Psych 380 1nd Edition Lecture 18 Outline of Current Lecture I. Bulimia nervosaCurrent LectureI. Bulimia nervosaa. Eating disorders are common in males than thought calibrates every calorie – always at the gym – hyperconscious of musclesII. Robbiea. 31 years oldb. Brought to attention by his sister and Dr. Halgin’s former studentc. Went from 175 lb  110 lb along the way, reclusive, refused to communicate with family, only left to buy foodd. Specialized treatmente. Horrifying stats – 1/10 will die from fatal disease or gastrointestinal issuesf. Family wants to reach out to someone they have a connection with Robbie’s sister told her fatherg. Trying to persuade Robbie to go to psychotherapyh. He gorges and purgesi. It is unlikely that he will come in and let down his defensesIII. Used to play Varsity tennis and won many awardsa. He injured his Achilles tendonb. He had to get surgery and go through rehabc. He was on a bunch of pain medsd. He would eat and the pain meds made him nauseous e. He purged and it made him feel betterf. He started gorging on food and then going home and purging to make himself feelbetter afterwardsIV. He eventually went back to worka. His boss said that he looked really bad – couldn’t be in the front of the storeb. His teeth looked awful from all of the stomach acid – they were decayed and rottedi. looks like moth eaten holes in teethc. Boss put him in the back roomd. He walked in on him purging in the men’s roome. He told him he couldn’t work there anymore – esp since it is a sports storef. He locked himself in his room and was in a semi psychotic stateg. Lost his sensibilityV. Video of woman with bulimiaa. Will do anything to avoid weight gainThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.b. Purges after eating massive amount of foodc. Exercises a lot & uses laxativesd. Young, white women in middle/upper class are most likely to get ite. At 18 years old she got her wisdom teeth out and lost a lot of weighti. This felt good being so thinii. She realized that she could lose weight by throwing up after eatingiii. She tried to get her friends to do it but they thought it was disgustingf. she started not letting herself eat until 3 pm and then would lose control over her ability to eatg. she would be engrossed in her foodh. she was a waitress and would neglect her tables when she was gorgingi. she would binge & purge dailyj. no control when she has foodk. can’t stop itl. control over not binging, can’t help itm. example of what she would eat:i. loaf of bread with a pound of butterii. a plate of scrambled eggs and hash brownsiii. 8 pieces of French toastiv. 5 danishesv. finish with chocolate or sweetsn. eats an unusual amounto. after purge – thinks “thank god I could get all of that out”p. determines how much is still left inside herq. she has been unable to overcome her problemr. wants to break the cycles. harder to purge everytimet. she inserts plastic bags into her throat in order to make herself gag & throw upu. she has tried antidepressants, therapy, and acupuncturev. OA – support groupsw. Natural medicinex. The only thing that has sort of worked is therapyVI. Recurrent binge episodes (1);a. Eating (in 2 hour period) excessive amountb. Lack of control of eating during episodec. Compensatory behaviors to prevent weight gain: vomiting, laxatives, diuretics or meds, fasting, excessive exercised. At least once per week for 3 monthse. Self evaluation unduly based on weight and shapeVII. Back to Robbiea. Would do compulsive exerciseb. Had a rowing machine, would do push-ups, jumping jacksc. He also has anorexiai. Distorted body image when he looks in the mirrorii. Sees himself as obese in the mirrord. Bulimeraxiai. Mixture of the twoe. Robbie thought he was fatf. Refused to turn the lights ong. He would go days without eating sometimesVIII. In July Robbie agreed to come in but never showed for the sessiona. His parents told him that they are killing them as he commits this slow suicideb. The same thing happens in Augustc. He looks like a skeleton, his teeth are rotten, he has gaunt eyesd. They say they are going to call the hospital but he won’t give up controle. He wants to control when things go into his body and when they leavef. Would he accept a phone call from Dr. Halgin? YesIX. Dr. Halgin says to Robbie – here is the situationa. I am concerned about your lifeb. You are dyingc. He says it is my life and I am doing what I want to dod. Since he is an athlete and hates the prospect of losing…e. Dr. Halgin asks him why he is forfeiting his life – why aren’t you giving yourself thechance to compete?f. Are you calling me a loser?g. Yeah, you aren’t even tryingh. It took a lot of urging but eventually Robbie came ini. Dr. Halgin was horrifiedj. Had never seen anyone so malnourishedk. He looked like he had just gotten out of a concentration campl. He didn’t even know how he could walkm. He sent him to the emergency room immediatelyn. The doctor said that he was within 24 hours of death and that they had never seen a person living with such low potassium levelso. They kept him against his will and he was very angryp. He gained some weightX. When he got out they sent him to a social worker who he didn’t really click withXI. He wanted something more challengingXII. He went to a physician and nutritionistXIII. Also went to a strength and conditioning coachXIV. Got dental implants – most of his teeth were removedXV. Got on boardXVI. Was at 150-155 lbXVII. Leveled off and came out of fog, was a success storyXVIII. Video – anorexia in 1990’s – home for anorexic/bulimic peoplea. Center in home like atomosphereb. They were sued because they didn’t have medically trained staff and people couldpotentially diec. Thousands of people contacted themd. Process: weighed them backwards so they couldn’t seee. Took responsibility for their weightf. Positive reinforcementg. Costs less than hospitalXIX. Occasionally Robbie would have a relapse – wouldn’t show up and said he had car problems, oversleptXX. Demon is going to be with him for a long timeXXI. Medication/drug soothes