1. Quick Write What appearance expectations are there for women today in Western Culture? Do you think that these expectations can lead to any sorts of consequences?

2. Psychology 2.11 Eating Disorders: Bulimia Nervosa

3. There is a large emphasis in society placed on women being “thin” In fact, being “thin has become an national obsession”. In the past few decades, there has been an increased consciousness about what we should or should not eat, and the nutritional value of food. Not surprisingly, during this same time period there has been an increase in the occurrence of eating disorders. Today we are going to focus on one: Bulimia Nervosa

4. Bulimia Nervosa Sometimes also known as binge-purge syndrome. Often follows a period of intense dieting that receives praise from friends and family. It is characterized by repeated episodes of uncontrollable overeating (binges) A binge occurs over a limited period of time. During this time, a person eats more than a normal person would over the same time span. There are two specific sub-sets of bulimia nervosa: Purging-type bulimia People with this disorder also repeatedly perform compensatory behaviors (forcing themselves to vomit, misuse of laxatives/enemas). Nonpurging-type bulimia nervosa Individuals compensate by fasting or exercising frantically.

5. Prevalence Rate and Onset Age Like other eating disorders, bulimia nervosa occurs more frequently in females (90-95% of cases) and begins in adolescence or young adulthood (most often between 15-21 years old). Females are diagnosed with a ratio of almost 10:1 The weight of people with bulimia nervosa usually stays within a normal range, but it may fluctuate markedly within that range. Studies have suggested that almost 40% of college aged women go through cycles of binges and purges. An alarming amount of young people have binged experimented with compensatory behaviors. In some research, as much as 6% have tried vomiting and 8% misused laxatives.

6. Prevalence Eating disorders, such as bulimia nervosa, tend to be much more common in industrialized countries. However, it may also be the case that proper research has not been conducted in non-industrialized countries.

7. Binges People with bulimia nervosa usually have 2-40 binge episodes per week. The average is usually about 10. The person will usually ingest massive amounts of high-caloric, soft food. The food is hardly tasted or thought about. Binge eaters consume more than 1,500 calories (many times more than 3,000) on average during an episode.

8. Binges (continued) Binges are often preceded by feelings of tension. The person feels powerless to control an overwhelming need to eat the “forbidden” food. Although there may be some relief attached to the binge, it is often followed by intense feelings of self-loathing. This is known as ego-dystonic behavior (the patient experiences the symptoms as something that they can’t control).

9. Compensatory Behaviors After a binge, people try and compensate of for and undo effects. Many people resort to vomiting. Vomiting fails to prevent the absorption of ½ the calories consumed during a binge. Likewise, frequent vomiting can affect one’s ability to feel sated. The use of laxatives fails almost completely to undo the caloric effects of a binge.

10. Compensatory Behaviors (continued) Vomiting and other compensatory behaviors may temporarily relieve the uncomfortable physical and emotional feelings associated with binging. However, over time, a cycle develops in which purging allows more binging and binging necessitates more purging.

11. Identifying bulimia nervosa Most bulimics have an average BMI (body mass index). This makes it more difficult to identify. Symptoms: Affective: Feelings of guilt, inadequacy, or shame. Behavioral: recurrent episodes of binge eating; use of vomiting, laxatives, exercise, or dieting to control weight. Cognitive: negative self-image; poor body image; tendency to perceive events as more stressful than most people; perfectionism Somatic: swollen salivary glands; erosion of tooth enamel; stomach or intestinal problems; heart problems.

12. What causes eating disorders? Theorists and researchers use a multidimensional risk perspective. There seems to be a consistent list of “risk factors”. The more factors are present, the more likely the development of a disorder is.

13. Sociocultural Perspective Many theorists believe that the current Western standards of female beauty have contributed to eating disorders. These standards have changed throughout history, but there has been a notable shift towards thin=attractive in the recent past.

14. Garner et al.,( 1980) Study tracked the height, weight, and age of contestants in the Miss America Pageant from 1959-1978. Found an average decline of .28 pound per year among contestants and .37 pound per year among winners. Same researchers also examined data from Playboy magazine centerfold models over the same time period and found that average weight, bust, and hip measurements of these women decreased steadily. More recent studies seem to indicate that these trends have continued.

15. Who is most susceptible? Thinness is valued in the world of fashion models, dancers, actors, and some athletes, these groups seem more prone to suffer from disorders than others.

16. Johnson, 1995 Conducted a survey of 1,443 athletes at 10 colleges around the US. Data showed that more than 9% of female athletes suffer from an eating disorder and 50% admit to eating behaviors that put them at risk. A whopping 20% of gymnasts surveyed were diagnosed with an eating disorder.

17. Economic/Racial differences in prevalence In past studies, white American women in the upper socioeconomic class have expressed more concern in “thinness” and dieting than African American women or white American women of the lower socioeconomic class. The prevalence of eating disorders used to mirror these feelings. Recently, there seems to be an increase in the prevalence of eating disorders for all women. Why do you think this may be?