Focus On EATING DISORDERS

F7.1 What Are Eating Disorders? Learning objective Name the three categories of eating disorders.

Eating Disorders CCHS reports that 3.8% of Canadian girls and women (aged 15 to 24) were at risk of eating disorder. Thirty percent of girls in grade nine and ten had tried to lose weight in the last year. Public Health Agency reports that 3% of women will be affected by eating disorders in their life time.

What Are Eating Disorders? When the emotional aspects of food and eating overpower the role of food as nourishment, an eating disorder may develop. They involve a persistent disturbance in eating patterns or other behaviors intended to control weight. They affect physical and nutritional health and psychological functioning. 4

Categories of Eating Disorders Anorexia nervosa: self-starvation Bulimia nervosa: bingeing or binge eating followed by purging Eating disorders not otherwise specified (EDNOS): abnormal behaviours that do not fit the above two categories, such as binge-eating disorder 5

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F7.2 What Causes Eating Disorders? Learning objective Discuss the genetic factors that influence the development of eating disorders. Discuss the psychological factors that influence the development of eating disorders. Describe how a society’s body ideal affects the incidence of eating disorders.

What Causes Eating Disorders? Figure F7.1 Figure F6.1 Causes of eating disorders Medical professionals must address genetic, psychological, and sociocultural factors if treatment for eating disorders is to be effective. 10

The Role of Genetics in Eating Disorders Certain genes may predispose a person to developing eating disorders. Examples: Levels of neurotransmitters such as serotonin may contribute to the behavior of anorexia and bulimia. A defect in melanocortin 4 receptor gene may be linked to binge-eating disorders and obesity. A single gene may not be the sole cause. 11

Common Psychological Issues in Eating Disorders People with eating disorders often have low self-esteem. They are often perfectionists. They try to use their relationship with food to gain control over their lives and boost their self-esteem. 12

Societal Messages About the Ideal Body Sociocultural and economic factors are important triggers for the onset of eating disorders. The sociocultural ideals about body size are linked to body image and the incidence of eating disorders. The view of an ideal body differs across cultures and has changed throughout history. People with eating disorders usually have a distorted body image. 13

Body Ideal in Modern America Figure F7.4 14

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F7.3 Anorexia Nervosa Learning objective Describe the psychological issues that characterize anorexia nervosa. Describe the behaviours associated with anorexia nervosa. Describe the changes in the body that occur as a result of anorexia nervosa. Explain how anorexia nervosa is treated.

Anorexia Nervosa Psychological issues Anorexic behaviour Figure F7.6 Overwhelming fear of gaining weight Disturbances in body image Anorexic behaviour Restricting type Binge-eating/purging type Figure F7.6 17

Anorexia Nervosa Physical symptoms Treatment Weight loss Mental and physical symptoms of starvation Treatment Resolving the psychological and behavioral problems Providing for physical and nutritional rehabilitation 18

F7.4 Bulimia Nervosa Learning objective Describe the psychological issues that characterize bulimia nervosa. Describe the behaviours associated with bulimia nervosa. Describe the changes in the body that occur as a result of bulimia nervosa. Explain how bulimia nervosa is treated.

Bulimia Nervosa Figure F7.8 Psychological issues Bulimic behavior Intense fear of becoming fat Negative body image and distorted perception of body size Usually socially isolated Bulimic behavior A pattern of semi-starvation interrupted by periods of gorging Nonpurging bulimia Purging bulimia Figure F7.8 20

Bulimia Nervosa Physical complications of bulimia: Treatment: Purging by vomiting brings many problems to the body systems. Laxative and diuretic abuse can cause dehydration and electrolytes imbalance. Treatment: Separating eating from emotions and from perceptions of success Promoting eating in response to hunger and satiety 21

F7.5 Binge-Eating Disorder Learning objective Distinguish binge-eating disorder from anorexia and bulimia.

Source: From the DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington DC: American Psychiatric Association, 2000. 23

Binge-Eating Disorder Figure F7.9 24

F7.6 Eating Disorders in Special Groups Learning objective Describe how eating disorders are different in men and women. Describe the impact of eating disorders during pregnancy on mother and baby. Describe the impact of eating disorders in children. Describe the eating disorders associated with athletes. Describe the relationship between diabetes and eating disorders.

Eating Disorders in Special Groups Eating disorders in men Much less than in women On the rise Certain groups at more risk Less likely to seek treatment Eating disorders during pregnancy Cause harm to the mothers and babies A common problem is pica 26

Eating Disorders in Special Groups Eating disorders in children More common in late adolescence and early adulthood Prevalence is increasing in younger children in the U.S. More girls than boys are affected Delayed growth and sexual maturation Other symptoms similar to those of adult patients 27

Eating Disorders in Special Groups Eating disorders in athletes Higher prevalence in female athletes Higher prevalence in certain sports Anorexia athletica Compulsive exercise Female athlete triad Disordered eating Amenorrhea Osteoporosis 28

Eating Disorders in Special Groups Eating disorders and diabetes May be more common, particularly in those who take insulin, than in the general public The treatment regimentation may contribute Many similarities between patients with diabetes and those with eating disorders Focus on food, diet, and body weight Control a central issue Guilty feelings if goals not met 29

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Female Athlete Triad Figure F7.12 32

F7.7 Preventing and Getting Treatment for Eating Disorders Learning objective Describe factors that predispose people to eating disorders. List the steps you could take to help a friend with an eating disorder. Describe strategies for the prevention of eating disorders.

Preventing and Getting Treatment for Eating Disorders Recognizing the risks Getting help for a friend or family member Reducing the prevalence of eating disorders 34

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