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Eating Disorders. Anorexia Nervosa. Restricting or Binge-Eating/Purging Type Body weight less than 85% of expected Intense fear of gaining weight Disturbance of body image Three months without period (for females) Look for hair falling out, wearing large size clothing
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Anorexia Nervosa • Restricting or Binge-Eating/Purging Type • Body weight less than 85% of expected • Intense fear of gaining weight • Disturbance of body image • Three months without period (for females) • Look for hair falling out, wearing large size clothing • Control and body distortion
Tx of Anorexia • Specialized Field due to medical complications • Often you will find separation/individuation issues and controlling/ emotionally punishing family system • Help move away from all or nothing thinking • Help increase awareness of feelings and drives • Antidepressants • Louise Ousley (Psychologist) and Marjory Guise (psychiatrist) • Work with physician and nutritionist. Cl must be under physicians care
Bulimia Nervosa • Purging and Nonpurging Type • Typically in the normal weight, but may be over or under weight • Binge and Compensation at least twice a week for 3 months • Look at fingers and teeth • Have cl obtain physical for internal organ damage and check potassium levels (cardiac problems can occur)
Cycles of Binge/Purge • Usually you will be able to identify triggers as the cycles occur. Often related to family or other relationships. • Anxiety increases and client seeks to reduce pain with binge • Binge reduces anxiety (like a drug), but is quickly followed by guilt and shame and anxiety. However, these emotions are more tolerable than the initial anxiety.
Tx of Bulimia • Helping Cl to recognize triggers and gain awareness of anxiety • Help to “delay” binges • Identify other ways to reduce this anxiety • Reduce self-criticism • Work on Separation/Individuation issues with family • Work on self-image aside from body size • Help find supports and “breaking of secret”
Tx Bulimia • Work with Nutritionist, physician, and at times psychiatrist • Antidepressants
Eating Disorder NOS • Anorexia • Normal weight • Females still have period Bulimia -- Purge or compensatory less than frequency required -- Regular chewing and spitting out of food -- Regular binges w/out compensatory Behavior