This document discusses eating disorders and related topics. It provides statistics showing that eating disorders are common, especially among young women, and that societal pressures around weight and thinness contribute to their development. The document examines various theories for what causes eating disorders, including genetic, biological, psychological, and socio-cultural factors. Family dynamics and mood disorders are also discussed as potential risk factors. The diagnostic criteria for eating disorders from the DSM-5 such as anorexia nervosa, bulimia nervosa, and binge eating disorder are summarized.
Eating disorder : symptoms, Diagnosis and treatment Heba Essawy, MD
This document outlines eating disorders including anorexia nervosa, bulimia nervosa, binge-eating disorder, and obesity. It discusses the diagnostic criteria, epidemiology, risk factors, medical complications, treatment including therapy and medications, and prognosis for each disorder. Diagnostic tools such as the Eating Disorder Inventory are also mentioned. The document is presented by Dr. Heba Essawy and provides an overview of eating disorders for information and education purposes.
There are three main categories of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders are caused by a combination of genetic and environmental factors, including family history of psychiatric disorders, childhood abuse, and beliefs about self-worth being tied to appearance and thinness. Diagnosis involves medical assessment, psychological evaluation, and meeting DSM-IV criteria for the specific disorder. Treatment aims to achieve healthy eating habits, body image, and prevent relapse using therapies like cognitive behavioral therapy and antidepressants when needed.
- Anorexia nervosa is characterized by self-induced starvation, an intense fear of gaining weight, and a disturbance in body image. It commonly occurs in mid-to-late adolescence and is more prevalent among females. Treatment involves hospitalization, psychotherapy including CBT, and sometimes pharmacotherapy. Prognosis is often poor, with high mortality rates.
- Bulimia nervosa involves recurrent binge eating followed by compensatory behaviors to prevent weight gain like purging. It affects about 1% of the population and is more common than anorexia. Biological and psychosocial factors may contribute to its development. Treatment focuses on CBT and antidepressant medication can also help reduce symptoms. Prognosis
The document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It provides information on the diagnostic criteria, prevalence, physical effects, course, and prognosis of these disorders. Specifically, it notes that while anorexia nervosa causes significant weight loss, individuals with bulimia nervosa do not lose weight in the same way due to binge eating and compensatory behaviors like purging. The etiology of eating disorders involves genetic, sociocultural, and psychological factors.
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.
This document provides an overview of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and obesity. It describes the general characteristics and diagnostic criteria for each disorder according to the DSM-V. For anorexia nervosa and bulimia nervosa, it outlines their epidemiology, biological and psychological etiologies, clinical features, treatment approaches, and prognosis. It also discusses the Eating Disorder Inventory assessment and compares some key aspects of anorexia nervosa and bulimia nervosa.
Power Point Presentation Eating Disordersyadirabonilla
The document discusses eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder, and obesity. It outlines the biological, psychological, developmental, and social risk factors for developing eating disorders. It also describes the signs and symptoms, medical consequences, and treatment approaches for anorexia nervosa and bulimia nervosa. The conclusion emphasizes the importance of seeking treatment early and provides suggestions for recovery such as making a support system, focusing on solutions, and trying new behaviors.
Eating disorder : symptoms, Diagnosis and treatment Heba Essawy, MD
This document outlines eating disorders including anorexia nervosa, bulimia nervosa, binge-eating disorder, and obesity. It discusses the diagnostic criteria, epidemiology, risk factors, medical complications, treatment including therapy and medications, and prognosis for each disorder. Diagnostic tools such as the Eating Disorder Inventory are also mentioned. The document is presented by Dr. Heba Essawy and provides an overview of eating disorders for information and education purposes.
There are three main categories of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders are caused by a combination of genetic and environmental factors, including family history of psychiatric disorders, childhood abuse, and beliefs about self-worth being tied to appearance and thinness. Diagnosis involves medical assessment, psychological evaluation, and meeting DSM-IV criteria for the specific disorder. Treatment aims to achieve healthy eating habits, body image, and prevent relapse using therapies like cognitive behavioral therapy and antidepressants when needed.
- Anorexia nervosa is characterized by self-induced starvation, an intense fear of gaining weight, and a disturbance in body image. It commonly occurs in mid-to-late adolescence and is more prevalent among females. Treatment involves hospitalization, psychotherapy including CBT, and sometimes pharmacotherapy. Prognosis is often poor, with high mortality rates.
- Bulimia nervosa involves recurrent binge eating followed by compensatory behaviors to prevent weight gain like purging. It affects about 1% of the population and is more common than anorexia. Biological and psychosocial factors may contribute to its development. Treatment focuses on CBT and antidepressant medication can also help reduce symptoms. Prognosis
The document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It provides information on the diagnostic criteria, prevalence, physical effects, course, and prognosis of these disorders. Specifically, it notes that while anorexia nervosa causes significant weight loss, individuals with bulimia nervosa do not lose weight in the same way due to binge eating and compensatory behaviors like purging. The etiology of eating disorders involves genetic, sociocultural, and psychological factors.
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.
This document provides an overview of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and obesity. It describes the general characteristics and diagnostic criteria for each disorder according to the DSM-V. For anorexia nervosa and bulimia nervosa, it outlines their epidemiology, biological and psychological etiologies, clinical features, treatment approaches, and prognosis. It also discusses the Eating Disorder Inventory assessment and compares some key aspects of anorexia nervosa and bulimia nervosa.
Power Point Presentation Eating Disordersyadirabonilla
The document discusses eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder, and obesity. It outlines the biological, psychological, developmental, and social risk factors for developing eating disorders. It also describes the signs and symptoms, medical consequences, and treatment approaches for anorexia nervosa and bulimia nervosa. The conclusion emphasizes the importance of seeking treatment early and provides suggestions for recovery such as making a support system, focusing on solutions, and trying new behaviors.
Complex eating disorder characterized by obsessive pursuit of thinness through dieting with extreme weight loss and disturbance of body image
Anorexia nervosa is typically characterized by
voluntary restriction of food intake ,distorted body image and fear of gaining weight
This document defines and provides diagnostic criteria for several feeding and eating disorders including pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified and unspecified feeding or eating disorders. The disorders are characterized by disturbances in eating behaviors and attitudes toward food that impair physical or psychosocial functioning. Diagnosis involves persistent inappropriate eating or feeding behaviors and meeting additional criteria regarding weight, control over eating, body image, or compensatory behaviors.
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?
This document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It defines them as mental illnesses involving serious disturbances in diet and discusses their signs, symptoms, causes and risk factors. Anorexia is characterized by an abnormally low body weight from excessive dieting and fear of gaining weight. Bulimia involves binge eating followed by purging. Both have physical, emotional and behavioral symptoms. Treatment involves medical care, psychotherapy, support groups and addressing the psychological and social factors contributing to the disorders.
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 document summarizes facts and information about eating disorders. It states that 20 million women and 10 million men in the US will suffer from an eating disorder in their lifetime. Body dissatisfaction is a major risk factor and many girls as young as 6 express concerns about weight and shape. It describes the main types of eating disorders - anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding/eating disorders. It covers symptoms, health effects, contributing factors, treatment approaches including cognitive behavioral therapy and stages of recovery, and prevention strategies.
An eating disorder is a condition affecting eating habits that can be self-inflicted or a bodily reaction to food. Anorexia nervosa is characterized by low body weight, distorted body image, and an obsessive fear of weight gain. Bulimia nervosa involves frequent episodes of binge eating followed by purging to avoid weight gain. Medical treatment for eating disorders includes nutritional therapy, counseling, and potentially hospitalization to restore healthy eating and weight.
Eating disorders are complex conditions that arise from a combination of psychological, interpersonal, and social factors. The document discusses three main eating disorders: anorexia nervosa, bulimia, and binge eating disorder. People with eating disorders often use food and control of food to cope with difficult emotions. Common behaviors include restrictive eating, excessive exercise, bingeing and purging. The development of eating disorders is influenced by factors like low self-esteem, depression, relationship issues, and sociocultural pressures related to body image.
This document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It covers the clinical picture, medical complications, risk factors, comorbidities, prognosis and treatment options. Anorexia is characterized by weight loss and fear of gaining weight while bulimia involves binge eating and compensatory behaviors. Both have higher prevalence in females and can lead to long term medical issues if not properly treated through psychotherapy and medication.
