eating disorders

1. Eating Disorders
Ashmin Adhikari

2. Definition
o A persistent disturbance in eating or eating
related behaviour that results in the impaired
consumption or absorption of food and that
significantly impairs physical health and
psychosocial functioning.
o Fatal illnesses which is associated with severe
disturbance in people’s eating behaviours and
related thoughts & emotions.

3. Aetiology/ Risk factor

4. Types
I. Anorexia Nervosa
II. Bulimia Nervosa
III. Binge eating Disorder
IV. Others
 Avoidant restrictive food intake disorder
 Pica
 Rumination disorder
 Unspecific feeding/ eating disorder

5. Anorexia Nervosa
 Is an eating disorder characterised by self-
starvation, low weight, fear of gaining weight &
strong desire to be thin.
 People with anorexia nervosa have intense fear of
becoming fat and see themselves fat even when they
aren’t so in order to correct this perceived flow,
strictly limiting food intake and exercising
excessively in order to lose weight.
 Anorexia falls into 2 general type:
• Restrictive type and Binge eating /purging type

6. Criteria of Anorexia (DSM-V)
1) Restricting energy intake relatively to required leading to a significantly low body
weight in context of age, sex, physical health.
2) Intense fear of gaining weight
3) Disturbance in the way in which one’s body weight or shaped is experienced under
influence of body weight on evaluation.

8. Bulimia Nervosa
 Is a serious life threatening
eating disorder characterized by
a cycle of bingeing and
compensatory behaviour such as
self induced vomiting designed
to undo or compensate for the
effects of binge eating.
 Eat Guilt Purge Eat
 Method of purging include
forced vomiting, excessive use of
laxatives, diuretics and
prolonged period of exercise

9. Criteria of Bulimia( DSM-V)
1) Recurrent episode of binge eating with
 Eating large amount of food in discrete period of time
 A sense of lack of control over eating during the episode
2) Recurrent inappropriate compensatory behaviour in order to prevent wt.
gain such as self induced vomiting, fasting, excessive exercise or even
misuse of laxatives.
3) Binge eating and inappropriate compensatory behaviour both occur at
least once a week for 3 months
4) Self evaluation is unduly influence by body shape & weight.

10. Signs and Symptoms
 Physical signs and symptoms
• Dehydration
• Frequent change in weight
• Dental problems such as enamel erosion
• Oesophagus erosion and hoarsen of voice
• Cuts and Calluses across the top of finger due to induced vomiting
• GI complaints like ulcer, stomach cramp

11. CONTI
 Binge eating signs
 Eating large amount of food
 Episode of excessive eating or not eating
at all
 Eating in secrecy
 Frequently dieting
 Purging signs
 Self induced vomiting
 Indulge in excessive exercises or self
induced starving
 Eluding in bathrooms
 Administrating laxatives, diuretics after
bingeing

14. Binge Eating Disorder
 It is characterised by recurrent episode of
eating large quantities of food (very
quickly), a feeling of loss of control
during binge, experiencing shame and
guilt afterwards but not using unhealthy
compensatory measures to counter the
binge eating.

15. CRITERIA
I. Recurrent episode of binge eating characterized by both ; eating in discrete period of
time, an amount of food that is definitely larger and a sense of lack of control over
eating during episode.
II. Eating rapidly than normal until feeling uncomfortably full.
III. Eating large amount of food when not feeling physically hungry.
IV. Eating alone as feeling embarrassed by how much one is eating.
V. Marked disgust, guilt regarding binge eating but doesn’t associated with recurrent use
of inappropriate compensatory behaviour.

16. Sign and Symptoms
 Appears uncomfortable eating around
others
 Any new practice with fade diets
including cutting out entire food group.
E.g. : yoyo diet
 Steals food in strange place

17. Treatment
i. Medical complication caused by starvation, vomiting & laxative should be addressed first.
ii. Include adequate Nutritional diet and restoration of body weight in anorexia.
iii. Eating disorders with other condition such as depression and anxiety should be treated with anti-
depressants and mood stabilizer.
iv. Therapy:
 CBT and Enhanced Cognitive behavioural therapy
 Dialectal behavioural therapy
 Psychodynamic therapy
 Interpersonal Psychotherapy

18. Reference
 Barlow ,D., Durand, V.M. & Stewart, H.S. (2009). Anormal psychology, An integrated approach
(7th edition). Toronto: Nelson education. 2009. Print.
 National eating disorder Association (2018) retrieved from
https://www.nationaleatingdisorders.org/about-us
 Parekh, R. (2017). What are Eating disorders?. American psychiatric association retrieved from
https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
 Sue,D., Sue, D.W, Sue,D. & Sue, S.(2015).Understanding Abnormal Behaviour. (11th edition).
Stamford, CT: Cengage learning.
 Schulman. S,J. (2020). Is therapy an effective treatment for eating disorder. Healthline Retrieved
from https://www.healthline.com/health/eating-disorder/therapy-for-eating-disorders