Eating Disorders I March 27, 2013 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D.

1. Eating Disorders IMarch 27, 2013PSYC 2340: Abnormal PsychologyBrett Deacon, Ph.D.

2. Eating Disorders • Disorders covered in Chapter 8: • Anorexia nervosa • Bulimia nervosa • Binge Eating Disorder (not covered much in this class) • Obesity (not covered much in this class)

3. Eating Disorders: An Overview • Two major types of DSM-IV eating disorders • Anorexia nervosa and bulimia nervosa • Severe disruptions in eating behavior • Extreme fear and apprehension about gaining weight • Have strong sociocultural origins –Westernized views (we’ll get into this next class)

4. Anorexia Nervosa • Hallmark symptom = successful weight loss ( > 15% below expected weight) • Intense fear of obesity • Relentless pursuit of thinness • Often begins with dieting, purging can be present

5. Anorexia Nervosa • DSM-IV subtypes of anorexia • Restricting type – no binging and purging; limit caloric intake via diet and fasting • Binge-eating-purging type – regular binging and purging; about 50% of anorexics

6. Anorexia Nervosa • Associated features • Marked disturbance in body image • High comorbidity with other psychological disorders • Weight loss methods have life threatening consequences

7. Bulimia Nervosa • Binge eating – hallmark symptom • Eating unusually large amounts of food within a 2-hour period, sense of lack of control during binge • Compensatory behaviors • Purging – self-induced vomiting, diuretics, laxatives • Alternatives – exercise, fasting

8. Bulimia Nervosa • Self-evaluation unduly influenced by body shape and weight • Disturbance does not occur exclusively during episodes of anorexia nervosa • Purging subtype – by far most common subtype (e.g., vomiting, laxatives, enemas) • Nonpurging subtype – about 1/3 of bulimics (exercise, fasting)

9. Bulimia Nervosa • Associated medical features • Most within 10% of normal weight • Purging can result in severe medical problems • Erosion of dental enamel, electrolyte imbalance • Kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage

10. How Effective is Vomiting Following a Binge in Eliminating Calories? • Kaye et al. (1993), Amount of calories retained after binge eating and vomiting, American Journal of Psychiatry: • “While caloric consumption during binge eating has been measured, it is notknown how many of the calories are retained in the gastrointestinal tractafter vomiting. In 17 normal weight bulimic patients, there appeared to bea ceiling on the number of calories retained after vomiting. That is,whether or not bulimic patients had small (mean = 1,549 kcal, SD = 505) orlarge (mean = 3,530 kcal, SD = 438) binges, they retained similar amountsof kilocalories (mean = 1,128, SD = 497, versus mean = 1,209, SD = 574,respectively) after vomiting.” • 72.8% calories retained for small binge, 34.2% calories retained for large binge

11. New for DSM-5: Binge Eating Disorder • A. Recurrent episodes of binge eating • B. The binge-eating episodes are associated with 3 (or more) of the following: • 1. Eating much more rapidly than normal • 2. Eating until feeling uncomfortably full • 3. Eating large amounts of food when not feeling physically hungry • 4. Eating alone because of feeling embarrassed by how much one is eating • 5. Feeling disgusted with oneself, depressed, or very guilty after overeating

12. New for DSM-5: Binge Eating Disorder • C. Marked distress regarding binge eating is present. • D. The binge eating occurs, on average, at least once a week for 3 months. • E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior and does not occur exclusively during the course Bulimia Nervosa or Anorexia Nervosa.

13. Body Image Exercise 1. What is your gender? 2. What figure most approximates your current figure? 3. What figure represents what you would like to look like (ideal figure)? 4. What figure do you think would be most attractive to the opposite sex? 5. What figure of the opposite sex do you find most attractive?