Dissociation refers to feeling disconnected from one's environment or self. Those with dissociative disorders experience persistent episodes of dissociation that severely impact daily life. The four main types of dissociative disorders are dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder. Treatment for dissociative disorders typically involves psychotherapy and managing stress, as childhood trauma is a main underlying cause. Diagnosis can be difficult due to overlapping symptoms with other mental health conditions.
This document discusses the psychopathology of eating disorders. It defines eating disorders and outlines the DSM-5 classification system, which includes pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder. It then examines psychological theories including psychodynamic, cognitive, and behavioral theories. Key psychodynamic differences between anorexia and bulimia are presented. Cognitive theory focuses on irrational beliefs and schemas while behavioral theory explores conditioning and observational learning influences. Obesity is discussed as an abnormal eating behavior rather than a disorder.
Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is characterized by two or more distinct personalities that take control of a person. Psychotherapy is the primary treatment, involving establishing trust and safety, mapping alters and trauma history, processing trauma memories, and integrating alters. Integration aims to unite alters into a single identity, while resolution stabilizes alter cooperation. Relapse is common, requiring ongoing treatment to solidify gains and prevent dissociative coping.
This is for a high school AP Psychology course. This is a fictionalized account of having a psychological aliment. For questions about this blog project or its contents please email the teacher Chris Jocham: jocham@fultonschools.org.
- Eating disorders are common among teenagers and young adults, especially females, with over half of teenage girls and one-third of boys using unhealthy weight control behaviors. Anorexia and bulimia typically onset during adolescence or early adulthood.
- Anorexia is characterized by self-starvation and excessive weight loss due to a distorted body image. Bulimia involves binge eating followed by purging. Both can have severe physical and psychological consequences if not treated.
- The development of eating disorders is influenced by a combination of genetic, personality, and socio-environmental factors such as low self-esteem, perfectionism, family relationships, and societal pressures related to body image.
This slide contains information regarding Dissociative Disorder. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
Cluster A personality disorders include paranoid, schizoid, and schizotypal personality disorders. They are characterized by odd, aloof features. Paranoid personality disorder involves pervasive distrust and suspiciousness of others. Schizoid personality disorder involves detachment from social relationships and a restricted range of emotions. Schizotypal personality disorder involves acute discomfort with and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior. Genetic and biological factors may contribute to the development of these disorders. Psychotherapy is the primary treatment approach.
This document provides an overview of culture-bound syndromes (CBS), which are illnesses or disorders that occur exclusively in certain cultures. It defines CBS and outlines their history and classification. Several specific CBS are described in detail, including koro (genital retraction syndrome), dhat syndrome, hwa-byung, ataque de nervios, and brain fag. The document examines the proposed causes and key symptoms of each syndrome and notes their typical cultural contexts. In total, over 20 different CBS are referenced from cultures around the world.
This is a presentation prepared fromPoulios Vasilis and Bakolas Giorgos during the course of English, for our comenius project Be Globaly aware. 1st Gymnasio Neou Psychikou.
This document discusses eating disorders and provides information about their types, symptoms, and causes. It defines eating disorders as serious mental illnesses that cause disturbances in eating habits and discusses four main types: anorexia nervosa, bulimia nervosa, binge eating disorder, and NOS. For each type, it provides descriptions of symptoms and health risks. Finally, it discusses psychological, interpersonal, social/cultural, and biological factors that may contribute to why people develop eating disorders, such as low self-esteem, stress, family relationships, cultural pressures around body image, and genetic components.
Complex eating disorder characterized by obsessive pursuit of thinness through dieting with extreme weight loss and disturbance of body image
Anorexia nervosa is typically characterized by
voluntary restriction of food intake ,distorted body image and fear of gaining weight
This document defines and provides diagnostic criteria for several feeding and eating disorders including pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified and unspecified feeding or eating disorders. The disorders are characterized by disturbances in eating behaviors and attitudes toward food that impair physical or psychosocial functioning. Diagnosis involves persistent inappropriate eating or feeding behaviors and meeting additional criteria regarding weight, control over eating, body image, or compensatory behaviors.
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?
This document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It defines them as mental illnesses involving serious disturbances in diet and discusses their signs, symptoms, causes and risk factors. Anorexia is characterized by an abnormally low body weight from excessive dieting and fear of gaining weight. Bulimia involves binge eating followed by purging. Both have physical, emotional and behavioral symptoms. Treatment involves medical care, psychotherapy, support groups and addressing the psychological and social factors contributing to the disorders.
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 document summarizes facts and information about eating disorders. It states that 20 million women and 10 million men in the US will suffer from an eating disorder in their lifetime. Body dissatisfaction is a major risk factor and many girls as young as 6 express concerns about weight and shape. It describes the main types of eating disorders - anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding/eating disorders. It covers symptoms, health effects, contributing factors, treatment approaches including cognitive behavioral therapy and stages of recovery, and prevention strategies.
An eating disorder is a condition affecting eating habits that can be self-inflicted or a bodily reaction to food. Anorexia nervosa is characterized by low body weight, distorted body image, and an obsessive fear of weight gain. Bulimia nervosa involves frequent episodes of binge eating followed by purging to avoid weight gain. Medical treatment for eating disorders includes nutritional therapy, counseling, and potentially hospitalization to restore healthy eating and weight.
Eating disorders are complex conditions that arise from a combination of psychological, interpersonal, and social factors. The document discusses three main eating disorders: anorexia nervosa, bulimia, and binge eating disorder. People with eating disorders often use food and control of food to cope with difficult emotions. Common behaviors include restrictive eating, excessive exercise, bingeing and purging. The development of eating disorders is influenced by factors like low self-esteem, depression, relationship issues, and sociocultural pressures related to body image.
This document discusses eating disorders such as anorexia nervosa and bulimia nervosa. It covers the clinical picture, medical complications, risk factors, comorbidities, prognosis and treatment options. Anorexia is characterized by weight loss and fear of gaining weight while bulimia involves binge eating and compensatory behaviors. Both have higher prevalence in females and can lead to long term medical issues if not properly treated through psychotherapy and medication.
Dissociation refers to feeling disconnected from one's environment or self. Those with dissociative disorders experience persistent episodes of dissociation that severely impact daily life. The four main types of dissociative disorders are dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder. Treatment for dissociative disorders typically involves psychotherapy and managing stress, as childhood trauma is a main underlying cause. Diagnosis can be difficult due to overlapping symptoms with other mental health conditions.
This document discusses the psychopathology of eating disorders. It defines eating disorders and outlines the DSM-5 classification system, which includes pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder. It then examines psychological theories including psychodynamic, cognitive, and behavioral theories. Key psychodynamic differences between anorexia and bulimia are presented. Cognitive theory focuses on irrational beliefs and schemas while behavioral theory explores conditioning and observational learning influences. Obesity is discussed as an abnormal eating behavior rather than a disorder.
Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is characterized by two or more distinct personalities that take control of a person. Psychotherapy is the primary treatment, involving establishing trust and safety, mapping alters and trauma history, processing trauma memories, and integrating alters. Integration aims to unite alters into a single identity, while resolution stabilizes alter cooperation. Relapse is common, requiring ongoing treatment to solidify gains and prevent dissociative coping.
This is for a high school AP Psychology course. This is a fictionalized account of having a psychological aliment. For questions about this blog project or its contents please email the teacher Chris Jocham: jocham@fultonschools.org.
- Eating disorders are common among teenagers and young adults, especially females, with over half of teenage girls and one-third of boys using unhealthy weight control behaviors. Anorexia and bulimia typically onset during adolescence or early adulthood.
- Anorexia is characterized by self-starvation and excessive weight loss due to a distorted body image. Bulimia involves binge eating followed by purging. Both can have severe physical and psychological consequences if not treated.
- The development of eating disorders is influenced by a combination of genetic, personality, and socio-environmental factors such as low self-esteem, perfectionism, family relationships, and societal pressures related to body image.
This slide contains information regarding Dissociative Disorder. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
Cluster A personality disorders include paranoid, schizoid, and schizotypal personality disorders. They are characterized by odd, aloof features. Paranoid personality disorder involves pervasive distrust and suspiciousness of others. Schizoid personality disorder involves detachment from social relationships and a restricted range of emotions. Schizotypal personality disorder involves acute discomfort with and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior. Genetic and biological factors may contribute to the development of these disorders. Psychotherapy is the primary treatment approach.
