Eating Disorders Chapter 1

Outline Disordered Eating and Eating Disorders Activities Definition Prevalence Types of Eating disorders Anorexia Nervous (AN) Bulimia Nervous (BN) Binge-Eating Disorder Eating Disorders Not Otherwise Specified (EDNOS) Activities

Learning Objectives of Today’s Session Define Disordered Eating and Eating Disorders Differentiate between disordered eating and eating disorders Discuss Eating Disorders Compare and contrast between types of Eating Disorders Assess the impact of Eating Disorders on Health

Disorders Eating Disordered eating is a pattern of atypical behaviors used to achieve or maintain a lower body weight; behaviors include chronic dieting, abuse of diet pills and laxatives, self-induced vomiting, and many others. https://www.psychologytoday.com/blog/contemporary-psychoanalysis-in-action/201402/disordered-eating-or-eating-disorder-what-s-the http://www.eatingdisorders.org.au/eating-disorders/disordered-eating-a-dieting

Disorders Eating Disordered eating can have a negative impact on a person's emotional, social and physical wellbeing. It may lead to fatigue, malnutrition or poor concentration, and may extend into clinically diagnosed eating disorders. Eating issues and disorders occur along a continuum. Mild dissatisfaction with one’s body shape to serious eating disorders https://www.psychologytoday.com/blog/contemporary-psychoanalysis-in-action/201402/disordered-eating-or-eating-disorder-what-s-the http://www.eatingdisorders.org.au/eating-disorders/disordered-eating-a-dieting Copyright © 2017 Cengage Learning. All Rights Reserved.

Disorders Eating and Eating Disorders The main factor differentiating disordered eating from an eating disorder is the level of severity and frequency of disordered eating behaviors. https://www.psychologytoday.com/blog/contemporary-psychoanalysis-in-action/201402/disordered-eating-or-eating-disorder-what-s-the http://www.eatingdisorders.org.au/eating-disorders/disordered-eating-a-dieting

Eating Disorders There are four diagnoses of eating disorders in the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V): Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder Eating Disorders Not Otherwise Specified (EDNOS) https://www.psychologytoday.com/blog/contemporary-psychoanalysis-in-action/201402/disordered-eating-or-eating-disorder-what-s-the

Eating Disorders Anorexia Nervosa (AN) Bulimia Nervosa (BN) Characterized by extreme weight loss, poor body image, amenorrhea, and intense fears of weight gain and obesity. Bulimia Nervosa (BN) Characterized by repeated bouts of uncontrolled eating followed by self-induced vomiting, laxatives or diuretic use, fasting, or vigorous exercise. Binge-Eating Disorder Characterized by periodic binge eating not followed by vomiting or use of laxatives. They are often clinically obese. The binge eating occurs, on average, at least once a week for 3 months. http://www.anad.org/get-information/about-eating-disorders/general-information/

Eating Disorders (cont.) Eating Disorders Not Otherwise Specified (EDNOS) Some patterns of disordered eating qualify as a legitimate psychiatric illness, but don’t fit into the strict diagnostic criteria for either anorexia, bulimia, or binge-eating disorder. Wide spectrum of eating disturbances Considered to be partial syndromes with frequency of symptoms that vary from above diagnostic criteria No weight requirements Subthreshold of AN, BN, BED, purging syndrome, night eating syndrome

Eating Disorders Statistics In the U.S., 20 million women and 10 million men suffer from a clinically significant eating disorders. Only 1 in 10 people with eating disorders receive treatment. Only 35% of people that receive treatment for eating disorders get treatment at a specialized facility for eating disorders. Eating disorders have the highest mortality rate of any mental illness. Almost 50% of people with eating disorders meet the criteria for depression. Copyright © 2017 Cengage Learning. All Rights Reserved.

Copyright © American Psychiatric Association. All rights reserved. From: Increased Mortality in Bulimia Nervosa and Other Eating Disorders American Journal of Psychiatry Figure 1. All-Cause and Suicide Standardized Mortality Ratios for Patients Evaluated for Treatment for Eating Disorders (N=1,885) Between 1979 and 1997 a Bars indicate 95% confidence intervals. Date of download: 05/17/2016 Copyright © American Psychiatric Association. All rights reserved. http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2009.09020247

Eating Disorders Statistics Women: Women are much more likely than men to develop an eating disorder. Only an estimated 5 to 15% of people with anorexia or bulimia are male. An estimated 0.5 to 3.7% of women suffer from anorexia nervosa in their lifetime. Research suggests that approximately 0.2 to 1% of adolescent females have anorexia. An estimated 1.1 to 4.2% of women have bulimia nervosa in their lifetime. An estimated 2 to 5% of Americans experience binge-eating disorder in a 6-month period. http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/ Copyright © 2017 Cengage Learning. All Rights Reserved.

Eating Disorders Statistics Students: According to the National Association of Anorexia Nervosa and Associated Disorders, 95% of those who have eating disorders are between the ages of 12 and 25.8 The mortality rate associated with anorexia nervosa is 12 times higher than the death rate associated with all causes of death for females 15-24 years old. http://www.vanderbilthustler.com/life/college_culture/article_2ba90c42-b4ac-11e3-8add-0017a43b2370 htmlttp://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/ .

Eating Disorders Activity I Activity I: Eating Disorders Awareness List three items that you have learned from my presentation. -   Which age group is most likely to develop eating disorder?

Eating Disorders Activity II Activity II: Eating Disorders Awareness Log in to the National Eating Disorders Association website (http://www.nationaleatingdisorders.org/). Click on the Learn tab and then among the index links to read the following articles: General Info about EDs: “Types & Symptoms of Eating Disorders” Contributing Factors and Prevention: “Factors that may contribute to eating disorders” Family & Friends: “What should I say? Tips for talking to a friend who may be struggling with an eating disorder” Copyright © 2017 Cengage Learning. All Rights Reserved.

Eating Disorders Activity II Activity II: Eating Disorders Awareness Questions: Compare the diagnostic criteria for two types of eating disorders: Anorexia Nervosa (AN) and Bulimia Nervosa (BN) List at least two similarities and dissimilarities criteria for two types of eating disorders: Bulimia Nervosa and Binge- Eating Disorder List three main factors that may contribute to AN and BN What are the main symptoms of binge eating disorder? Copyright © 2017 Cengage Learning. All Rights Reserved.

Eating Disorders Activity III Activity III: Watch a video: https://www.youtube.com/watch?v=-N-E24mAOTg&feature=youtu.be Questions Why do you think so many women report dissatisfaction with their appearance? What factors do you think contribute to this dissatisfaction? Based on the information presented in the video, identify at least three signs of Shelly’s eating disorder. How can you as an individual (friend or family member) help to prevent eating disorders for a loved one? Similarly, how could you as a health professional propose a prevention program? Copyright © 2017 Cengage Learning. All Rights Reserved.

Eating Disorders Activity IV- Case Study Activity IV Questions: Based on the information in this case study, what evidence led to the diagnosis of anorexia in Kelly? Review the position statement from the Academy of Nutrition and Dietetics on nutrition therapy for eating disorders (available at: http://www.eatrightpro.org/~/media/eatrightpro%20files/practice/position%20and%20practice%20papers/position%20papers/position_paper_nutrition_intervention.ashx Why is it important that Kelly is being seen by an entire treatment team versus only a registered dietitian?  Where should the registered dietitian start with Kelly’s nutrition care plan? Using the guidelines in Table 1, estimate the calorie and protein needs for Kelly at her current weight using the DRIs.  How many calories per kilogram would the DRIs provide?  Using the guidelines in Table 2, how many calories per day should be a goal for Kelly?