Understanding Eating Disorders: Anorexia and Bulimia

1. Eating DisordersModule 69

2. Eating Disorders • Anorexia nervosa - drop significantly below weight, irrational fear of gaining weight and distorted body image • Bulimia nervosa - characterized by binges of extreme overeating followed by self-induced purging such as vomiting, laxatives • Weight fluctuations within normal ranges • Binge-eating - disorder characterized by recurring episodes of binge eating without purging followed by remorse.

3. Men’s & Women’s Body Images According to surveys on body image, people in our society are much more dissatisfied with their bodies now than they were a generation ago. Women are still more dissatisfied than men, but today’s men are more dissatisfied with their bodies than the men of a generation past.

4. Anorexia NervosaKey Features • Refusal to maintain a normal body weight • Intensely afraid of being overweight. • Suffer from delusions of being overweight. • Denies there is a problem. • Intensely concerned with how others perceive them • Usually in adolescent females • May put themselves on self-starvation regimens • May become dangerously underweight

5. Other Qualities - Anorexia • Unhealthy way to cope with emotional problems, perfectionism, and a desire for control. • Often equate self-worth with how thin you are. You are never thin enough. • Most deadly of all psychological disorders. Malnutrition does permanent damage to body organs, leading to death.

6. Anorexia - Symptoms • Physical Symptoms • Abnormal blood counts, fatigue, brittle nails, thin and breaking hair, no menstruation, constipation, dry skin, always cold, irregular heart rhythms, low blood pressure, dehydration, osteoporosis, dizziness or fainting • Emotional or behavioral symptoms • Refusal to eat, denial of hunger, excessive exercise, flat mood, difficulty concentrating, preoccupation with food, denying the seriousness of low body weight

7. Anorexia - Red Flags • Skipping meals • Making excuses for not eating • Rigid eating rituals, like cutting food into small pieces, or counting food • Weighing food • Cooking for others but not eating themselves • Repeatedly weighing self • Wearing baggy or layered clothes • Complaining about being fat

8. Psychological Explanation • It is a way to control a portion of one’s life, particularly when other parts of life seem out of control. • There is self hate – prevents person from seeing • May have OCD traits that make it easier to stick to diets and forgo food even when hungry. • May have extreme drive for perfectionism, so they are never thin enough.

9. Biological Explanation • Possible genetic predisposition, especially with traits towards perfectionism, sensitivity, and perserverance – all associated with anorexia. • Brain scans reveal high levels of serotonin in brains of anorexics. • Serotonin hinders appetite. • Serotonin may help deal with anxiety.

10. Socio-Cultural Explanation • Western culture promotes thinness. • Success and worth are equated to being thin. • This is true for actors, dancers, models, athletes, and generalized to most jobs. • Our society discriminates against overweight people. • Peer pressure – kids can be cruel.

11. Family Environment • Mothers who focus on their own weight and their daughter’s weight as well • Highly competitive, high achieving, overly protective

12. Complications • More than 5% diagnosed die. • Death can occur suddenly from heart arrhythmias, failure or electrolyte imbalance. • Bone loss • Lung problems resembling emphysema • Kidney problems • Every organ sustains damage, including the brain, when severely malnourished. Damage is not fully reversible.

13. Bulimia Nervosa • An eating disorder characterized by episodes of overeating – binge eating (usually high calorie foods) • Overeating is followed by purging - vomiting, using laxatives, fasting, or excessive exercise • Usually stay within their normal weight. • Usually recognize they have an eating disorder.

14. Bulimia – Other Qualities • Common to live in a world of secret shame and self-disgust. • Feel trapped by the addition and relationship with food. • Eat until it’s painful then purge. • Eventually teach body to purge easily with small amounts of food. • No-purging bulimia uses fasting or over exercising.

15. Bulimia - Symptoms • Physical symptoms • Damaged teeth and gums, swollen salivary glands, sores in throat and mouth, bloating, dehydration, fatigue, dry skin, irregular heartbeat, knuckles with cores, scars or calluses, puffy cheeks • Emotional and behavioral symptoms • Constant dieting, binge eating alone, eating to discomfort, going to bathroom after eating, hoarding food, depression, anxiety, disappearing food

16. Biological Explanation • Genetic links • Abnormal serotonin levels (probably not enough) - connected to food intake

17. Psychological Explanation • Low self-worth and perfectionism • Trouble controlling impulsive behavior • Trouble managing moods or expressing anger • Families my have higher-than-usual incidence of childhood obesity & negative self-evaluation • Families of people with bulimia may have more conflicts, criticism, and unpredictability • Sometimes history of sexual abuse

18. Sociocultural Explanation • Society promotes thinness • Success and worth associated with being thin • Peer pressure – especially among girls • Similar risk factors to anorexia

19. Binge Eating Disorder • Compulsive overeating – consuming huge amounts of food while feeling out of control and powerless to stop • Typically last 2 hours or on and off all day • Gorge themselves as fast as they can barely realize what they are eating or tasting • Feel extremely distressed after binging • No attempt to make-up for the overeating

20. Binge - Other Qualities • Struggle with feelings of guilt, disgust, depression • Worry about their bodies knowing they have no control with eating • Desperately want to stop but can’t. • It’s a food addiction.

21. Binge - Complications • Type 2 diabetes • Gallbladder disease • Heart disease • Certain types of cancer • Sleep apnea • High cholesterol, blood pressure • Gastrointestinal problems

22. PicaStrange but True! • Hippocrates the first to describe the disorder • People display a compulsive craving for inedible substances such as clay, dirt, laundry starch, chalk, buttons, paper, dried paint, burnt matches, ashes, sand, oyster shells or broken crockery. • Seen most often in pregnant women or nursing women but also with people with severe mental disorders. • Could be a behavioral response to stress. • Usually caused by malnourishment. Body craves what it needs.