This document provides an overview of culture-bound syndromes (CBS), which are illnesses or disorders that occur exclusively in certain cultures. It defines CBS and outlines their history and classification. Several specific CBS are described in detail, including koro (genital retraction syndrome), dhat syndrome, hwa-byung, ataque de nervios, and brain fag. The document examines the proposed causes and key symptoms of each syndrome and notes their typical cultural contexts. In total, over 20 different CBS are referenced from cultures around the world.
This is a presentation prepared fromPoulios Vasilis and Bakolas Giorgos during the course of English, for our comenius project Be Globaly aware. 1st Gymnasio Neou Psychikou.
This document discusses eating disorders and provides information about their types, symptoms, and causes. It defines eating disorders as serious mental illnesses that cause disturbances in eating habits and discusses four main types: anorexia nervosa, bulimia nervosa, binge eating disorder, and NOS. For each type, it provides descriptions of symptoms and health risks. Finally, it discusses psychological, interpersonal, social/cultural, and biological factors that may contribute to why people develop eating disorders, such as low self-esteem, stress, family relationships, cultural pressures around body image, and genetic components.
Here are a few thoughts on combining Feeding and Eating Disorders:
- It makes sense to group them together as they are both disorders involving food/nutrition. Looking at them together provides a more holistic perspective.
- Feeding disorders often occur in infants/children while eating disorders usually emerge later, but there is overlap in symptoms, behaviors and treatments. Combining the categories acknowledges the relationships and developmental trajectories.
- An integrated approach may help identify issues earlier on before they escalate into more serious disorders. It also promotes considering the biological, psychological and social aspects of each.
- Parents/practitioners may find it less confusing than separate categories. It provides a unified framework for assessment, diagnosis and intervention across
Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health.
Up to 4% of adolescents and young adults suffer from eating disorders like anorexia nervosa and bulimia nervosa. Anorexia nervosa is characterized by refusal to maintain a healthy body weight and an intense fear of gaining weight. Bulimia nervosa involves recurrent binge eating and compensatory behaviors like purging. Both disorders involve biological factors like changes in neurotransmitters and hormones as well as psychological and social factors like perfectionism, low self-esteem, and troubled family relationships. They have varying mortality rates, symptoms, comorbidities, and treatments depending on the specific type and characteristics of each case.
This document provides an overview of organic brain disorders including the definition, clinical features, etiology, diagnosis, and management. Some key points:
- Organic brain disorders are caused by primary brain pathology or secondary brain dysfunction due to systemic disease. Common causes include neurodegenerative disorders, vascular disorders, infections, tumors, and toxic/metabolic disorders.
- Delirium is characterized by acute onset of confusion and impaired consciousness. Dementia is a chronic disorder characterized by cognitive decline over months to years. Organic amnestic syndrome specifically involves memory impairment.
- Evaluation involves medical history, physical/neuro exam, and lab/imaging tests to identify underlying causes. Treatment focuses on correcting any reversible causes as
This document lists and defines several eating disorders including nervous anorexia, nervous bulimia, orthorexia, vigorexia, seudorexia, potomania, drunkorexia, sadorexia, consumer syndrome, and pregorexia. It provides a high-level overview of the different types of eating disorders mentioned without descriptions of each one.
Thiamine, also known as vitamin B1, is an essential nutrient that plays a key role in carbohydrate metabolism. It consists of a pyrimidine ring connected to a thiazole ring. Thiamine acts as a cofactor for several enzymes involved in the breakdown of carbohydrates and the citric acid cycle. Deficiency of thiamine can cause diseases like beriberi, which presents as either "wet" beriberi with edema or "dry" beriberi with neurological symptoms. Treatment involves high doses of thiamine supplementation.
This document discusses vitamin B1 (thiamine). It begins by classifying B1 as a water-soluble vitamin that is part of the B-complex group. It then describes B1's functions in energy metabolism and as a coenzyme. Sources of B1 are also listed, including pork, liver, beans and enriched grains. The document concludes by covering absorption in the small intestine, deficiencies that can arise from inadequate intake such as beriberi, and issues related to toxicity.
Binge eating disorder is characterized by eating unusually large amounts of food and feeling out of control during binges. Unlike bulimia or anorexia, people with binge eating disorder do not purge their food. It is estimated that about 2% of US adults have binge eating disorder, which affects women slightly more than men. Potential causes include depression, dieting, using food to cope with emotions, and biological factors like brain chemistry. Treatment options include nutritional counseling, cognitive behavioral therapy, and antidepressant or appetite suppressant medication under a doctor's supervision.
Thiamine (vitamin B1) is an essential cofactor required for several enzyme reactions involved in carbohydrate metabolism. It is present in plant and microbial sources but not synthesized by animals. A deficiency impairs the metabolism of pyruvate, α-ketoglutarate, and branched-chain amino acids, most severely affecting the nervous system and heart. Deficiency causes diseases like beriberi, characterized by peripheral neuropathy or heart failure. Treatment involves high-dose thiamine supplementation.
Rumination Monitoring White Paper - Heat Detection SystemSCR - Dairy Farming
Rumination is a proven indicator of cow health and wellbeing. Electronic rumination monitoring provides dairy producers early detection of health issues, enables nutrition management, and improves heat detection. The SCR Heatime HR System constantly monitors individual cow rumination and activity. Sudden drops in average rumination alerted one farm to remove a soy component causing issues, and rumination increased once removed. Electronic rumination monitoring improves herd health and productivity.
The document discusses eating disorders and their biological causes. It describes the three main types of eating disorders - anorexia, bulimia, and binge eating - and their defining characteristics. It then explains several biological factors that may contribute to eating disorders, including heritability, hypothalamic activity, serotonin levels, estrogen levels, and irregularities in neurotransmitters like dopamine and cortisol. Genetics and hormones like estrogen appear to make some individuals more susceptible during puberty.
This document provides an outline and introduction for a seminar on eating disorders presented by Dr. Diptadhi Mukherjee and moderated by Dr. D.J. Chetia at LGBRIMH, Tezpur on 23/09/15. The seminar covered the history, epidemiology, etiology, nosology, differential diagnosis, comorbidity, complications, Indian scenario, and management of eating disorders. It discussed the main eating disorders of anorexia nervosa, bulimia nervosa, and binge eating disorder. The seminar emphasized the multifactorial nature of eating disorders and recommended a multidisciplinary treatment approach.
The document discusses eating disorders such as anorexia and bulimia. It provides information on triggers such as negative self-image and media influence. It describes the consequences of eating disorders which can be social, psychological, mental, and medical. It defines anorexia as extreme weight loss and fear of gaining weight. Bulimia involves binge eating and then vomiting or using laxatives. The document provides tips to avoid eating disorders such as being happy with yourself, not comparing to others, talking to someone about problems, and remembering the negative health impacts.
This document discusses eating disorders and provides information on hunger, satiation, satiety, and the female athlete triad. It defines key terms and concepts and describes anorexia nervosa, bulimia, compulsive exercise, and binge-eating disorder. Dietary strategies are presented for combating different eating disorders, including gradually increasing calorie intake for anorexia and planning meals to prevent binging for bulimia. Sports with high risks for eating disorders are also identified.
1) Substance abuse and dependence are significant problems, with over 15% of the US population over 18 having a serious substance use disorder, mostly involving alcohol or other drugs.
2) Substance use disorders involve both behavioral and physical dependence, and are considered medical disorders rather than character flaws.
3) The DSM-IV classification system categorizes several substance-induced disorders outside of the main substance use disorders category, including substance-induced persisting dementia and substance-induced psychotic disorders.
This document discusses gender dysphoria and provides instruction for classroom activities on the topic. It begins with defining gender dysphoria as experiencing a mismatch between biological sex and gender identity. Students are asked to complete tasks studying the signs and symptoms of gender dysphoria, biological and psychological explanations, and the biosocial approach. They read a story about Hannah and analyze it from biological and psychological perspectives. Finally, the document previews that after the Easter break students will have an assessment covering all topics studied so far on gender and psychology, and provides revision instructions.
1. The document discusses human sexual motivation and response, including the four stages of the sexual response cycle, sex hormones like estrogen and testosterone, and sexual disorders.
2. It also covers topics like changing social attitudes toward sex and marriage, sexual orientation arising from multiple influences like genetics and socialization, and the motivation to seek novel stimuli.
3. Research suggests determinants of sexual orientation and motivation involve genetics, prenatal hormone levels, and postnatal socialization.
