Eating disorders affect over 5 million people annually and are more common in females than males. Genetics may play a role, as identical twins are more likely to both experience an eating disorder than fraternal twins. Common eating disorders include anorexia nervosa, bulimia nervosa, binge-eating disorder, and night eating syndrome. Treatment involves both psychological therapy and nutrition therapy to address underlying emotional issues and establish healthy eating patterns.

1. Chapter 13 Eating Disorders Lecture PowerPoint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. The Ideal Body Image Media promotion Need for social acceptance Influence and stress on young individuals Eating is a necessity Dieting may lead to a disorder

3. Food: More Than Just Nutrients Linked to personal emotions Source of comfort Release of neurotransmitters and natural opioids Food used as a reward or bribe Can lead to disordered eating

4. Overview of Eating Disorders Affects more than 5 million people Females outnumber males (5 to 1) 85% of cases develop during adolescence Co-occurs with other psychological disorders Recognition of disorder is critical to treatment Diagnostic and Statistical Manual of Mental Disorders

5. Genetic Link? Identical twins are more likely to share eating disorders Fraternal twins are less likely

6. Characteristics: Anorexia & Bulimia

7. Profile of an Anorexic Usually Caucasian female Middle–upper socioeconomic class “ Responsible, meticulous, and obedient” Competitive and obsessive May have conflicts with family High family expectations Expression of self control

8. Warning Signs of Anorexia Abnormal, rigid eating habits Eating very little food (300-600 kcal/day) Hiding and storing food Exercising compulsively Preparing meals for others, but not eating Withdrawing from friends and family Critical of self and others Sleep disturbances and depression Ammenorrhea

9. Anorexia Health Problems “ Skin-and-bone” appearance Lowered body temperature Lanugo and loss of hair Lower basal metabolism, decreased heart rate Iron deficiency anemia and other nutrient deficiencies Rough, dry, scaly, cold skin Low white blood cell count, potassium Constipation, ammenorrhea

11. Intervention Person typically in denial Supportive confrontation by loved ones Hospitalization for severe cases Eating disorders clinic Multidisciplinary team Gain trust and cooperation Restore sense of balance, purpose, and a future

12. Nutrition Therapy Increase food intake to raise basal metabolism Prevent further weight loss Restore appropriate food habits Restrict excessive activity Ultimately achieve and maintain weight gain

13. Psychological Therapy Cognitive behavior therapy Determine underlying emotional problems Reject sense of accomplishment associated with weight loss Family therapy, support group

14. Bulimia Nervosa

15. Profile of a Bulimic Young adults (commonly female college students) Predisposed to becoming overweight At or slightly above normal weight Frequent weight-reduction diets as a teen Impulsive behavior Usually from disengaged families

16. Secret Lives of Bulimics Many are not diagnosed Hidden binge-and-purge habits Elaborate food rules Binge may consist of 3,000+ kcal Convenient, high-sugar, high-fat foods Loss of control Purge Vomiting and laxatives to avoid weight gain Excessive exercise ( “debting” ) Binge-Purge cycles triggered by emotional factors

17. Effects of Bingeing and Purging Absorption of calories 33%-75% absorbed after vomiting 90% absorbed when laxatives are used Can cause weight gain and weight fluctuations Leads to guilt, depression, low self-esteem

18. Vicious Cycle of Bulimia

19. Bulimia Health Problems Vomiting causes most health problems Demineralization of teeth Drop in blood potassium Swelling of salivary glands Stomach ulcers and bleeding Constipation Ipecac syrup is toxic

20. Treatment of Bulimia Nervosa Decrease episodes of bingeing & purging Psychotherapy to improve self-acceptance Change “all-or-none” attitude about food Correct misconceptions about food Establish good, normal eating habits Group therapy Antidepressants Long-term therapy

21. Binge-Eating Disorder

22. Profile of a Binge-Eater Considers self as hungrier than normal Isolates self to eat large quantities Suffers from stress, depression, anxiety, loneliness, anger, frustration that can trigger binge Uses food to reduce stress, provide feeling of power and well-being Usually binges on “junk” foods Eats without regard to biological need

23. Treatment of Binge-Eating Eat in response to hunger, not emotions Learn to eat in moderation Avoid restrictive diets that can intensify problems Address hidden emotions “ Overeaters Anonymous” Antidepressants

24. Night Eating Syndrome Eating > 1/3 of calories after evening meal Not feeling hungry in the morning Need to eat to help fall asleep Waking at night to eat Depressed

25. Profile of Female Athlete Triad Female athletes in appearance-based and endurance sports 15% swimmers; 62% gymnasts; 32% other 1. Disordered eating 2. Irregular menses or ammenorrhea 3. Osteoporosis and loss of estrogen Bone density similar to 50-60 year olds Bone loss is largely irreversible

26. The Female Athlete Triad

27. Treatment of Female Athlete Triad Reduce preoccupation with food, weight, and body fat Gradually increase meals and snacks Rebuild body to healthy weight Establish regular menses Decrease training by 10%-20%

28. Dying To Be Thin It is normal to be concerned about diet, health, and body weight Weight typically fluctuates Treat physical, emotional problems early Discourage restrictive diets Correct misconceptions about foods, diet Thin is not necessarily better