Review the prevalence of eating disorders
Identify assessment areas
Identify risk and protective factors
Explore complications
Explore potential guidelines for treatment
Based on APA Guidelines for Eating Disorders, the NICE Guidelines for Eating Disorder Recognition and Treatment, and the NEDA Coach and Trainer’s Toolkit
A direct link to the CEU course is https://www.allceus.com/member/cart/index/product/id/56/c/
Will be released as part of the Counselor Toolbox Podcast
Review the prevalence of eating disorders
Identify assessment areas
Identify risk and protective factors
Explore complications
Explore potential guidelines for treatment
Based on APA Guidelines for Eating Disorders and the NICE Guidelines for Eating Disorder Recognition and Treatment
A direct link to the CEU course is https://www.allceus.com/member/cart/index/product/id/56/c/
Will be released as part of the Counselor Toolbox Podcast
Review the prevalence of eating disorders
Identify assessment areas
Identify risk and protective factors
Explore complications
Explore potential guidelines for treatment
Based on APA Guidelines for Eating Disorders and the NICE Guidelines for Eating Disorder Recognition and Treatment
A direct link to the CEU course is https://www.allceus.com/member/cart/index/product/id/56/c/
Will be released as part of the Counselor Toolbox Podcast
Feeding and Eating disorders are one of the devastating disorders , Anorexia is a killer disease , very common in childhood and adolescent, mainly in girls more than boys. Bulimia is charecterize by binge eating followed by compulsive purging . Binge eating disorders and night eating syndrome are becoming very prevalent
Feeding disorders as avoidant restrictive food intake disorder , rumination disorders and pica are the types of feeding disorders in infant and childhood period
psychological rehabilitation, nutritional plan and medical therapy are the most effective lines of treatment foe eating Disorders
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
Presented during 5th Psychology Congress New Era University, Diliman, QC Philippines November 21, 2008
Looking for customized in-house training sessions that fit your needs, particularly in the Philippines? Please send me an email at clarencegapostol@gmail.com or WhatsApp +971507678124. When your request is received I will follow up with you as soon as possible.Thank you!
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
The 7 Dimensions of Addiction Treatment ModelPeter Dimaira
Men’s Long Term Substance Abuse Treatment
Daily schedules are customized based on our clients needs to include individual counseling by master’s level clinicians. Bright Futures provides group therapy, educational group lectures, health and wellness education, 12-step groups and recreational activities. Therefore, therapists will begin to rebuild family connections and work with both individuals and loved ones through the recovery process.
Bright Futures Treatment Center is an evidence-based program, using a collection of tried and true methods that have proven success rates.
Comprehensive Long Term Substance Abuse Treatment
Meeting with our Psychiatrist, medical staff and nutritionist are part of the treatment plan. Most, if not all our comprehensive and complete approach is designed to meet the physical, mental and emotional components of recovery and healing.
Furthermore, health & wellness is an integral part of recovery. In addition, learning to listen to your body and treat it well are foundations to a successful recovery. Finally personal fitness, yoga, meditation, massage and mindfulness activities promote lasting behavioral change.
see more about how we implement Dr. James Stobodzien information here visit: https://brightfuturestreatment.com/
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
These are slides from a webinar from APA's Online Academy series. (http://apaonlineacademy.bizvision.com/)
Conducting psychological assessments can be one of the most ethically challenging areas of practice. Providing evaluations that are accurate, useful and consistent with the latest advances in research and theory are only a few of these challenges. This workshop will review several ethical issues of concern that graduate students who are engaged in assessment need to be attentive to. The ethical issues to be covered include informed consent, multicultural considerations, release of test data, third party requests for services, and assessment in the digital age. The workshop will be useful for identifying ethical pitfalls and for ensuring that diagnosis, and assessment are as valid and useful as possible for both clinicians and clients.