This document summarizes the symptoms, diagnostic criteria, prevalence, and treatment approaches for gender identity disorder according to the DSM-IV. It describes symptoms in children, adolescents, and adults which include a strong desire to be the opposite sex and discomfort with one's biological sex. Treatment involves psychotherapy, hormone therapy, and potentially sexual reassignment surgery, with the goal of helping individuals live comfortably in their identified gender.
Eating disorders are serious mental illnesses that involve severe disturbances in eating behaviors and thoughts about food, weight, and body shape. They can include eating extremely small or large amounts of food and feeling out of control over eating. Eating disorders frequently coexist with other mental health conditions like depression and anxiety. They are more common in women than men and often begin during adolescence or young adulthood. If left untreated, eating disorders can cause serious physical and mental health problems and even death. Treatment involves a multidisciplinary team to address medical, nutritional, and psychological aspects.
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.
This document provides an overview of nutrition therapy for eating disorders. It discusses how nutrition professionals are essential members of multidisciplinary clinical teams treating eating disorders, possessing knowledge of nutrition, physiology, and skills for promoting behavior change. The document reviews nutrition assessment, interventions, monitoring, and considerations regarding professional boundaries in the treatment of eating disorders. It emphasizes that training and experience in nutrition therapy specific to eating disorders can help achieve positive patient outcomes.
The document discusses risk factors for eating disorders including biological, psychological, developmental, and social factors. It separates risk factors into eating-specific (direct) factors and generalized (indirect) factors. Some key eating-specific biological risks include genetics, appetite regulation, and gender. Key psychological risks include poor body image, maladaptive eating attitudes, and overvaluation of appearance. Developmental risks include identifications with body-concerned relatives/peers and trauma affecting bodily experience. Social risks include maladaptive family attitudes toward eating/weight and peer/cultural pressures regarding thinness. The document aims to provide an overview of various risk factors to better understand the development and prevention of eating disorders.
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.
Increasing number of individuals is being diagnosed with eating disorders, as social media and western culture portray thinness as signs of happiness and well-being. Individuals with eating disorders are obsessed with food, body image, and weight loss. Depending on the severity and duration of their illness, they may display physical symptoms such as weight loss, amenorrhea, loss of interest in sex, low blood pressure, depressed body temperature, chronic and unexplained vomiting and the growth of soft, fine hair on the body and face.
Current Therapeutic Approaches in Anorexia Nervosa Edited.pptxRonakPrajapati63
1) Current therapeutic approaches for anorexia nervosa discussed in the document include restricting food intake, binge eating and purging behaviors, cognitive behavioral therapy, family therapy, and medication.
2) Anorexia nervosa is defined by significantly low body weight, an intense fear of gaining weight, and a disturbed perception of body weight and shape. Diagnostic criteria include in the DSM-5 and ICD-10 are discussed.
3) Risk factors for anorexia nervosa include genetic, biological, developmental, psychological, environmental, and social factors. The etiology is complex with both biological and psychosocial components.
This document discusses eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and night eating syndrome. It covers predisposing factors, medical complications, psychiatric complications, nursing diagnoses, care, and treatment. Eating disorders can cause biological changes like malnutrition and even death. Treatment involves stabilizing nutrition, monitoring activity, family involvement, group therapies, and cognitive behavioral therapy to establish healthy eating patterns. The goal is for patients to restore physiological health and normalize body weight and nutrition.
This document discusses the bidirectional relationship between obesity and various psychiatric disorders. It notes that obesity can cause mental health issues due to low self-esteem, stigma, and medical issues, while psychiatric disorders can contribute to obesity through unhealthy behaviors, medication side effects, and reduced support systems. Both conditions are linked by biological and physiological factors like changes to the HPA axis, use of food as a coping mechanism, and effects on dopamine levels. Childhood obesity in particular is connected to future mental health problems. Effective management requires a multidisciplinary team and treatments like psychotherapy, lifestyle changes, and addressing psychosocial factors rather than just focusing on weight loss.
This document discusses prevention of eating addictions. It begins by establishing links between eating and the brain's reward system, and discusses common eating disorders like anorexia and bulimia. Prevention programs should aim to educate the public on signs and risks while also addressing cultural issues and low self-esteem. Effective prevention addresses societal pressures around thinness and gender roles while building self-esteem. Primary prevention targets youth through educating teachers and using books to promote healthy attitudes. Relapse prevention involves follow-up care and helping those recovering identify personal triggers.
Nutrition Assessment of Eating Disordersegonzalezrd
This document provides information on eating disorders including statistics, diagnostic criteria, treatment options, and nutritional considerations. It discusses several specific eating disorders - anorexia nervosa, bulimia nervosa, binge eating disorder, orthorexia, and muscle dysmorphia. For anorexia nervosa, it outlines the diagnostic criteria, demographics, physical and psychological symptoms, dangers including high mortality rate, and nutritional treatment approach. For bulimia nervosa, it describes the diagnostic criteria involving recurrent bingeing and purging as well as the relationship with food.
Part of a 12 part series of courses at AllCEUs.com resulting in the receipt of a certificate in eating disorders counseling. Addresses bulimia, binge eating, anorexia, obesity. Uses The Body Betrayed by Zerbe and Brief Therapy with Eating Disorders by McDonald in addition to Dr. Snipes clinical experiences.
Eating disorders are serious medical illnesses involving severe disturbances in eating behavior and weight regulation. The three main types are anorexia nervosa, bulimia nervosa, and binge-eating disorder, which are characterized by extreme efforts to control weight and shape that can become life-threatening without treatment. Eating disorders frequently co-occur with other illnesses and have high rates of mortality. While the causes are complex and involve genetic, biological, psychological, and social factors, treatment aims to restore nutrition, weight, and stop disordered behaviors through psychotherapy and sometimes medication. Researchers continue studying these illnesses to better understand risk factors and develop more targeted treatments.
This is an in dept look about disorders from a psychological standpoint. The disorders talked in this are eating and anxiety disorders. They are looked at from a Biological, Cognitive, and Socio-Cultural standpoints which are the 3 key areas of research in psychology.
- Approximately 17% of children and 30% of adults in the US are obese. Many obese children become obese adults.
- Obesity is associated with excessive television watching, dietary intake, urban areas, and maternal obesity during pregnancy which increases childhood obesity risk.
- Sara, a 7 year old girl, is progressively gaining weight. Her grandmother encourages sweets while her parents are worried about her health and future obesity risks like diabetes and heart disease.
Anorexia nervosa is an eating disorder characterized by restrictive eating habits and an intense fear of gaining weight. People with anorexia often diet excessively and exercise compulsively in an attempt to lose weight. Long-term effects of anorexia include potential medical complications due to malnutrition as well as psychological issues like depression, anxiety, and social withdrawal. Treatment aims to address the psychological factors driving the disorder and support healthy eating and weight restoration.
This document discusses body image and eating disorders. It provides statistics showing eating disorders have increased threefold in the last 50 years and primarily affect young women. The three main types of eating disorders - anorexia nervosa, bulimia nervosa, and binge-eating disorder - are described. Risk factors for developing an eating disorder include personality, family influence, media exposure, and societal pressures. Treatment is challenging due to lack of motivation and insight from those suffering from eating disorders.
Treasure, J., Claudino, A. M., & Zucker, N. (2010). Eating disorde.docxwillcoxjanay
Treasure, J., Claudino, A. M., & Zucker, N. (2010). Eating disorders. The Lancet, 375(9714), 583-93. Retrieved from http://search.proquest.com/docview/199059169?accountid=87314
Eating disorders
Treasure, Janet; Claudino, Angélica M; Zucker, Nancy.The Lancet375.9714 (Feb 13-Feb 19, 2010): 583-93.
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[...] binge eating disorder is often associated with obesity. Investigators of a study of a large sample of American children aged 9-14 years reported that 7.1% of boys and 13.4% of girls displayed disordered eating behaviours.35 The pivotal effect on health has led to the inclusion of eating disorders among the priority mental illnesses for children and adolescents identified by WHO.36 Eating disorders have been reported worldwide both in developed regions and emerging economies such as Brazil and China.37,38 The lifetime prevalence of eating disorders in adults is about 0.6% for anorexia nervosa, 1% for bulimia nervosa, and 3% for binge eating disorder.19,20 Women are more affected than are men, and the sex differences in lifetime prevalence in adults could be less substantial than that quoted in standard texts: 0.9% for anorexia nervosa, 1.5% for bulimia nervosa, and 3.5% for binge eating disorder in women; and 0.3%, 0.5%, and 2.0%, respectively, in men.20 Many people with eating disorders, who were detected in community studies in the USA, do not seek treatment.20 Pathogenesis A comprehensive review published in 2004 summarised the risk factors for eating disorders,39 and a position paper from the Academy of Eating Disorders outlined the evidence supporting these diseases as biologically-based forms of severe mental illnesses.40 In this section we draw attention to some present areas of emphasis.
