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PSY 1205: Eating Disorders
Western Beauty Ideal
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Small body and no body fat is what determines your self worth
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Evidence of Western Beauty Ideal
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rise of eating disorders
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Eating Disorders
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-Anorexia Nervosa
-Bulimia Nervosa
-Binge Eating Disorder
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Anorexia Nervosa
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Fear of obesity, drive for thinness, food restrictions, body weight significantly below normal, body image disturbance
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Bulimia Nervosa
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-body shape/weight overly influence self-evaluation
-recurrent binge eating
-purging behavior (throwing up) |
Binge-eating disorder
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Recurrent episodes of binge eating in absence of purging
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DSM-5 Criteria for Anorexia Nervosa
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-BMI= less than 18.5
-Intense fear of gaining weight and being fat
-distorted body image
(amenorrhea not required for diagnosis) |
Two subtypes of anorexia nervosa
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1 Restricting- restricting the amount of caloric intake you have.
2 Binge eating/purging - consuming a unusually large amount of food in a short period of time. Then throwing it up for weight loss. |
Perfectionism
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An unhealthy compulsion to make one perfect
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Anorexia Nervosa Age of onset
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Adolescence – usually begins after the person has been on a diet and is often triggered by a stressful event.
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Commodity of Anorexia Nervosa
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depression, OCD, phobias, alcoholism, and PD's
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Suicide rates in anorexia
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High
5% completing
20% attempting |
Anorexia Nervosa: Physical Changes
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-Low blood pressure, kidney and gastrointestinal problems, brittle nails,, dry skin, hair loss, depretion of potassium and sodium
-Lanugo- soft downy body hair
-Depletion of electrolytes |
Anorexia Nervosa prognosis
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-50%-70% recover
-may take many years
-relapse common
-difficult to modify distorted view of self, especially in cultures that highly value thinness
-death rates 10x higher than general population |
Two types of Bulimia Nervosa
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Purging type: throwing up/self-induced vomiting.
non-purging type: fasting/ excessive exercise, but not purging. |
Difference between anorexia and bulimia?
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both can involve binging and purging
Anorexia: < 85% ideal body weight
Bulimia: normal weight |
binge |
an out-of-control consumption of an amount of food that is far greater than what most people would eat
|
Bulimia Nervosa: Onset and Prevalence
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Onset late adolescence or early adulthood
Prevalence 1 – 2%
90% women
Suicide attempts & completions higher than in general population but lower than in anorexia nervosa |
Comorbidity of Bulimia Nervosa
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depression, PDs, anxiety, substance abuse, conduct disorder
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suicide and bulimia nervosa
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higher than in general population but lower than anorexia nervosa
|
Bulimia Nervosa: physical changes
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-menstrual irregularities
-potassium depletion from purging
-laxative use depletes electrolytes and can cause cardiac irregularities
-loss of dental enamel from vomiting |
Prognosis of Bulimia Nervosa
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-75% recover
-10-20% remain fully symptomatic
-Early intervention linked with improved outcome
-Poorer prognosis when depression and substance abuse are combined |
Binge Eating Disorder
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-recurrent episodes of binge eating without purging
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Do all obese people meet the criteria for Binge-Eating Disorder?
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No, they must report a feeling of loss of control over eating. 2-25% may qualify.
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Risk factors of Binge-Eating Disorder
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Adverse childhood experiences (abuse/neglect), Parental depression, vulnerability to obesity, repeated negative comments from family members, & poor emotional state
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Do most people with eating disorders receive treatment?
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no, 1/10 people do.
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Are antidepressants effective with eating disorders?
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For bulimia nervosa, not anorexia nervosa
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What does CBT for Bulimia challenge?
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-challenges societal ideas of thinness
-challenges beliefs about weight and dieting
-it is more effective than medication |
Treatment for Anorexia Nervosa
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-Immediate goal is increase weight to avoid medical complications and avoid death
-Second goal is long term maintenance of weight gain
|
CBT in Anorexia Nervosa
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-All or nothing thinking
-Reductions in symptoms through 1 year
-Also effective for Binge Eating Disorder |
Cognitive Behavioral Therapy methods used to treat Eating Disorders
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-Nutrition Interventions
(meal planning, weekly goals, hydration)
-Psychoeducation
(food pyramid, the truth about purging)
-Distraction&Alternative behaviors |
Etiology of Eating Disorders: Genetics
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family and twin studies support genetic link
-first degree relatives of individuals with both disorders more likely to have the disorder
-higher MZ(compared to DZ) concordance rates for both anorexia and bulimia
-body dissatisfaction, desire for thinness, binge eating, and weight preoccupation
-all heritable |
Etiology of Eating Disorders: Neurobiological Factors
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-Low levels of endogenous opioids
-Serotonin related to feeling of satiety, feeling full
-Dopamine related to feeling pleasure and motivation |
Etiology of Eating Disorders: Cognitive Behavioral View (Anorexia)
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-Focus on body dissatisfaction and fear of fatness
-Certain behaviors neg. reinforcing to reduce anxiety about weight
-Perfectionism and personal inadequacy lead to excessive concern about weight
-Feelings of self control brought about by weight loss are pos reinforcing
-Criticism from fam and friends regarding weight |
Etiology of Eating Disorders: Cognitive Behavioral View (Bulimia)
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-Self worth strongly influenced by weight
-low self esteem
-rigid restrictive eating triggers lapses which can become binges
-Disgust with oneself and fear of gaining weight lead to compensatory behavior
-stress, neg affect triggers binge
|
Etiology of Eating Disorders: Sociocultural Factors
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-American society values thinness
-Dieting becomes more prevalent
-Women viewed as objects
-Overweight individuals are viewed poorly |
Etiology of Eating Disorders: Family Characteristics
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-self-report indicates high levels of family conflict
-parental reports don't always indicate family problems |
Etiology of Eating Disorders: Child Abuse
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-self reports of high rates of childhood sexual and physical abuse
-reports of abuse not specific to eating disorders |