The Rising Prevalence of Eating Disorders: What Is Our Role?

1. The Rising Prevalence of Eating Disorders: What Is Our Role? Dr. Lisa Alastuey University of Houston Dr. Tara Tietjen-Smith Texas A&M University – Commerce Presented at a TAHPERD Convention

2. Objectives: • TLW: • Describe the various types of eating disorders including the female athlete triad. • Discuss media and other influences on disordered eating. • Identify individuals with an eating disorder. • Identify treatment and prevention options for individuals with diagnosed eating disorders.

3. Something To Think About… • “As many as 8 out of 10 adolescent females are fighting an unhealthy battle with food that could destroy their emotional and physical well-being, and ultimately lead to a full-blown eating disorder.” • -Ira Sacker, M.D., author of the book Dying To Be Thin.

4. Something To Think About… • “Girls who restrict calories, constantly watch their weight and live in fear of getting fat are in the majority.” • -Sharlene Hesse-Biber, Ph.D., author of the book Am I Thin Enough Yet?

5. Prevalence of Eating Disorders • In the United States, 5 to 10 million females suffer from an eating disorder. • The first case was identified medically in 1668.

6. General Definition • A disturbance in eating behavior that places a person’s physical and/or psychological health at risk. • Seen more in women. (But the statistics are growing for men.) • Denial of illness

7. Types of Eating Disorders • Anorexia • Bulimia • Compulsive Overeating • **One can have a combination of eating disorders. • **Most often seen in today’s Westernized Culture.

8. Types of Eating Disorders • There are other eating disorders that are not clinically defined. • Eating the same thing every day • Completely avoiding fat • Extreme dieting • Etc.

9. Anorexia Nervosa (Anorexia) • An inaccurate perception of one’s own nutritional state. • Literally means “loss of appetite”. • A person with anorexia nervosa is hungry, but he or she denies the hunger because of an irrational fear of becoming fat.

10. Anorexia: Warning Signs • Deliberate self-starvation with weight-loss • Intense, persistent fear of gaining weight • Refusal to eat, except tiny portions • Continuous dieting • Denial of hunger • Periodic bingeing and vomiting • Compulsive exercise and hyperactivity • Abnormal weight loss • Sensitivity to cold • Absent or irregular menstruation • Increased hairiness

11. Anorexia: Physical and Psychological Problems • Malnutrition sets in, & physical changes become more visible • Amenorrhea (stop menstruation) • Extreme sensitive to cold (low body fat) • Hair and skin problems (peach fuzz, dry) • Fluid and electrolyte abnormalities (irregular heart beat) • Injuries to nerves and tendons • Abnormalities of immune function • Damage to vital organs (heart & brain) • Dehydration Depression • Mood Swings Shame and guilt • Low self-esteem Withdrawal • Perfectionism and more…

12. Anorexia: “Nervous Loss of Appetite” • Food is the most important thing in life. • 97% of anorexics are white • Ages 11 to 60 most common between 13 to 22 • 1 out of every 250 girls • In 80% of the cases the anorexic is the 2nd born child • Low intake of calories 300-600 per day • Exercise beyond reason

13. 2 Stages of Anorexia • Acute Stage • Continuing weight loss • Multiplying symptoms of nutritional deprivation • Consolidating recently formed eating and drinking patterns that allow only minimal consumption • Timing and privacy

14. 2 Stages of Anorexia • Entrenched Stage (long-term anorexia) • Patterns affect personalities • Hopelessness accepted • Cynicism about psychotherapist and other professional who failed them (tailored her environment to her illness)

15. Bulimia • Recurring periods of binge eating, during which large amounts of food are consumed in a short period of time – sometimes as many as 20,000 calories during the course of a single binge. • Occurs at least twice a week • Bulimia is more prevalent than anorexia

16. Bulimia: Warning Signs • Preoccupation with food • Frequent binge eating, usually in secret, followed by vomiting and fasting • Abuse of laxatives, diuretics, diet pills, or drugs to induce vomiting • Compulsive exercising • Swollen salivary glands and pancreas • Broken blood vessels in the eyes

17. Bulimia: Physical and Psychological Problems • Malnutrition • Serious heart, kidney, and liver damage • Intestinal ulcers • Ruptured stomach • Tears of the esophagus • Dehydration • Tooth/gum corrosion • Depression Low self-esteem • Shame/guilt Withdrawal • Mood swings Perfectionism • Impaired family and social relationships

18. Compulsive Overeating (Binge Eating Disorder) • Uncontrolled binging beyond one’s energy needs, accompanied by shameful and guilty eating. Repeated failures to gain control of food and weight further sabotage self-esteem.

19. Fast Facts… • The average model is 5’11” tall and weighs only 117 pounds. • The average woman is 5’4” tall and weighs 140 pounds. • The average plus size model wears a size 10-12. • The number one wish for girls ages 11 to 17 is to be thinner. • 40% of nine and ten-year-olds are on diets; girls as young as five have expressed fears of getting fat. • Researchers have attributed the eating disorders prevalence to society’s constant pressure to be thin. Thinness is often equaled with physical attractiveness, success, and happiness.

20. Influences • T.V. (1960’s Twiggy, etc.) • Magazines (supermodels, Kate Moss) • Barbie • Parents • Peers • Job • “Yourself”

21. More Influences • Adolescent girls’ discontent about body image is directly correlated to how often they read fashion magazines, which are filled with ads featuring underweight models. • Viewing television commercials leads to increased body dissatisfaction for both male and female adolescents. • After television was introduced in Fiji, there was a significant increase in eating disorders among adolescent girls. • A study of 500 female models found that almost half were malnourished according to the World Health Organization standards.

22. Eating Disorders Among Athletes • Very prevalent among athletes, even males. • Sports in which a certain body type or build has been described or required for a competitive edge, especially cycling, running, dancing, gymnastics, figure skating, and wrestling.

23. Female Athlete TriadDisordered Eating/ Amenorrhea/ Osteoporosis • Young women who train strenuously can: • Exhibit amenorrhea • Practice abnormal eating behaviors • Be susceptible to stress fractures & osteoporosis • The identification of any one ailment in the triad requires prompt screening for the other two disorders.

24. Men and Eating Disorders • The increasing muscularity in toy action figures helps set unrealistic body ideals for boys. • More than half of boys ages 11 to 17 chose a physical ideal only possible through the use of steroids.

25. Treatment Approaches • Eating disorders are very complex and usually have underlying psychological factors that are not associated with eating. • They should be diagnosed and treated by qualified professionals.

26. Treatment Approaches • Individualized Interventions • Family Counseling • Psychological Treatment • Antidepressant drug therapy • Working with a team of health professionals: • Physician, registered dietician, nurses, health/physical educators, etc.

27. References • Adolescent Medicine Committee of CPS (2004). Eating disorders in adolescents: Principles of diagnosis and treatment. www.cps.ca • www.anred.com • Anspaugh, D. J. & Ezell, G. (2004). Teaching today’s health. Pearson Benjamin Cummings: San Fransisco. • www.eating-disorders.com • www.empoweredparents.com • Focus Adolescent Services (2005). Help you daughter create a healthy body image. www.focusas.com/BodyImage.html • Hoffman, R.P. (2001). Eating disorders in adolescents with Type I diabetes. Postgraduate Medicine, 109(4), 1-8. www.postgradmed.com • McCardle, W.D., Katch, F.L., & Katch, V.L. (2005). Sports & exercise nutrition. Lippincott Williams & Wilkins; Baltimore. • Society of Adolescent Medicine (2003). Eating disorders in adolescents: Position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 33, 496-503.