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This Seminar adds to the previous Lancet Seminar about eating disorders, published in 2003, with an emphasis on the biological contributions to illness onset and maintenance. The diagnostic criteria are in the process of review, and the probable four new categories are: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. These categories will also be broader than they were previously, which will affect the population prevalence; the present lifetime prevalence of all eating disorders is about 5%. Eating disorders can be associated with profound and protracted physical and psychosocial morbidity. The causal factors underpinning eating disorders have been clarified by understanding about the central control of appetite. Cultural, social, and interpersonal elements can trigger onset, and changes in neural networks can sustain the illness. Overall, apart from studies reporting pharmacological treatments for binge eating disorder, advances in treatment for adults have been scarce, other than interest in new f ...
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
Screening and assessment for internet gaming addictiondrleighholman
This document discusses screening and assessment for internet gaming addiction. It reviews 18 existing screening instruments and finds that they have various limitations and shortcomings. Specifically, they do not all assess the same diagnostic criteria and indicators of addiction. Some key issues are that they do not adequately measure continued use despite harm or deception/secrecy. The document recommends improvements to measures, such as including items to assess personal beliefs about problems or others' views, comorbidities, scoring guidelines, and norms. It summarizes several example instruments and their development and validation.
Diagnostic considerations internet gaming use disorderdrleighholman
This document discusses diagnostic considerations and theories regarding internet gaming addiction. It begins by outlining the debate around whether video games or the internet is the primary platform. It then summarizes Griffiths' video game addiction theory and criteria. Several models and issues with the research are discussed. International prevalence rates are reviewed, with problematic gaming estimated around 3% generally. The DSM-5 criteria for internet gaming disorder is outlined. Etiology, risk factors, differential diagnosis, and comorbidity are explored. Structural characteristics of online games that may contribute to addiction are also summarized.
This document discusses internet gaming addiction and problematic online gaming. It begins by describing how online gamers are more likely to demonstrate problematic use compared to offline gamers. It then provides a history of internet and video game addiction, describing early concepts from the 1970s onward. The document outlines different typologies of games and their associated addiction risks, such as massively multiplayer online role-playing games (MMORPGs) posing the highest risk. Several models of internet gaming addiction and issues with related research and screening/assessment are also summarized.
Gambling use disorder treatment considerationsdrleighholman
This document discusses problem gambling and pathological gambling. It describes three levels of gambling from social gambling to problem and pathological gambling. It outlines the phases gamblers go through from winning to losing to desperation. It also discusses cognitive distortions common in gamblers and treatment approaches like CBT and MI. Medications like naltrexone may help reduce gambling behavior as well as self-exclusion programs and limiting access to funds.
Diagnostic considerations gambling use disorderdrleighholman
The document discusses changes made in the DSM-5 to the classification of Substance-Related Disorders, including renaming the category to Substance Use and Addictive Disorders. Gambling Disorder is included in this category, and Internet Gaming Disorder is included in a separate section. Process and behavioral addictions beyond substance use are also acknowledged. Key diagnostic criteria for Gambling Disorder include preoccupation with gambling, tolerance, withdrawal symptoms, unsuccessful attempts to control gambling, and continuing to gamble despite negative consequences. Epidemiology, course, risk factors, and common comorbidities of Gambling Disorder are also summarized.
Screening & assessment for gambling use disorderdrleighholman
This document provides information on several screening tools that can be used to assess gambling behavior and identify potential gambling disorders. It summarizes the South Oaks Gambling Screen (SOGS), which is a 20-item self-report measure that classifies responses as indicative of no problem, possible problem, or probable pathological gambling. It also describes the Massachusetts Gambling Screen (MAGS), which is a brief 14-item survey that classifies individuals into categories of non-problem, in transition, or pathological gamblers. Additionally, it mentions the Gamblers Anonymous 20 Questions tool and a 2-question rule out tool to screen for problem gambling.
Gambling use disorder process addictionsdrleighholman
This document discusses compulsive gambling and problem gambling. It defines compulsive gambling as gambling behavior that violates one's intentions to limit gambling. Problem gambling is defined as gambling behavior that causes disruptions in major life areas or is associated with impaired functioning. Many of the same symptoms are seen in compulsive gambling as in substance use disorders, including denial of the problem, disruption of families, loss of control, and lying. Screening tools and assessments for problem gambling are also discussed.
This document provides information on screening and assessment tools for eating disorders. It describes several self-report questionnaires and clinical interviews used to screen for and diagnose eating disorders, including the SCOFF questionnaire, Eating Attitudes Test (EAT-26/40), Bulimia Test-Revised (BULIT-R), Eating Disorder Examination (EDE), and Interview for the Diagnosis of Eating Disorders-IV (IDED-IV). Diagnostic criteria from the DSM-5 for anorexia nervosa including associated features are also outlined.
3. Why is this so important?
3
81% of 10 year olds are afraid of being fat
51% of 9 & 10 year old girls feel better about themselves if they are
on a diet
91% college women who had attempted to control their weight
through dieting
22% dieted "often" or "always“
95% of all dieters will regain their lost weight in 1-5 years
55% of "normal dieters" progress to pathological dieting
35% of these progress to partial or full-syndrome eating disorders
Americans spend over $50 billion on dieting and products each
year
58 million of the adult U.S. population are overweight or obese
up from 25% of American adults in 1980 to 33% today
Adapted from: http://www.divorcedoc.com/psychotherapy/statistics.htm
4. What Causes Eating Disorders?
4
Most theorists subscribe to a multidimensional
risk perspective:
Several key factors place individuals at risk
More factors = greater risk
Leading factors:
Sociocultural conditions (societal and family pressures)
Psychological problems (ego, cognitive, and mood disturbances)
Biological factors
5. Eating Disorders:Etiology
5
• Genetics
– Relatives of patients with anorexia are eight times more
likely to develop an eating disorder
– Twin studies:
• Monozygotic twins have a 58-76% concordance, while dizygotic
twins with 35-45% concordance
• Monozygotic twins have a 46%-56% concordance, while dizygotic
twins with 18%-35% concordance for bulimia
• Neurochemical
– Serotonin precursor (5-HIAA) reduced in anorexia when
ill and normalize upon recovery
– Recovery from bulima associated with high levels of
serotonin
6. Eating Disorders:Etiology
Psychosocial
6
Difficulty with transition to adulthood
Changes of body associated with puberty
Adult autonomy
Stressful times of transition
Family conflicts
Ineffective attempts to cope with stress
7. What Causes Eating Disorders?
Societal Pressures
7
Many theorists believe that current Western
standards of female attractiveness have contributed
to increases in eating disorders
Standards have changed throughout history toward a thinner
ideal
Miss America contestants have declined in weight by 0.28 lbs/yr;
winners have declined by 0.37 lbs/yr
Playboy centerfolds have lower average weight, bust, and hip
measurements than in the past
8. What Causes Eating Disorders? Societal Pressures
8
Certain groups are at greater risk from these
pressures:
Models, actors, dancers, and certain athletes
Of college athletes surveyed, 9% met full criteria for an eating
disorder while another 50% had symptoms
20% of surveyed gymnasts met full criteria for an eating disorder
9. What Causes Eating Disorders? Societal Pressures
9
Societal attitudes may explain economic and racial
differences seen in prevalence rates
In the past, white women of higher SES expressed more
concern about thinness and dieting
These women had higher rates of eating disorders than African
American women or white women of lower SES
Recently, dieting and preoccupation with food, along with rates
of eating disorders, are increasing in all groups
10. What Causes Eating Disorders? Societal Pressures
10
The socially accepted prejudice against overweight
people may also add to the “fear” and preoccupation
about weight
About 50% of elementary and 61% of middle school girls are
currently dieting
12. Did you know that…
12
15% of young women in the United States (who are
NOT diagnosed with an eating disorder), have
disordered eating attitudes and behavior, according
to the National Institute of Mental Health.
