Psych 2510 – Trull Chapter 8: Eating DisordersBody dissatisfaction- Refers to dissatisfaction or distress with one’s appearance, an overinvestment in the way one appears, and avoidance of certain situations or things because they elicit body concernsEating Disorders: Major Features- Weight concernso Drive for thinness- Body dissatisfaction- Eating problemso Restricted eating or dieting o Lack of control over eatingAnorexia Nervosa- Individuals refuse to maintain a minimum, normal body weight- Have an intense fear of gaining weight - Show disturbance in the way they view their body shape and weight- Has been observed in countries around the world and does not appear to be culture-boundBulimia Nervosa- Marked by:o Binge eating – eating excess amounts in small amounts of time and feeling out of control of eating o Inappropriate methods to prevent weight gain Compensatory behaviors- Purging, non-purging o Self-evaluation greatly influenced by body shape and weight- Profile of Sara, a patient suffering from bulimia nervosa. - Primarily found in Western cultures and may be a culture-bound disorder. Binge Eating Disorder- Some people have recurrent episodes of binge eating but without compensatory behaviors like purging, excessive exercise, or fasting. - Binge eating episode involves both:o Eating in specified period of time, an amount of food that is larger than normal o Feeling lack of control over eating - Experience lack of control over eating during a certain period that leads to discomfortEpidemiology of Eating Disorders- Women are about 10 times more likely to have anorexia nervosa or bulimia nervosa than men- Many people with an eating disorder do not seek treatment- People with eating disorders have higher mortality rate- More typical in western cultures 1Psych 2510 – Trull o Especially bulimia- Comorbid disorders: mood, anxiety, personality, substance abuse disordersStigma- People often view those with eating disorders as responsible for their behavior- These are stigmatizing statements, and the percentages to which people agree with them. Biological Risk Factors - Genetic predisposition:o AN: 28-74%o BN: 54- 83%o BE: 411-57%- .- The brain structures most likely involved in eating problems are the hypothalamus and amygdala o Lateral hypothalamus associated with weight gain and appetite changes Interacts with amygdala  Cues that surround eating o Serotonin  satietyo Dopamine  pleasureo Endogenous opioids  craving- Personality traits: perfectionism, impulsivity Eating disorders have some genetic basis, but environmental risk factors are also important in development of these disorders Environmental Risk Factors- Perfectionism and impulsivity are personality-based risk factors for eating disorders- Family characteristics and media exposure to the thin ideal.o Controlling, conflictual, expressed emotion- Media exposure to thin ideal- Cognitive; Body dissatisfaction and body image disturbance- Cultural factors o Bulimia nervosa appears to be a culture-bound syndromeo Anorexia nervosa does not. Diathesis-stress model  useful way of integrating various biological and environmental risk factors for eating disordersPrevention- Eating disorder prevention programs target one or more risk factors - Some prevention programs are administered over the interneto Work to reduce excessive weight concerns and body dissatisfaction- Success:o Modestly successful o 51% reduce risk factorso 29% reduce ED symptoms Assessment2Psych 2510 – Trull - Major approaches to assess eating disorders include:o Interviews Structured: include certain criteria for classifying patients with ED Unstructured o Self-report questionnaires  screening o Self-monitoring Diaries Electronic diaries used to monitor eating behavior, moods, thoughts, and concernso Physical assessment.  Medical- Check BMI, muscle strength, etc. Treatment- Treatments for eating disorders share some general aims: o Returning to a healthy weighto Increasing motivation to restore healthy eating patternso Providing education about healthy eatingo Aiding recognition of problematic thoughts, feelings, and behaviorso Enlisting support from otherso Preventing relapse.- Biological Approaches: o Controlled weight gain o Medication  EX: SSRIs  Appetite suppression for this with binge eating - Family and cognitive behavioral therapieso Most effective psychological treatments for eating disorders- Cognitive behavioral therapy o Focuses on interrupting the binging and purging cycles by questioning social standards for attractiveness, challenging beliefs that encourage food restriction, and developing normal eating habitsOutcome- Of the eating disorders, the prognosis, course, and treatment outcome for bulimia nervosa is most favorable, followed by binge eating disorder and anorexia nervosa.- AN: highest mortality rate of any mental disorder (10%)o 40% remain chronically impaired - BN: intermittent courseo CBT: successfully treats about 30-50% cases o Medication might be