amenorrhea if her period occur only following 30127

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Eating Disorders

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    1. Eating Disorders 3.27.2007

    2. Anorexia Nervosa Refusal to maintain body weight at or above a minimally normal weight for age and height Intense fear of gaining weight or becoming fat, even though underweight Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight In postmenarcheal females, amenorrhea is present (A woman is considered to have amenorrhea if her period occur only following hormone)

    3. Subtypes of Anorexia Nervosa Restricting Type – Binge-Eating/Purging Type –

    4. Facts about Anorexia Nervosa Prevalence: Gender: Age of Onset: Course: With treatment –

    5. Associated Features Death Comorbidity

    6. Associated Features Behavioral Features Psychological Features

    7. Medical Complications Visually Apparent Amenorrhea Lanugo Thin, brittle hair and/or hair loss Dry skin Pale, yellowish complexion Sensitivity to cold

    8. Medical Complications Not Visually Apparent Anemia Low blood pressure Electrolyte and mineral imbalances Low levels of Potassium (hypokalemia) Results in heart arrhythmias Reduced immune system functioning Kidney damage High cholesterol Slowed heart rate Heart failure Serious bone loss, seems to be irreversible

    9. Bulimia Nervosa A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: 1. Eating, in a discrete period of time, an amount of feed that is definitely larger than most people would eat during a similar period of time and under similar circumstances 2. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)

    10. Bulimia Nervosa B. Recurrent, inappropriate compensatory behavior in order to prevent weight gain (e.g. self-induced vomiting, laxatives, diuretics, fasting, excessive exercise) C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months D. Self-evaluation is unduly influenced by body shape and weight E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa

    11. Subtypes of Bulimia Nervosa Purging Type – Nonpurging Type –

    12. Facts about Bulimia Nervosa Prevalence: Gender: Age of Onset: Course:

    13. Associated Features Comorbidity Impulsivity and risk taking Hoarding food, may lead to stealing food Shame, guilt, self-deprecation Intense efforts to hide bingeing and purging

    14. Medical Complications Related to Purging Electrolyte Imbalances Low levels of Potassium Low blood pressure Seizures Loss of tooth enamel Mouth ulcers, tears to the throat, and cavities Calluses to hands Small red dots around the eyes Swollen salivary glands Gastro-intestinal problems

    15. Sociocultural Factors and Eating Disorders Over the past 40 years, the number of full-body shots of women on the covers of popular fashion magazines has significantly increased Over the past 20 years, there has been a significant decrease in the overall body size of models pictured Between the years 1959 and 1988, the overall body size of Playboy models and Miss America contestants has significantly decreased, eventually leveling off at approximately 13-19% below their expected/ideal body weights.

    16. Sociocultural Factors and Eating Disorders

    17. Sociocultural Factors and Eating Disorders Social Comparison Internalization of the thin ideal Self-objectification Self-discrepancy

    18. Cultural Factors Thought to be a White, Upper-middle class disorder Increasing rates in other ethnic groups in the U.S. Also prevalent in more countries that are more Industrialized or “Western”: South Africa, Japan, Hong Kong, Taiwan, Singapore, India, Iran, China, Korea, Argentina Becker’s study of EDs in Fiji

    19. Cultural Factors Clinical Features seem to differ across countries 58% of Anorectics in Hong Kong are not excessively concerned about fat, but “stomach bloating” Young women in Ghana emphasized religious ideas of self-control and denial of hunger Japanese women report lower levels of perfectionism and less of a drive for thinness Cultural and historical evidence supports the theory that Anorexia is less culture-bound than Bulimia Nervosa

    20. Risk Factors Personal Genetics

    21. Risk Factors Family Influences Family dysfunction Preoccupation with desirability of thinness, dieting, and physical appearance Anorexia Nervosa Bulimia Nervosa

    22. Eating Disorder Not Otherwise Specified (EDNOS) Possibilities: For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range All of the criteria for Bulimia Nervosa are met except that the binge eating and compensatory behavior occur at a frequency of less than twice a week or for a duration of less than 6 months

    23. Eating Disorder Not Otherwise Specified (EDNOS) Possibilities: 4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food 5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food 6. Binge-eating disorder

    24. Binge Eating Disorder Recurrent episodes of binge eating (large amounts of food and loss of control) characterized by: Eating large amounts of food when not physically hungry Eating more rapidly than normal Eating until uncomfortably full Eating alone because embarrassed about the quantity of food being consumed Feeling guilty, depressed, or disgusted with ones self afterwards Absence of regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa

    25. Facts about Binge Eating Disorder Prevalence: Gender: Age of Onset: Course:

    26. Eating Disorders Treatment Levels of Care Outpatient Intensive Outpatient/Partial Day Treatment Inpatient Residential Treatment Professionals Psychologists Dieticians Psychiatrists Physicians

    27. AN - Treatment Medications Family-Based Treatment Cognitive Behavioral Treatment

    28. BN - Treatment Medications Family-Based Treatment Cognitive Behavioral Treatment Behavioral component – Cognitive component – Interpersonal Treatment

    29. BED - Treatment Medications Cognitive Behavioral Treatment Gastric Bypass

    30. Problems with Treatment Generally speaking, we don’t have good treatments for eating disorders Treatments Focus on eliminating behavioral symptoms (restricting, bingeing, purging, etc.) Don’t do a good job of treating body dissatisfaction, overevaluation of shape and weight Don’t do a good job of addressing why people transition from one eating disorder to another

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