13. Eating Disorders:
Sociocultural Factors
13
• Anne Becker, Harvard researcher, studied the influence of
American television on eating patterns in Fiji
– Fiji had traditionally been a nation that has cherished the fuller figure
• Since the arrival of TV to the island of Fiji in 1995, the
percentage of eating disorders among young girls aged 15-19
years increased from 3% to 15%
• The number of girls dieting (62 per cent) and girls feeling "too
big or fat" (74 per cent) has also increased since 1995.
• It is believed that the sudden infusion of Western cultural images
and values through TV changed the way Fijian girls view
themselves and their bodies
14. What Causes Eating Disorders? Family Environment
14
Families may play an important role in the
development of eating disorders
As many as half of the families of those with eating disorders
have a long history of emphasizing thinness, appearance, and
dieting
Mothers of those with eating disorders are more likely to be
dieters and perfectionistic themselves
15. What Causes Eating Disorders? Family Environment
15
Abnormal family interactions and forms of
communication within a family may also set the
stage for an eating disorder
Minuchin cites “enmeshed family patterns” as causal
factors of eating disorders
These patterns include overinvolvement in, and overconcern
about, family member’s lives
16. What Causes Eating Disorders?
Ego Deficiencies and Cognitive Disturbances
16
Bruch argues that eating disorders are the result of
disturbed mother–child interactions, which lead to
serious ego deficiencies in the child and to severe
cognitive disturbances
17. What Causes Eating Disorders?
Ego Deficiencies and Cognitive Disturbances
17
According to Bruch, parents may respond to their
children either effectively or ineffectively
Effective parents accurately attend to a child’s biological
and emotional needs
Ineffective parents fail to attend to child’s internal needs;
they feed when the child is anxious, comfort when the
child is tired, etc.
There is some empirical support for Bruch’s theory
from clinical reports
18. What Causes Eating Disorders? Mood Disorders
18
Many people with eating disorders, particularly
those with bulimia nervosa, experience symptoms of
depression
Theorists believe mood disorders may “set the stage” for eating
disorders
19. What Causes Eating Disorders? Mood Disorders
19
There is empirical support for the claim that mood
disorders set the stage for eating disorders:
Many more people with an eating disorder qualify for a
clinical diagnosis of major depressive disorder than do
people in the general population
Close relatives of those with eating disorders seem to
have higher rates of mood disorders
People with eating disorders, especially those with
bulimia nervosa, have low levels of serotonin
Symptoms of eating disorders are helped by
antidepressant medications
20. What Causes Eating Disorders? BiologicalFactors
20
Biological theorists suspect certain genes may leave
some people particularly susceptible to eating
disorders
Consistent with this model:
Relatives of people with eating disorders are 6 times more likely to
develop the disorder themselves
Identical (MZ) twins with bulimia: 23%
Fraternal (DZ) twins with bulimia: 9%
These findings may be related to low serotonin
21. What Causes Eating Disorders? Biological Factors
21
Other theorists believe that eating disorders may be
related to dysfunction of the hypothalamus
Researchers have identified two separate areas that control
eating:
Lateral hypothalamus (LH)
Ventromedial hypothalamus (VMH)
22. What Causes Eating Disorders? Biological Factors
22
Some theorists believe that the LH and VMH are
responsible for weight set point – a “weight
thermostat” of sorts
Set by genetic inheritance and early eating practices, this
mechanism is responsible for keeping an individual at a
particular weight level
If weight falls below set point: Ý hunger, ß metabolism Þ binges
If weight rises above set point: ß hunger, Ý metabolism
Dieters end up in a fight against themselves to lose weight
23. Eating Disorders: Risk Factors
23
Activities with
heightened
weight/shape demands
Childhood obesity
Familial psychiatric
history and/or obesity
Diabetes
Routine Dieting or
restrained eating
Premorbid personality
disorder(s)
24. Eating Disorders
24
Although not historically true, current Western
beauty standards equate thinness with health and
beauty
Thinness has become a national obsession!
There has been a rise in eating disorders in the
past three decades
Two main diagnoses:
Anorexia nervosa
Bulimia nervosa
26. ED Changes from DSM IV TR- DSM 5
DSM IV TR
Pica, Rumination, and
Avoidant/Restrictive in
chapter of disorders
usually 1st diagnosed in
infancy, childhood, or
adolescence
No Binge Eating
Disorder
DSM 5
Pica Rumination, &
Avoidant/Restrictive in
ED chapter
Recognition of Binge
Eating Disorder
Anorexia Nervosa &
Bulimia Nervosa
criteria updated
27. Eating Disorders
Can only be diagnosed with one of the following at
any given time:
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
28. EDs: (307.51/F50.8)Binge Eating Disorder (p. 380)
DSM IV TR:
Appendix B: Criteria Sets and Axes Provided for Further
Study
Diagnosed as ED NOS
DSM 5:
Added BED to Feeding and Eating Disorders chapter
Recognition that a large percentage of ED NOS diagnoses
could be attributed to BED
More severe and less common than overeating and
associated with significant physical and psychological
problems
Criteria A-E will must be met
29. Binge Eating Disorder Criteria (p. 350)
A.Recurrent episodes of binge eating. An episode of
binge eating is characterized by both of the
following:
1. Eating, in a discrete period of time (w/in 2-hour
period), an amount of food that is definitely larger
than what most people would eat in a similar
period of time under similar circumstances.
1. A sense of lack of control over eating during the
episode (e.g. feeling that one cannot stop eating
or control what or how much one is eating).
30. Binge Eating Disorder Criteria (p. 350)
B. The binge-eating episodes are associated with
3/more of the following:
1. Eating much more rapidly than normal.
2. Eating until feeling uncomfortably full.
3. Eating large amounts of food when not feeling
physically hungry.
4. Eating alone because of feeling embarrassed by
how much one is eating.
5. Feeling disgusted with oneself, depressed or very
guilty afterward.
31. Binge Eating Disorder Criteria (p. 350)
C. Marked distress regarding binge eating is
present.
D. The binge eating occurs, on average, at least
once a week for 3 months.
E. The binge eating is not associated with the
recurrent use of inappropriate compensatory
behavior as in bulimia nervosa and does not
occur exclusively during the course of bulimia
nervosa or anorexia nervosa.
32. Binge Eating Disorder Specifiers (p. 350)
Partial/Full Remission After full criteria for
BED were met, binge-eating disorder were
previously met,
Partial: Binge eating occurs at an average frequency of less
than one episode per week for a sustained period of time.
Full: none of the criteria have been met for a sustained
period of time.
