Disordered Eating

1. Disordered Eating

2. Disordered Eating vs. Eating Disorder • Eating disorders are psychiatric conditions • Extreme, continuous body dissatisfaction coupled with long-term eating patterns that negatively affect body functioning • Typical behaviors = food restriction, obsessive exercise, self-induced vomiting • Anorexia & bulimia nervosa

3. Disordered Eating vs. Eating Disorder • Disordered Eating general application of atypical eating behavior to maintain low weight • Going on & off diets; refusing to ingest fats • Usually not chronic behaviors: rarely cause illness • Many people do seek psychiatric care for it

4. Intimately tied to body image • Body image: the way you feel about your body

5. Factors contributing to Eating Disorders • Family environment • Unrealistic media images • Sociocultural values • Personality traits • Genetic & Biological factors

6. Factors contributing to Eating Disorders • Family environment • You’re more likely to develop an eating disorder if a sibling has one • Families with anorexic member are more “uptight” • Rigid structure; avoidance of controversial topics; fuzzy interpersonal boundaries • Families with bulimic member are more “chaotic” • Less stable organization; less nurturing; more angry & disruptive

7. Factors contributing to Eating Disorders • Unrealistic media images • Adolescents are less capable of understanding that these are uncommon, unrealistic, and often unnatural body types. • Consequently less able to distance themselves from a need to acquire that body

8. Factors contributing to Eating Disorders • Sociocultural values • “Western values” contribute to eating disorders • Significantly more common in white Western women than others (worldwide) • Everyday interactions with family and peers influence how we feel about our bodies

9. Factors contributing to Eating Disorders • Personality Traits • People with anorexia nervosa tend toward social inhibition, compliance, emotional restraint • Do these traits predispose one to the disease, or are they side-effects of starvation? • People with bulimia nervosa tend to be impulsive, extroverted, have low self-esteem • seek external validation • Prone to mood swings that result in binging • Prone to self-criticism • Prone to anxiety disorders and substance abuse

10. Factors contributing to Eating Disorders • Genetic & Biological factors • Both bulimia & anorexia are much more common among related individuals • Could be due to genetic or cultural transmission • Twin studies of bulimia nervosa found that relatedness (heritability) & key environmental factors EACH accounted for ~50% of the variability in who was diagnosed • Imbalances in hormones involved with feelings of hunger may also be involved

11. Anorexia nervosa • Suite of unhealthful practices employed to reduce weight below 85% of normal (for height & weight) • 90-95% are young women • 0.5-1% of US females develop AN • 5 - 20 % of those diagnosed will die from complications within 10 years. • Leading cause of death in females aged 15-24

12. Anorexia nervosa • Symptoms: • Self-starvation; refusal to maintain minimal body weight • Intense fear of weight gain, despite being underweight by all measures • Undue influence of body weight on self-image or denial of problem • Amenorrhea in women past puberty • Absence of at least three menstrual cycles

13. Anorexia nervosa • Health risks: • Loss of body fat • Loss of proteins from skeletal muscle and organs. Reduction of non-vital functions • Periods cease; growth stops • Electrolyte imbalance - leads to irregular heart beat & heart failure (cramping is least of your worries) • Cardiovascular problems - tachycardia, low bp, dizziness • GI problems - general weakness & loss of function • Osteoporosis…why?

14. Bulimia nervosa • Binging • High rate & quantity of food consumption: more than usual (in relation of time, place, social context) • Loss of self control; inability to stop; sense of euphoria • Occur ~ twice or more per week • Purging • Usually, but not always, after each binge • Vomiting, laxatives, obsessive exercise

15. Bulimia nervosa • Prevalence • Affects 1-4% of women (estimate) • Mortality rates much lower than for AN (1% dying within 10 years) • Occurs mostly in women, but also in men competing in sports requiring a thin build

16. Bulimia nervosa • Symptoms • Recurrent episodes of binging • Recurrent inappropriate compensatory behavior (laxatives, vomiting, diuretics) • Binge-purge cycle continues for more than three months • Body shape & weight unduly influence self-image

18. Bulimia nervosa • Health risks • Electrolyte imbalance leads to irregular heart beat & heart failure • Caused by dehydration & loss of Na+ and K+ through vomiting • GI problems: inflammation, ulceration, possible rupture of esophagus • Caused by HCl + mechanical trauma from frequent vomiting • Dental problem: tooth decay, staining & mouth sores • HCl in vomit • Calluses on hands, swelling in cheek & jaw area

19. Disordered Eating patterns • Binge eating • Chronic dieting • Chronic overeating

20. Binge Eating Disorder • Symptoms: • Often overweight • Lack of control during binging • Chaotic eating behaviors (eating too fast, too much, in private) • Negative self-esteem, poor body image • Often associated with depression, substance abuse, anxiety disorders

21. Binge Eating Disorder • HealthRisks: • Increased risk of overweight or obesity • Foods eaten during binge are often high in fat and sugar • Increased stress (caused be negative self-talk) leads to psychological distress

22. Chronic Dieting • Symptoms: • Preoccupation with food, weight, calories • Classify food as “good” or “bad” • Strict dieting • Excessive exercise • Chronic fatigue • Loss of concentration; mood swings • Increased criticism of body shape

23. Chronic dieting • HealthRisks: • Insuffiecient nutrient intake • Insufficient caloric intake • low vitamin and mineral intake • Decreased energy expenditure due to a reduced BMR • Decreased ability to exercise • Increased risk of eating disorder

24. Reduced BMR with dieting

25. Female Athlete Triad • Female athlete triad: serious medical syndrome frequently seen in female athletes; consists of • Disordered eating • Menstrual dysfunction • Osteoporosis • Seen especially in sports that emphasize lean bodies or use subjective scoring • Examples?