Feeding and Eating disorders are one of the devastating disorders , Anorexia is a killer disease , very common in childhood and adolescent, mainly in girls more than boys. Bulimia is charecterize by binge eating followed by compulsive purging . Binge eating disorders and night eating syndrome are becoming very prevalent
Feeding disorders as avoidant restrictive food intake disorder , rumination disorders and pica are the types of feeding disorders in infant and childhood period
psychological rehabilitation, nutritional plan and medical therapy are the most effective lines of treatment foe eating Disorders
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
Presented during 5th Psychology Congress New Era University, Diliman, QC Philippines November 21, 2008
Looking for customized in-house training sessions that fit your needs, particularly in the Philippines? Please send me an email at clarencegapostol@gmail.com or WhatsApp +971507678124. When your request is received I will follow up with you as soon as possible.Thank you!
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
The 7 Dimensions of Addiction Treatment ModelPeter Dimaira
Men’s Long Term Substance Abuse Treatment
Daily schedules are customized based on our clients needs to include individual counseling by master’s level clinicians. Bright Futures provides group therapy, educational group lectures, health and wellness education, 12-step groups and recreational activities. Therefore, therapists will begin to rebuild family connections and work with both individuals and loved ones through the recovery process.
Bright Futures Treatment Center is an evidence-based program, using a collection of tried and true methods that have proven success rates.
Comprehensive Long Term Substance Abuse Treatment
Meeting with our Psychiatrist, medical staff and nutritionist are part of the treatment plan. Most, if not all our comprehensive and complete approach is designed to meet the physical, mental and emotional components of recovery and healing.
Furthermore, health & wellness is an integral part of recovery. In addition, learning to listen to your body and treat it well are foundations to a successful recovery. Finally personal fitness, yoga, meditation, massage and mindfulness activities promote lasting behavioral change.
see more about how we implement Dr. James Stobodzien information here visit: https://brightfuturestreatment.com/
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
These are slides from a webinar from APA's Online Academy series. (http://apaonlineacademy.bizvision.com/)
Conducting psychological assessments can be one of the most ethically challenging areas of practice. Providing evaluations that are accurate, useful and consistent with the latest advances in research and theory are only a few of these challenges. This workshop will review several ethical issues of concern that graduate students who are engaged in assessment need to be attentive to. The ethical issues to be covered include informed consent, multicultural considerations, release of test data, third party requests for services, and assessment in the digital age. The workshop will be useful for identifying ethical pitfalls and for ensuring that diagnosis, and assessment are as valid and useful as possible for both clinicians and clients.
Eating Disorders in Children & Teens 101 – How to Support_.pdfPoojaSubramanian1
Eating disorders are complex medical and psychiatric illnesses that are generally characterized by an unhealthy relationship with food and/or body image. The root causes might be several though.
"An introduction to the most common forms of eating disorders, with essential information about causes, risk factors, and treatment options. An excellent starting point for anyone who is struggling with an eating disorder, or who suspects that someone they love is in danger."
Most Frequently Asked Questions about Anorexia and BulimiaEllern Mede
Anorexia (also known as anorexia nervosa) and bulimia (also known as bulimia nervosa) are two of the most common eating disorders in the U.K. These are also the most dangerous eating disorders as they can manifest immediate and future health concerns, sometimes long-range problems, depending upon how long the condition exists. If you or someone you know has an eating disorder, please don’t wait. Seek information now and get help.
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week in the form of live webinars (https://allceus.com/webinar ) and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week in the form of live webinars (https://allceus.com/webinar ) and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week in the form of live webinars (https://allceus.com/webinar ) and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week in the form of live webinars (https://allceus.com/webinar ) and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week in the form of live webinars (https://allceus.com/webinar ) and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes produces 2 episodes each week and offers CEUs based on the podcast at AllCEUs.com/counselortoolbox
Infographic is based on Counselor Toolbox Podcast which can be subscribed to on any podcast player like Apple Podcasts, Castbox or Google Play. Counseling and Social Work CEUs are available on this topic at AllCEUs.com
Infographic is based on Counselor Toolbox Podcast which can be subscribed to on any podcast player like Apple Podcasts, Castbox or Google Play. Counseling and Social Work CEUs are available on this topic at AllCEUs.com
More from Dr. DawnElise Snipes ★AllCEUs★ Unlimited Counselor Training (20)
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...The Lifesciences Magazine
Cold Sores, medically known as herpes labialis, are caused by the herpes simplex virus (HSV). HSV-1 is primarily responsible for cold sores, although HSV-2 can also contribute in some cases.
