Body Image and Disordered Eating

Developed by

Counseling & Wellness Services for the Department of Housing

& Residential Education

Session Outline

Body Image Eating Disorders Warning signs and tips Resources

What is body image?

An inner view of your outer self Not based on reality Four components:

Visual Mental Emotional Kinesthetic

Positive Body Image

Doesn’t measure worth by weight / size Doesn’t buy into “ideal” or “perfect” body

Realistic Proud Expressive Comfy

Fostering Positive Body Image

Promote body acceptance in: One’s self One’s community The media

Replace criticism with forgiveness Health comes in EVERY size

Use positive self-talk Body criticisms sabotage a healthy lifestyle

Negative Body Image

Visual distorted, unrealistic view

Mental feel ugly compared to “ideal”

Emotional ashamed, self-conscious

Kinesthetic uncomfortable, not expressive

Fostering Negative Body Image

Social internalization of “ideal body”

Psychological low self-esteem, depression

Interpersonal abuse, troubled family life

And the Consequences?

Depression

Substance abuse

Disordered eating patterns

Emotional distress

Eating Disorders

Low self-esteem

Some statistics…

Eating Disorders

Severe disturbances in eating behavior Extreme concern about body size, shape

Risk Factors Biological Psychological – 50-75% with history of

depression Developmental Social

And the Consequences?

Stunted growth

Cardiac arrest

Depression

Vitamin and mineral deficiencies

Emotional problems

Infertility

Damage to heart and brain

Anorexia Nervosa (AN)

APA Diagnostic Criteria

Refusal to maintain “normal” BMI (18.5 – 24.9)

Intense fear of gaining weight

Negative body image and denial

For women: amenorrhea (loss of period) (about to change)

Restricting Type vs. Binge-Eating/Purging Type

Anorexia Nervosa (AN)

What’s the big deal?

The highest mortality rate of any psychiatric condition

5 – 10% of people with AN die within 10 years 18 – 20% will be dead after 20 years Only 30 – 40% ever fully recover

Anorexia Nervosa (AN)

Warning signs:

Clinical (what a doctor or RD sees) Abnormal weight loss or underweight BMI Low blood pressure/pulse Muscle wasting Bone loss Dehydration or excessive hydration Fainting/dizziness Hair loss or abnormal hair growth (lanugo) Loss of period

Anorexia Nervosa (AN)

Warning signs:

Behavioral: (What a friend/family member sees) Dieting or restricting when not overweight Negative body image, feels fat Preoccupied with food, calories, nutrition Denies hunger cues (doesn’t eat when hungry) Exercises excessively Frequent weighing Feels bloating/nausea after normal amounts of food

Bulimia Nervosa (BN)

APA Diagnostic Criteria

Recurrent binge eating

Recurrent compensation for binges

Negative body image

Normal, overweight or obese BMI (>24.9)

Purging Type vs. Non-Purging Type

Bulimia Nervosa (BN)

Prevalence: 1% - 4.2% in US females

For men: prevalence ratio 1:6 - 1:10

Bulimia Nervosa (BN)

Warning Signs

Clinical Electrolytes, throat/teeth, kidneys, fatigue, period, hair

Behavioral Eating without weight gain, bathroom, emotions,

weight, mood

Binge Eating Disorder (BED) Not defined by APA Diagnostic Criteria (EDNOS)

Recurrent binge eating

Eating rapidly until uncomfortable, often when not hungry. Eating alone and feeling disgusted or shameful

Distress about binge eating

Two days a week for 6 months? (about to change)

No compensatory behavior

Binge Eating Disorder (BED)

What’s the big deal?

Prevalence: Estimated at 2% Most common eating disorder

In morbidly-obese treatment-seeking populations: prevalence of 25%

Binge Eating Disorder (BED)

Warning signs:

Clinical Weight gain, blood pressure, cholesterol, diabetes

Behavioral Depressed, late-night, secretive eating, low self-

esteem, avoids social/sexual contact, copes with food

Spectrum of Disordered Eating

Fasts for one week a month

Obsesses about food

Hates his body

Binges on chocolate cake and pie every Friday night

Exercises three times a day

Throws up once a month

Orthorexia

Bigorexia

Pregorexia

Treating Eating Disorders

How do you think eating disorders should be treated?

Treating Eating Disorders

Individualized therapy

Team Approach MD Psychotherapist/Psychiatrist Registered Dietitian

OK… so, how do I talk about this?

Educate yourself! Be caring and nonjudgmental Expect anger Continue to offer support Do not accept disordered eating behaviors Inform RA or parents if she or he is in trouble Offer resources: CWS, CHS, something-

fishy.com

Resources

Counseling & Wellness Services http://campushealth.unc.edu/cws

Campus Health Services http://campushealth.unc.edu

PACE (Pathway to Awareness in College Eating) http://www.pace.unc.edu/

Something Fishy http://www.something-fishy.org

Events at UNC-Chapel Hill

Love Your Body Day – October

National Eating Disorders Awareness Week – February

Carolina Women’s Center – Various events

SHAPE (Students Helping to Achieve Positive Esteem)

For questions contact:

Antonia Hartley, MPH, RD, LDN

Clinical Nutrition Specialist

UNC Campus Health Services

Appointments: 919.966.2281

Email: antonia@email.unc.edu

Follow her on Twitter! @UNCNutrition