Severity
Mild: 1-3 episodes of binge eating each week
Moderate: 4-7 episodes of binge eating each
week
Severe: 8-13 episodes of binge eating each week
Extreme: 14/more episodes of binge eating each
week
33. BED: Associated Features
Prevalence: (p. 351)
12 month prevalence among adults:
Female: 1.6%
Males: .8%
Development & Course : (p. 352)
Binge eating usually precedes BED whereas dieting usually
precedes onset of binge eating in bulimia nervosa)
Treatment seeking BED clients are usually older than AN/BN
treatment seeking clients
Course: persistent, similar to BN in severity & duration
Risk and Prognostic Factors: Indication of
Genetic predisposition
34. BED: Associated Features
Culture-Related Diagnostic Issues
Similar across industrialized countries
Similar across ethnicities
Functional Consequences
Social role adjustment problems
Impaired health-related quality of life & life satisfaction
Increased medical morbidity & mortality
Increased health care utilization compared with BMI-matched
control subjects
35. BED: Associated Features
Differential Diagnosis
Bulimia Nervosa:
BED doesn’t have recurrent compensatory (purge/exercise) behavior
BED consistently higher rates of improvement than BN
Obesity:
BED higher rates of overvaluation of body weight and shape
BED rates of psychiatric comorbidity are significantly higher
BED better outcomes
Bipolar & MDD can be given in addition to BED if meet full criteria for
both
Borderline PD & BED can be given if meet full criteria for both
Comorbidity *linked to severity of BED not degree of
obesity*
Most common: bipolar, depressive, & anxiety disorders
Less common: substance use disorders
36. EDs: Anorexia Nervosa
Several minor but important changes in criteria:
Criterion A DSM 5:
Focuses on behaviors indicating AN like restricting calorie intake
No longer includes the word “refusal” in terms of weight
maintenance – implies intention – hard to assess
Elimination of Criterion D DSM IV TR: Amenorrhea
required
Cannot be applied to males, premenstrual females, females taking
oral contraceptives, and post-menopausal females
May have other AN criteria and still have some menstrual activity
37. Anorexia Nervosa
37
There are two main subtypes:
Restricting type
Lose weight by restricting “bad” foods, eventually restricting
nearly all food
Show almost no variability in diet
Binge-eating/purging type
Lose weight by vomiting after meals, abusing laxatives or
diuretics, or engaging in excessive exercise
Like those with bulimia nervosa, people with this subtype may
engage in eating binges
38. Anorexia Nervosa
38
About 90%–95% of cases occur in females
The peak age of onset is between 14 and 18 years
Between 0.5% and 2% of females in Western
countries develop the disorder
Many more display some symptoms
Rates of anorexia nervosa are increasing in North
America, Japan, and Europe
39. Anorexia Nervosa
39
The “typical” case:
A normal to slightly overweight female has been on a diet
Escalation to anorexia nervosa may follow a stressful
event
Separation of parents
Move or life transition
Experience of personal failure
Most patients recover
However, about 2% to 6% become seriously ill and die as a result
of medical complications or suicide
40. Anorexia Nervosa: The Clinical Picture
40
The key goal for people with anorexia nervosa is
becoming thin
The driving motivation is fear:
Of becoming obese
Of giving in to the desire to eat
Of losing control of body shape and weight
41. Anorexia Nervosa: The Clinical Picture
41
Despite their dietary restrictions, people with
anorexia are preoccupied with food
This includes thinking and reading about food and planning
for meals
This preoccupation may be the result of food deprivation
rather than its cause
Famous 1940s “starvation study” with conscientious objectors
42. Anorexia Nervosa: The Clinical Picture
42
People with anorexia nervosa also think in
distorted ways:
Often have a low opinion of their body shape
Tend to overestimate their actual proportions
Adjustable lens assessment technique
Hold maladaptive attitudes and misperceptions
“I must be perfect in every way”
“I will be a better person if I deprive myself”
“I can avoid guilt by not eating”
43. Anorexia Nervosa: The Clinical Picture
43
People with anorexia may also display certain
psychological problems:
Depression (usually mild)
Anxiety
Low self-esteem
Insomnia or other sleep disturbances
Substance abuse
Obsessive-compulsive patterns
Perfectionism
44. Anorexia Nervosa: Medical Problems
44
Caused by starvation:
Amenorrhea
Low body temperature
Low blood pressure
Body swelling
Reduced bone density
Slow heart rate
Metabolic and electrolyte
imbalances
Dry skin, brittle nails
Poor circulation
Lanugo
45. EDs: Bulimia Nervosa
Basically the same criteria EXCEPT
Compensatory behaviors:
DSM IV TR 2x/week
DSM 5 1 time/week
46. Bulimia Nervosa
46
Bulimia nervosa, also known as “binge-purge
syndrome,” is characterized by binges:
Bouts of uncontrolled overeating during a limited period
Eats more than most people would/could eat in a similar period
47. Bulimia Nervosa
47
The disorder is also characterized by compensatory
behaviors, such as:
Vomiting
Misusing laxatives, diuretics, or enemas
Fasting
Exercising excessively
48. Bulimia Nervosa
48
Like anorexia nervosa, about 90%–95% of bulimia
nervosa cases occur in females
The peak age of onset is between 15 and 21 years
Symptoms may last for several years with periodic
letup
49. Bulimia Nervosa
49
Patients are generally of normal weight
Often experience weight fluctuations
Some may also qualify for a diagnosis of anorexia
51. Bulimia Nervosa
51
Teens and young adults have frequently attempted
binge-purge patterns as a means of weight loss,
often after hearing accounts of bulimia from
friends or the media
In one study:
50% of college students reported periodic binges
6% tried vomiting
8% experimented with laxatives at least once
Surveys suggest that as many as 5% of women
develop the full syndrome
52. Bulimia Nervosa: Binges
52
For people with bulimia nervosa, the number of
binges per week can range from 2 to 40
Average: 10 per week
Binges are often carried out in secret
Binges involve eating massive amounts of food rapidly
with little chewing
Usually sweet foods with soft texture
Binge-eaters commonly consume more than 1000
calories (often more than 3000 calories) per binge
episode
53. Bulimia Nervosa: Binges
53
Binges are usually preceded by feelings of tension
and/or powerlessness
Although the binge itself may be pleasurable, it is
usually followed by feelings of extreme self-blame,
guilt, depression, and fears of weight gain and
“discovery”
54. Bulimia Nervosa:
Compensatory Behaviors
54
After a binge, people with bulimia nervosa try to
compensate for and “undo” the caloric effects
The most common compensatory behaviors:
Vomiting
Fails to prevent the absorption of half the calories consumed
during a binge
Affects ability to feel satiated Þ greater hunger and bingeing
Laxatives and diuretics
Also almost completely fail to reduce the number of calories
consumed
55. Bulimia Nervosa: Compensatory Behaviors
55
Compensatory behaviors may temporarily relieve the
negative feelings attached to binge eating
Over time, however, a cycle develops in which purging Þ
bingeing Þ purging
56. Bulimia Nervosa
56
The “typical” case:
A normal to slightly overweight female has been on an intense
diet
Research suggests that even among normal subjects, bingeing
often occurs after strict dieting
For example, a study of binge-eating behavior in a low-calorie
weight loss program found that 62% of patients reported binge-eating
episodes during treatment
57. Bulimia Nervosa vs. Anorexia Nervosa
57
Similarities:
Onset after a period of dieting
Fear of becoming obese
Drive to become thin
Preoccupation with food, weight, appearance
Elevated risk of self-harm or attempts at suicide
Feelings of anxiety, depression, perfectionism
Substance abuse
Disturbed attitudes toward eating
58. Bulimia Nervosa vs. Anorexia Nervosa
58
Differences:
People with bulimia are more worried about pleasing
others, being attractive to others, and having intimate
relationships
People with bulimia tend to be more sexually experienced
People with bulimia display fewer of the obsessive
qualities that drive restricting-type anorexia
People with bulimia are more likely to have histories of
mood swings, low frustration tolerance, and poor coping
59. Bulimia Nervosa vs. Anorexia Nervosa
59
Differences:
People with bulimia tend to be controlled by emotion –
may change friendships easily
People with bulimia are more likely to display
characteristics of a personality disorder
Different medical complications:
Only half of women with bulimia experience amenorrhea vs.