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
Eating Disorders Assessment: Part 1
1. Eating Disorders Assessment
Part 1
Instructor: Dr. Dawn-Elise Snipes, PhD, LPC, LMHC
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
2. Objectives
Review the prevalence of eating disorders
Identify assessment areas
Identify risk and protective factors
Explore complications
Explore potential guidelines for treatment
Based on APA Guidelines for Eating Disorders, the NICE
Guidelines for Eating Disorder Recognition and Treatment,
and the NEDA Coach and Trainer’s Toolkit
3. Prevalence of Eating Disorders
20% of women struggle with disordered eating
10-15% of people with eating disorders are male
40% of male football players were found to engage in
disordered eating
Muscle dysmorphia and body fat preoccupation is seen in a
majority of bodybuilders and wrestlers
90% of people with eating disorders become symptomatic
between 12 and 25
4. Risk Factors
The exact causes of anorexia nervosa are unknown. However,
the condition sometimes runs in families; young women with a
parent or sibling with an eating disorder are likelier to develop
one themselves.
People with anorexia come to believe that their lives would be
better if only they were thinner.
These people tend to be perfectionists and overachievers.
The typical person with anorexia is a good student involved in
school and community activities.
Many experts think that anorexia is part of an unconscious
attempt to come to terms with unresolved conflicts or painful
childhood experiences.
While sexual abuse has been shown to be a factor in the
development of bulimia, it is not associated with the
development of anorexia.
5. Risk Factors
Biological factors may include an abnormal biochemical make up of the
brain
The hypothalamic-pituitary-adrenal axis (HPA) is responsible for
releasing certain neurotransmitters including serotonin,
norepinephrine, and dopamine, which regulate stress, mood, and
appetite.
People with eating disorders tend to have lower levels of serotonin and
norephinephrine
Starving, bingeing and purging in and of themselves can alter brain
chemistry
Both undereating and overeating can activate brain chemicals that
produce feelings of peace and euphoria, thus temporarily dispelling
anxiety and depression. Leading some to conclude that food is used to
self-medicate painful feelings and distressing moods.
New research suggests that there is a biological link between stress
and the drive to eat. Comfort foods — high in sugar, fat, and calories —
seem to calm the body’s response to chronic stress.
6. Risk Factors
Psychological Risk Factors
Low self-worth and low-self esteem /Feelings of inadequacy
Obsessive behaviors regarding food and diets and may often also
display obsessive-compulsive personality traits in other parts of
their life.
A strong, even extreme drive for perfectionism.
They have unrealistic expectations of themselves and others
In spite of their many achievements, they feel inadequate.
They see the world dichotomously
individuals who develop anorexia are led to think that they are never
thin enough regardless of how much weight is lost.
Negative affect: depression, anxiety, anger, stress or loneliness
A sense of lack of control in life
7. Risk Factors
Psychological Risk Factors
Wanting to take control and fix things in an unhappy life, but
not really knowing how, and under the influence of a culture
that equates success and happiness with thinness, the person
tackles her/his body instead of the problem at hand.
Dieting, bingeing, purging, exercising, and other strange
behaviors are not random craziness, but misguided and
ineffective, attempts to take charge in a world that seems
overwhelming.
8. Risk Factors
Interpersonal
Troubled personal relationships
Difficulty expressing emotions and feelings (including
alexthymia)
History of being teased or ridiculed based on size or weight;
History of physical or sexual abuse.
