Eating Disorders Two Main Types  Anorexia Nervosa  Bulimia Nervosa Largely a Caucasian Problem Largely a Female Problem Largely a Westernized Problem Largely an Upper SES Problem Serious Medical Problems, Including Death!

Bulimia Nervosa Bingeing Sense of Lack of Control Compensatory Behavior Subtypes  Purging  Nonpurging

Anorexia Nervosa Fear of Gaining Weight and/or Losing Control of Eating Deliberate Weight Loss  85% of Normal Body Weight Life-Threatening Consequences Two Subtypes  Restricting  Bingeing-Purging

Bulimia and Anorexia Causes?  Social and Cultural Factors Thinness Equals Success Distorted View Has Increased Over Time  Media Sets Impossible Idealized Images

Bulimia and Anorexia Causes?  Psychological and behavioral considerations Low sense of personal control and self-confidence Perfectionistic attitudes Distorted body image Preoccupation with food Mood intolerance

Bulimia and Anorexia Causes?  Familial Successful and Driven Concerned about Appearances Eager to Maintain Harmony Deny or Ignore Conflicts Lack of Open Communication

Bulimia and Anorexia Causes?  Biological Influences Runs in Families Unclear What is Inherited  Psychological Influences Diminished Sense of Control Low Self-Esteem

Treatment of Eating Disorders Medical Treatments  Bulimia Antidepressants can help reduce bingeing and purging behavior Antidepressants are not efficacious in the long-term  Anorexia There are none with demonstrated efficacy

Treatment of Bulimia Nervosa Psychosocial treatments  Cognitive-behavioral therapy (CBT) Is the treatment of choice Basic components of CBT  Interpersonal psychotherapy Results in long-term gains similar to CBT

Treatment of Anorexia Nervosa Goals and Strategies  Weight restoration First and easiest goal to achieve  Psychoeducation  Behavioral and cognitive interventions Target food, weight, body image, thought and emotion  Treatment often involves the family  Long-term prognosis for anorexia is poorer than for bulimia

Binge-Eating Disorder Experimental diagnostic category Engage in food binges, but do not engage in compensatory behaviors Associated Features  Many individuals with binge-eating disorder are obese  Most are older than bulimic and anorexic people  Show more psychopathology than obese people who do not binge  Share similar concerns as anorexic and bulimic people regarding body shape and weight

Other Eating Disorders Rumination Disorder Pica Feeding Disorder  “Failure to Thrive Syndrome” Obesity – Not an eating disorder, but a major health problem, especially in the US (could be in previous chapter)