almost all women with anorexia
People with bulimia suffer damage caused by purging, especially
from vomiting and laxatives
60. Treatments for Eating Disorders
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Eating disorder treatments have two main goals:
Correct abnormal eating patterns
Address broader psychological and situational factors that
have led to and are maintaining the eating problem
This often requires the participation of family and friends
61. Treatments for Anorexia Nervosa
61
The initial aims of treatment for anorexia nervosa
are to:
Restore proper weight
Recover from malnourishment
Restore proper eating
62. Treatments for Anorexia Nervosa
62
In the past, treatment took place in a hospital
setting; it is now often offered in an outpatient
setting
In life-threatening cases, clinicians may need to
force tube and intravenous feedings on the patient
This may breed distrust in the patient and create a power
struggle
Most common technique now is the use of
supportive nursing care and high-calorie diets
Necessary weight gain is often achieved in 8 to 12 weeks
63. Treatments for Anorexia Nervosa
63
Researchers have found that people with anorexia
must overcome their underlying psychological
problems to achieve lasting improvement
64. Treatments for Anorexia Nervosa
64
Therapists use a mixture of therapy and education
to achieve this broader goal, using a combination
of individual, group, and family approaches
One focus of treatment is building autonomy and self-awareness
Therapists help patients recognize their need for independence
and control
Therapists help patients recognize and trust their internal feelings
65. Treatments for Anorexia Nervosa
65
Another focus of treatment is correcting disturbed
cognitions, especially client misperceptions and
attitudes about eating and weight
Using cognitive approaches, therapists correct disturbed
cognitions and educate about body distortions
66. Treatments for Anorexia Nervosa
66
Another focus of treatment is changing family
interactions
Family therapy is important for anorexia
The main issue is often separation
67. Treatments for Anorexia Nervosa
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The use of combined treatment approaches has
greatly improved the outlook for people with
anorexia nervosa
But even with combined treatment, recovery is difficult
The course and outcome of the disorder vary from
person to person
68. Treatments for Anorexia Nervosa
68
Positives of treatment:
Weight gain is often quickly restored
83% of patients still showed improvements
after several years
Menstruation often returns with return to normal weight
The death rate from anorexia is declining
69. Treatments for Anorexia Nervosa
69
Negatives of treatment:
Close to 20% of patients remain troubled for years
Even when it occurs, recovery is not always permanent
Anorexic behaviors recur in at least one-third of recovered
patients, usually triggered by stress
Many patients still express concerns about body shape and weight
Lingering emotional problems are common
70. Treatments for Bulimia Nervosa
70
Treatment is frequently offered in specialized eating
disorder clinics
71. Treatments for Bulimia Nervosa
71
The initial aims of treatment for bulimia nervosa are
to:
Eliminate binge-purge patterns
Establish good eating habits
Eliminate the underlying cause of bulimic patterns
Programs emphasize education as much as therapy
72. Treatments for Bulimia Nervosa
72
Several treatment strategies:
Individual insight therapy
The insight approach receiving the most attention is cognitive
therapy, which helps clients recognize and change their
maladaptive attitudes toward food, eating, weight, and shape
As many as 65% stop their binge-purge cycle
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Several treatment strategies:
Individual insight therapy
If cognitive therapy isn’t effective, interpersonal therapy (IPT), a
treatment that seeks to improve interpersonal functioning, may be
tried
A number of clinicians also suggest self-help groups or self-care
manuals
74. Treatments for Bulimia Nervosa
74
Several treatment strategies:
Behavioral therapy
Behavioral techniques are often included in treatment as a
supplement to cognitive therapy
Diaries are often a useful component of treatment
Exposure and response prevention (ERP) is used to break the
binge-purge cycle
75. Treatments for Bulimia Nervosa
75
Several treatment strategies:
Antidepressant medications
During the past decade, antidepressant drugs have been used in
bulimia treatment
Most common is fluoxetine (Prozac), an SSRI
Drugs help as many as 40% of patients
Medications are best when used in combination with other forms
of therapy
76. Treatments for Bulimia Nervosa
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Several treatment strategies:
Group therapy
Provides an opportunity for patients to express their thoughts,
concerns, and experiences with one another
Helpful in as many as 75% of cases, especially when combined
with individual insight therapy
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Left untreated, bulimia can last for years
Treatment provides immediate, significant
improvement in about 40% of cases
An additional 40% show moderate improvement
Follow-up studies suggest that 10 years after
treatment about 90% of patients have fully or
partially recovered
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Relapse can be a significant problem, even among
those who respond successfully to treatment
Relapses are usually triggered by stress
Relapses are more likely among persons who:
Had a longer history of symptoms
Vomited frequently
Had histories of substance use
Have lingering interpersonal problems
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Finally, treatment may also help improve overall
psychological and social functioning
Editor's Notes
Pica, Rumination & Avoidant/Restrictive moved to ED.
Binge ED Recognized – reduce ED NOS
“In recent years, clinicians and researchers have realized that a significant number of individuals with eating disorders did not fit into the DSM-IV categories of anorexia nervosa and bulimia nervosa. By default, many received a diagnosis of “eating disorder not otherwise specified.” Studies have suggested that a significant portion of individuals in that “not otherwise specified” category may actually have binge eating disorder” (APA Fact Sheet on Feeding and Eating Disorders).
AN and BN criteria updated.
Mutually exclusive diagnostic criteria exist for disorders having similar features they differ significantly in other areas (pg. 329):
Rumination disorder
Avoidant/restirctive food intake disorder
Anorexia Nervosa
Bulimia Nervosa
Binge-Eating Disorder
We will go review the specific criteria for Binge Eating Disorder on the following slides.
Associated Features: (351)
Normal and overweight and obese individuals
Distinct from obesity. Most obese individuals do not engage in recurrent binge eating.
“Obese individuals with BED consume more calories in lab studies of eating behavior and have greater functional impairment, lower quality of life, more subjective distress, and greater psychiatric comorbidity than obese individuals without BED” (p. 351).
Diagnostic Features (p. 351)
“The context in which the eating occurs may affect the clinician’s estimation of whether the intake is excessive. For example, a quantity of food that might be regarded as excessive during a typical meal might be considered normal during a celebration or holiday meal.”
Discrete Period of Time: usually less than 2 hours
Single episode: may not be restricted to one setting (i.e. restaurant & home but not continual snacking on small amounts of food throughout the day.)
Sense of lack of Control:
”inability to refrain from eating or to stop eating once started.”
Dissociative quality during or following
May be able to stop if someone enters the room unexpectedly
May be described as acute loss of control or general pattern of uncontrolled eating
Binges can be planned
Or
May have stopped trying to control eating
Diagnostic Features:
“Binge eating seems to be characterized more by an abnormality in the amount of food consumed than by a craving for a specific nutrient” (p. 351).
Typically ashamed of their eating problems
Secrecy: Attempt to conceal their symptoms
Triggers:
Negative affect (emotion regulation)
Interpersonal stressors
Dietary restraint
Negative feelings related to body weight, body shape, and food
Boredom
“Binge eating may be minimized or mitigate factors that precipitated the episode in the short-term” (it works initially) “but negative self-evaluation and dysphoria often are delayed consequences”
(indicates a addictive/relapse cycle)
Prevalence:
12 month prevalence among 18yo/older:
Female: 1.6%
Males: .8%
Less skewed in BED than bulimia nervosa
As frequent among racial/ethnic minorities as white women
More prevalent among those seeking weight-loss treatment than general population
Development: not much known about development of BED
Associated with increased body fat, weight gain, and increases in psychological symptoms
Common in adolescent and college-age samples
Loss of control eating or episodic binge eating may represent a prodromal phase of eating disorders for some individuals.
Binge eating usually precedes BED whereas dieting usually precedes onset of binge eating in bulimia nervosa)
Usually begins in adolescence or young adulthood, but can begin in later adulthood.
Course:
Remission rates in both natural course and treatment outcome studies are higher for binge-eating disorder than for bulimia nervosa or anorexia nervosa.
Relatively persistent, course is comparable to BN in terms of severity and duration
Crossover from BED to AN/BN is uncommon
Risk & Prognostic Factors:
“BED appears to run in families, which may reflect additive genetic influences” (p. 352).
Culture-Related Diagnostic Issues:
Prevalence of BED similar across industrialized countries and among Latinos, Asians, Caucasians, and African Americans.
Functional Consequences of BED: Associated with
Social role adjustment problems
Impaired health-related quality of life and life satisfaction
Increased medical morbidity and mortality
Associated increased health care utilization compared with BMI-matched control subjects
May be associated with an increased risk for weight gain & devmt of obesity
Differential Diagnosis:
Bulimia Nervosa:
Clinical presentation & recurrent inappropriate compensatory behavior (e.g., purging, driven exercise) – not in BED
BED may report dieting attempts, but “don’t show marked or sustained dietary restriction designed to influence body weight & shape between binge-eating episodes” (352)
Response to treatment: BED consistently higher rates of improvement than BN
Obesity:
Associated with obesity but different.
BED clients with obesity have higher rates of overvaluation of body weight and shape
BED rates of psychiatric comorbidity are significantly higher
BED better treatment outcomes than obesity without BED
Bipolar & Depressive Disorders:
Increased eating in the context of major depressive episode may/may not be associated with loss of control.
If full criteria are met for MDD/Bipolar Disorder and BED, then they can both be given.
Borderline PD:
“If full criteria for both disorders are met, both diagnoses should be given” (353).
Comorbidity:
Most common are bipolar disorders, depressive disorders, anxiety disorders
Less common substance use disorders
“Psychiatric comorbidity is linked to the severity of binge eating and not to the degree of obesity” (353).
Several minor but important changes in criteria
Criterion A focuses on behaviors, like restricting calorie intake, and no longer includes the word “refusal” in terms of weight maintenance since that implies intention on the part of the patient and can be difficult to assess.
DSM IV TR Criterion D requiring Amenorrhea, or the absence of at least 3 menstrual cycles, was deleted in DSM 5 because it cannot be applied to males, pre-menstrual females, females taking oral contraceptives, and post-menopausal females.
DSM-5 criteria reduce the frequency of binge eating and compensatory behaviors that people with bulimia nervosa must exhibit to once a week from twice weekly as specified in the DSM IV TR.