Some people with eating disorders use the behaviors to
avoid sexuality.
Others use them to try to take control of themselves and
their lives by creating and winning the power struggles
inside
9. Risk Factors
Interpersonal
Inside they still they feel weak, powerless, victimized,
defeated, and resentful.
People with eating disorders often lack a sense of identity.
They try to define themselves by manufacturing a socially
approved and admired exterior.
People with eating disorders often are legitimately angry, but
because
They seek approval and fear criticism,
They do not know how to express their anger in healthy ways.
They feel “fat.”
They turn it against themselves by starving or stuffing.
10. Risk Factors
Interpersonal
Appearance-obsessed friends or romantic partners, sorority
houses, theatre troupes, dance companies and sports that
emphasize size and weight can foster eating disordered
behavior
Some may be withdrawn with only superficial or conflicted
connections to other people.
Others may seem to be living exciting lives filled with friends
and social activities, but will confess that they do not feel
they really fit in, that no one seemed to really understand
them, and that they had no true friends or confidants with
whom they could share thoughts, feelings, doubts,
insecurities, fears, hopes, ambitions,
Often they desperately want healthy connections to others
but fear criticism and rejection
11. Risk Factors
Family Risk Factors
Family history of an eating disorder
Familial attitudes toward weight, dieting and eating
Overvaluing appearance
Making jokes about appearance
Deficit in emotional support
Overly enmeshed or detached family dynamics: Smothered in
overprotective families, or abandoned, misunderstood, and
alone
Addiction within the family or other causes of significant family
disruption
Parents who focus primarily on success and performance rather
than on the youth as a whole person.
12. Risk Factors
Family Risk Factors
These families tend to be overprotective, rigid, and ineffective at
resolving conflict.
Sometimes mothers are emotionally cool while fathers are physically
or emotionally absent.
There are high expectations of achievement and success.
Children learn not to disclose doubts, fears, anxieties, and
imperfections.
Instead they try to solve their problems by manipulating weight and
food.
(Am J Clin Nutr 2003;78:215) indicates that when parents restrict
eating, children are more likely to eat when they are not hungry.
The more severe the restriction, the stronger the desire to eat
prohibited foods, setting the stage for a full blown eating disorder in
the future
13. Risk Factors
Sociocultural Risk Factors
Western culture’s desire for thinness and displays of extreme,
unrealistic thinness as beautiful
Success and self-worth are commonly associated with being thin in
this culture.
Peer pressure and teasing others about looks or weight.
Sports that emphasize appearance, weight requirements or
muscularity. For example: gymnastics, diving, bodybuilding or
wrestling.
Sports that focus on the individual rather than the entire team. For
example: gymnastics, running, figure skating, dance or diving, versus
teams sports such as basketball or soccer.
Endurance sports such as track and field/running, swimming.
Overvalued belief that lower body weight will improve performance.
Training for a sport since childhood or being an elite athlete.
14. Risk Factors
Sociocultural Risk Factors
Western culture’s desire for thinness and displays of extreme, unrealistic thinness
as beautiful. Photoshop Acne
Success and self-worth are commonly associated with being thin in this culture.
Happy People
Peer pressure and teasing others about looks or weight.
Sports that emphasize appearance, weight requirements or muscularity.
Endurance sports such as track and field/running, swimming.
Overvalued belief that lower body weight will improve performance.
Training for a sport since childhood or being an elite athlete.
Media
Reading between the lines of many ads reveals a not-so-subtle message — “You are
not acceptable the way you are. The only way you can become acceptable is to buy
our product and try to look like our model (who is six feet tall and wears size four
jeans — and is probably anorexic). If you can’t quite manage it, better keep buying
our product. It’s your only hope.”
