Issues of

1. Appetite, Eating, And Weight Issues of

2. Appetite: 1. a desire for food or drink. 2. a desire to satisfy any bodily need or craving. You may have too big of an appetite or too small; both of which may become serious problems. Too big of an appetite or too small of an appetite may be connected to independent psychological and/or medical issues. Appetite Issues

3. No: Through interaction between internal organs, hormones, and the brain, the body as a whole controls when we get hungry, the intensity of hunger and the urgency we feel to consume nutritious foods. Are we in control of appetite?

4. Yes: If we do not replace what is consumed, our body thinks it is STARVING; that is the body believes that there is not enough food in the environment to sustain itself. Because we are biologically programmed to do whatever it takes to survive, our system shift gears to consuming less and saving more. Are we in control of appetite?

5. The causes of eating disorders tend to be heterogeneous and multifactorial. Genetic Many researchers believe that there is an inherited predisposition to having an eating disorder. Studies have shown that the co-occurrence of eating disorders among identical twins is greater than fraternal twins. Other research on the genetic component of eating disorders has focused on neurochemistry. Researchers have found that the neurotransmitters serotonin and norepinephrine are significantly decreased in acutely ill patients suffering from Anorexia and Bulimia Nervosa (Depression and PTSD). Besides creating a sense of physical and emotional satisfaction, the neurotransmitter serotonin also produces the effect of feeling full and having had enough food. Individuals with eating disorders have been shown to have a higher levels of the hormones vasopressin and cortisol than the general population. Both these hormones are normally released in response to physical and possible emotional stress, and may contribute to some of the dysfunction seen in eating disordered individuals. Eating issues: Possible Reasons

6. Sociological Environmental conditions reinforce the practice of an eating disorder. We live in a society that reinforces the idea to be happy and successful we must be thin. Today, you cannot read a magazine or newspaper, turn on the television, listen to the radio, or shop at the mall without being assaulted with the message that fat is bad. During adolescence, a particularly vulnerable time to the development of an eating disorder, the influence of peers becomes important. Self monitoring and comparing ourselves to others becomes central to our psyche. Peer teasing and pressures to conform to the norm are common in the background of eating disorder individuals. As our bodies developed and changed, how others and we reacted to these changes influenced our eventual body acceptance. Other societal issues include dysfunctional families, sexual abuse, physical abuse, domineering coaches and controlling relationships. Eating issues: Possible Reasons

7. Psychological The practice of an eating disorder can be viewed as a survival mechanism. Just as an alcoholic uses alcohol to cope, a person with an eating disorder can use eating, purging or restricting to deal with feelings and emotions that may otherwise seem overwhelming. Through the practice of the eating disorder, the individual may feel a sense of partial control over their seemingly uncontrollable life. Some of the underlying issues that are associated with an eating disorder include low self-esteem, depression, feelings of loss of control, feelings of worthless, identity concerns, family communication problems and an inability to cope with intense emotions. The practice of an eating disorder may be an expression of something that the eating disordered individual has found no other way of expressing. Eating issues: Possible Reasons

8. Bulimia Nervosa Anorexia Nervosa Eating Disorder Not Otherwise Specified Eating issues: types

9. Affects 3% to 10% of adolescent and college-aged women in the US Twenty-five per cent are initially anorexic Commonly occurs with affective disorders, impulse control disorders, BPD, posttraumatic symptoms, substance abuse, and drug abuse Successful outcome is negatively impacted by familial obesity Some facts about Bulimia

10. Recurrent episodes of binge eating • Feeling of lack of control over bingeing • Purging through vomiting, fasting, diuretics, strict dieting, or exercise Diagnostic criteria for bulimia • Two binge episodes a week over three months • Self-evaluation unduly influenced by shape or weight

11. No organic cause has been isolated Societal pressure to be thin Family dysfunction such as chaos, open conflict, hunger for attachment, caretaker underinvolvement, disconnection Causes of Bulimia Nervosa

12. 1 in 200 persons in the US will develop AN • 90% are women • Diagnosis most common at puberty or age 18 • 50-75% have major depression • 25% have OCD Some facts about anorexia • 5% die • less than 40% recover spontaneously • 70% can be helped with competent tx • twin studies show inheritability at 55% • may be a gene involved

13. She refuses to maintain weight above 15% of normal • She has intense fear of gaining weight • She has a disturbed body image • She has not menstruated for at least 3 cycles Diagnostic criteria for anorexia nervosa • She is the restricting type because of dieting, fasting, or excessive exercise • She is the binge/purge type because of vomiting, laxatives, enemas, or diuretics in addition to restricting

14. be depressed, irritable, and insomniac • have swollen joints • have dry hair and skin • have brittle nails • be lethargic and constipated • lose bone mass • have arrested sexual development A person with anorexia can • Have low body temp, heart rate, and blood pressure • have heart arrhythmias from low potassium • die from cardiac arrest, pneumonia, or suicide

15. Rough formula for minimum normal weight: 5’ = 100 every + 1”= + 5 lbs 5’7”= 135 lbs • It is always highly recommended to have a full blood work and a complete check-up to make sure the cause of excessive weight is not medical. • Best way to control your weight in a healthy way is to have 6 well-balanced meals per day. • Exercising up to 90 minutes / day is considered healthy. WEIGHT ISSUES

16. The ideal treatment team: Psychiatrist, individual therapist, family therapist, group therapist (can be the same as individual therapist), and dietitian. In some cases inpatient treatment is necessary, some cases it is recommended, and in other cases it is not necessary. Antidepressants, when combined with psychotherapy can be beneficial. Motivation for change is critical for success. Treatment