Disordered Eating
Disordered Eating vs. Eating Disorder
• Eating disorders are psychiatric conditions– Extreme, continuous body dissatisfaction
coupled with long-term eating patterns that negatively affect body functioning
– Typical behaviors = food restriction, obsessive exercise, self-induced vomiting
– Anorexia & bulimia nervosa
Disordered Eating vs. Eating Disorder
• Disordered Eating general application of atypical eating behavior to maintain low weight– Going on & off diets; refusing to ingest fats– Usually not chronic behaviors: rarely cause
illness– Many people do seek psychiatric care for it
Intimately tied to body image
• Body image: the way you feel about your body
Factors contributing to Eating Disorders
• Family environment• Unrealistic media images• Sociocultural values• Personality traits• Genetic & Biological factors
Factors contributing to Eating Disorders
• Family environment– You’re more likely to develop an eating disorder
if a sibling has one– Families with anorexic member are more
“uptight”• Rigid structure; avoidance of controversial topics; fuzzy
interpersonal boundaries– Families with bulimic member are more
“chaotic”• Less stable organization; less nurturing; more angry &
disruptive
Factors contributing to Eating Disorders
• Unrealistic media images– Adolescents are less capable of understanding
that these are uncommon, unrealistic, and often unnatural body types.
– Consequently less able to distance themselves from a need to acquire that body
Factors contributing to Eating Disorders
• Sociocultural values– “Western values” contribute to eating disorders
• Significantly more common in white Western women than others (worldwide)
– Everyday interactions with family and peers influence how we feel about our bodies
Factors contributing to Eating Disorders
• Personality Traits– People with anorexia nervosa tend toward social
inhibition, compliance, emotional restraint• Do these traits predispose one to the disease, or are
they side-effects of starvation?– People with bulimia nervosa tend to be impulsive,
extroverted, have low self-esteem• seek external validation• Prone to mood swings that result in binging• Prone to self-criticism• Prone to anxiety disorders and substance abuse
Factors contributing to Eating Disorders
• Genetic & Biological factors– Both bulimia & anorexia are much more
common among related individuals• Could be due to genetic or cultural transmission
– Twin studies of bulimia nervosa found that relatedness (heritability) & key environmental factors EACH accounted for ~50% of the variability in who was diagnosed
– Imbalances in hormones involved with feelings of hunger may also be involved
Anorexia nervosa• Suite of unhealthful practices
employed to reduce weight below 85% of normal (for height & weight)
• 90-95% are young women• 0.5-1% of US females develop AN
– 5 - 20 % of those diagnosed will die from complications within 10 years.
• Leading cause of death in females aged 15-24
Anorexia nervosa• Symptoms:
– Self-starvation; refusal to maintain minimal body weight
– Intense fear of weight gain, despite being underweight by all measures
– Undue influence of body weight on self-image or denial of problem
– Amenorrhea in women past puberty• Absence of at least three menstrual cycles
Anorexia nervosa• Health risks:
– Loss of body fat– Loss of proteins from skeletal muscle and organs.
Reduction of non-vital functions• Periods cease; growth stops
– Electrolyte imbalance - leads to irregular heart beat & heart failure (cramping is least of your worries)
– Cardiovascular problems - tachycardia, low bp, dizziness
– GI problems - general weakness & loss of function– Osteoporosis…why?
Bulimia nervosa• Binging
– High rate & quantity of food consumption: more than usual (in relation of time, place, social context)
– Loss of self control; inability to stop; sense of euphoria
– Occur ~ twice or more per week• Purging
– Usually, but not always, after each binge– Vomiting, laxatives, obsessive exercise
Bulimia nervosa• Prevalence
– Affects 1-4% of women (estimate)– Mortality rates much lower than for AN
(1% dying within 10 years)– Occurs mostly in women, but also in men
competing in sports requiring a thin build
Bulimia nervosa• Symptoms
– Recurrent episodes of binging– Recurrent inappropriate compensatory
behavior (laxatives, vomiting, diuretics)– Binge-purge cycle continues for more
than three months– Body shape & weight unduly influence
self-image
Bulimia nervosa• Health risks
– Electrolyte imbalance leads to irregular heart beat & heart failure
• Caused by dehydration & loss of Na+ and K+ through vomiting
– GI problems: inflammation, ulceration, possible rupture of esophagus
• Caused by HCl + mechanical trauma from frequent vomiting– Dental problem: tooth decay, staining & mouth sores
• HCl in vomit– Calluses on hands, swelling in cheek & jaw area
Disordered Eating patterns• Binge eating• Chronic dieting• Chronic overeating
Binge Eating Disorder• Symptoms:
– Often overweight– Lack of control during binging– Chaotic eating behaviors (eating too fast,
too much, in private)– Negative self-esteem, poor body image– Often associated with depression,
substance abuse, anxiety disorders
Binge Eating Disorder• Health Risks:
– Increased risk of overweight or obesity– Foods eaten during binge are often high
in fat and sugar– Increased stress (caused be negative
self-talk) leads to psychological distress
Chronic Dieting• Symptoms:
– Preoccupation with food, weight, calories• Classify food as “good” or “bad”
– Strict dieting– Excessive exercise
• Chronic fatigue– Loss of concentration; mood swings– Increased criticism of body shape
Chronic dieting• Health Risks:
– Insuffiecient nutrient intake– Insufficient caloric intake
• low vitamin and mineral intake– Decreased energy expenditure due to a
reduced BMR– Decreased ability to exercise– Increased risk of eating disorder
Reduced BMR with dieting
Female Athlete Triad• Female athlete triad: serious medical syndrome
frequently seen in female athletes; consists of– Disordered eating– Menstrual dysfunction– Osteoporosis
• Seen especially in sports that emphasize lean bodies or use subjective scoring– Examples?
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