An important question for people who watch TV, read magazines, and go to movies
— do these media present images that open a window on the real world, or do they
hold up a fun house mirror in which the reflections of real people are distorted into
impossibly tall, thin sticks
15. Risk Factors
Three risk factors are thought to particularly contribute to
a female athlete’s vulnerability to developing an eating
disorder:
Social influences emphasizing thinness
Performance anxiety
Negative self-appraisal of athletic achievement.
A fourth factor is identity solely based on participation in
athletics.
16. Risk Factors
The Female Athlete Triad
Disordered eating, amenorrhea, and osteoporosis.
Disordered eating can cause amenorrhea which leads to calcium
and bone loss, putting the athlete at greatly increased risk for
stress fractures of the bones.
While any female athlete can develop the triad, adolescent
girls are most at risk because of the active biological changes
and growth spurts, peer and social pressures, and rapidly
changing life circumstances that go along with the teenage
years.
17. Checklist
A panel at the 2004 International Conference on Eating Disorders in
Orlando, Florida, suggested the following screening checklist
High weight concerns before age 14
High level of perceived stress
Behavior problems before age 14
History of dieting
Mother/sibling/peers diet and is concerned about appearance
Negative self-evaluation
Perfectionism
No male friends
Parental control/enmeshment
Rivalry with one or more siblings
Competitive with siblings’ shape and/or appearance
Shy and/or anxious
Distressed by parental arguments or life events occurring in the year before the
illness develops
Critical comments or teasing from family members or friends about weight,
shape and eating
18. Protective Factors
Protective Factors:
Positive, person-oriented coaching/parenting style rather than
negative, performance-oriented coaching style.
Social influence and support from teammates/friends with
healthy attitudes towards size and shape.
Coaches/parents who emphasize factors that contribute to
personal success such as motivation and enthusiasm rather
than body weight or shape.
Coaches and parents who educate, talk about and support the
changing female body
Coaches and parents who model as well as teach healthy
coping skills and how to deal with failure
19. Red Flags
Skipping meals
Making excuses for not eating
Eating only a few certain "safe" foods
Adopting rigid meal or eating rituals, such as spitting food out after chewing
Cooking elaborate meals for others but refusing to eat
Repeated weighing or measuring of themselves
Frequent checking in the mirror for perceived flaws
Complaining about being fat
Not wanting to eat in public
Calluses on the knuckles and eroded teeth if inducing vomiting
Covering up in layers of clothing
Disappearing shortly after a meal
Swollen salivary glands and/or puffy face
20. Assessment
Be alert throughout assessment and treatment to signs of bullying,
teasing, abuse (emotional, physical and sexual) and neglect.
When assessing a person with a suspected eating disorder, find out what
they and their family members know about eating disorders and address
any misconceptions.
Offer people with an eating disorder and their family members education
and information on:
the nature and risks of the eating disorder and how it is likely to affect them
the treatments available and their likely benefits and limitations.
When communicating with people with an eating disorder and their family
members
Be sensitive when discussing a person's weight and appearance
Be aware that family members may feel guilty and responsible for the eating
disorder (or may have no issue with it)
Show empathy, compassion and respect
Provide information in a format suitable for them, and check they understand it.
21. Areas for Assessment
History
General clinical
Height/weight
Blood pressure
Pulse
Nutrition
Exercise
Mental Status
Orientation
Obsessions
SI/HI
22. Areas for Assessment cont…
History
A disproportionate concern about their weight or shape
Problems managing a chronic illness that affects diet, such as
diabetes or celiac disease
Menstrual or other endocrine disturbances, or unexplained
gastrointestinal symptoms
Physical signs of malnutrition, including poor circulation, dizziness,
palpitations, fainting or pallor, delayed puberty
Compensatory behaviors, including laxative or diet pill misuse,
vomiting or excessive exercise
Abdominal pain that is associated with vomiting or restrictions in
diet, and that cannot be fully explained by a medical condition
Whether they take part in activities associated with a high risk of
eating disorders (i.e. professional sport, dance, or modeling).
23. Areas for Assessment
History
Family
MH/Addiction
Obesity
Attitudes about weight, shape and eating
Family interactions in relation to the patient’s disorder
Family attitudes toward eating, exercise, and appearance
Identify family stressors whose amelioration may facilitate
recovery
Involve parents/household members and, whenever appropriate,
health professionals who routinely work with the patient
24. Assessment
When assessing for an eating disorder or deciding whether
to refer people for assessment, take into account any of
the following that apply:
An unusually low or high BMI or body weight for their age
Rapid weight loss
Dieting or restrictive eating practices (such as dieting when
they are underweight) that are worrying them, their family
members, or professionals
Family members report a change in eating behavior
Social withdrawal, particularly from situations that involve
food
Other mental health problems
25. Ongoing Assessment
During treatment, it is important to monitor the patient for
Shifts in weight
Blood pressure
Pulse and other cardiovascular parameters
Behaviors likely to provoke physiological decline and collapse
Increasing levels of anxiety, self-harm and/or suicidal ideation
Patients with a history of purging behaviors should also be
referred for a dental examination
Bone density examinations should be obtained for patients who
have been amenorrheic for 6 months or more
26. Physical Complications of Anorexia
Weakness
Fatigue
Palpitations
Faintness
Shortness of breath
Chest pain
Bradycardia
Hypotension
Cold intolerance
Abdominal pain
Apathy
Poor concentration
Food obsessions
Irritability
Depression
Seizures
Reduced bone density
Cavities
Gingivitis
Hair loss or brittle hair
Muscle weakness
Arrested development of
secondary sex characteristics
28. Assessment Instruments
(EDI-3™) Eating Disorder Inventory-3™ (Garner)
Behavior and attitudes toward food, weight and body image,
ineffectiveness, low self-esteem, perfectionism, interpersonal
distrust, interoceptive awareness, identification and maturity
fears
EDE-Q Eating Disorders Examination Questionnaire
(Fairburn)
Restraint, weight concern, shape concern
ACTA Attitude Regarding Change in Eating Disorders (Beato)
Assessment of attitude regarding change in ED
Other instruments including the BDI, STAI, Barratt
Impulsiveness Scale, Millon Clinical Multiaxial Inventory
(personality)
29. Placement
Factors suggesting that hospitalization may be appropriate
include:
Rapid or persistent decline in oral intake
A decline in weight despite maximally intensive outpatient or partial
hospitalization interventions
The presence of additional stressors that may interfere with the
patient’s ability or willingness to eat
Knowledge of the weight at which instability previously occurred
Co-occurring psychiatric problems
The degree of the patient’s denial and resistance to participate in
his or her own care in less intensively supervised settings
30. Placement
Partial Hospitalization
The more successful programs meet at least 5 days/week for
8 hours/day
Careful monitoring includes weight determinations 2-3x/week
done directly after the patient voids and while the patient is
wearing the same class of garment
It is important to routinely monitor
Serum electrolytes
Urine specific gravity
Blood pressure
Oral temperatures
31. Summary
There are a myriad of psychological, biological, interpersonal,
familial and sociocultural factors which may contribute to the
development of eating disorders
Unlike mood disorders, clinicians working with patients with
eating disorders must be vigilant about monitoring basic vital
signs and ensuring health monitoring
The initial assessment needs to explore not only biological and
psychological factors which may have contributed to the
development, but also what is maintaining that.
It is important to remember that many patients with eating
disorders have poured over literature regarding health and
nutrition, and the disorder is about much more than food.
What does it mean to gain weight?
What will happen if you gain 5 pounds?
32. Summary
People with eating disorders are very afraid of rejection
and criticism and may lash out or lash in at perceived
slights
Help the person with an eating disorder
Understand the function of food/shape/restriction for them
Develop a healthier self esteem and sense of self efficacy
Learn how to cope with stress
Improve communication skills and emotional vocabulary
Develop strategies to deal with the media and cultural and
peer pressure