Chapter 11 Eating Disorders

Overview of Eating Disorders Affects more than 5 million people Affects more than 5 million people 85% of cases develop during adolescence 85% of cases develop during adolescence Co-occurs with other psychological disorders Co-occurs with other psychological disorders Recognition of disorder is critical to treatment Recognition of disorder is critical to treatment END-CHAPTER 11 – Very informative: Personal Reflections: -Thoughts of an Anorexic - Thoughts of a Bulimic

Genetic Link? Identical twins are more likely to share eating disorders Identical twins are more likely to share eating disorders –Genetically predisposed? Fraternal twins are less likely Fraternal twins are less likely

Characteristics: Anorexia & Bulimia

Helpful Resources Course TEXTBOOK – Wardlaw 7 th Edition Course TEXTBOOK – Wardlaw 7 th Edition –Contemporary Nutrition Academy of Eating Disorders- Academy of Eating Disorders- – National Eating Disorders Association National Eating Disorders Association – National Institute of Mental Health National Institute of Mental Health – UCSC – Womens Center UCSC – Womens Center –

Warning Signs of Anorexia Abnormal, rigid eating habits Abnormal, rigid eating habits Eating very little food ( kcal/day) Eating very little food ( kcal/day) Hiding and storing food Hiding and storing food Exercising compulsively Exercising compulsively Preparing meals for others, but not eating Preparing meals for others, but not eating Withdrawing from friends and family Withdrawing from friends and family Critical of self and others Critical of self and others Sleep disturbances and depression Sleep disturbances and depression Ammenorrhea Ammenorrhea

Anorexia Health Problems “Skin-and-bone” appearance “Skin-and-bone” appearance Lowered body temperature Lowered body temperature Lanugo and loss of hair Lanugo and loss of hair Lower basal metabolism, decreased heart rate Lower basal metabolism, decreased heart rate Iron deficiency anemia and other nutrient deficiencies Iron deficiency anemia and other nutrient deficiencies Rough, dry, scaly, cold skin Rough, dry, scaly, cold skin Low white blood cell count, potassium Low white blood cell count, potassium Constipation, ammenorrhea Constipation, ammenorrhea < % body fat, shutdown of reproductive hormones < % body fat, shutdown of reproductive hormones

Nutrition Therapy Increase food intake to raise basal metabolism Increase food intake to raise basal metabolism Prevent further weight loss Prevent further weight loss Restore appropriate food habits Restore appropriate food habits Restrict excessive activity Restrict excessive activity Ultimately achieve and maintain weight gain to establish setpoint Ultimately achieve and maintain weight gain to establish setpoint

Bulimia Nervosa

Bulimia Health Problems Vomiting causes most health problems Vomiting causes most health problems Demineralization of teeth Demineralization of teeth Drop in blood potassium Drop in blood potassium Swelling of salivary glands Swelling of salivary glands Stomach ulcers and bleeding Stomach ulcers and bleeding Constipation Constipation Ipecac syrup is toxic Ipecac syrup is toxic

Treatment of Bulimia Nervosa Decrease episodes of bingeing & purging Decrease episodes of bingeing & purging Psychotherapy to improve self-acceptance Psychotherapy to improve self-acceptance Change “all-or-none” attitude about food Change “all-or-none” attitude about food Correct misconceptions about food Correct misconceptions about food Establish good, normal eating habits Establish good, normal eating habits Group therapy Group therapy Antidepressants Antidepressants Long-term therapy Long-term therapy

Binge-Eating Disorder

Profile of a Binge-Eater Considers self as hungrier than normal Considers self as hungrier than normal Isolates self to eat large quantities Isolates self to eat large quantities Suffers from stress, depression, anxiety, loneliness, anger, frustration that can trigger binge Suffers from stress, depression, anxiety, loneliness, anger, frustration that can trigger binge Uses food to reduce stress, provide feeling of power and well-being Uses food to reduce stress, provide feeling of power and well-being Usually binges on “junk” foods Usually binges on “junk” foods Eats without regard to biological need Eats without regard to biological need

Treatment of Binge-Eating Eat in response to hunger, not emotions Eat in response to hunger, not emotions Learn to eat in moderation Learn to eat in moderation Avoid restrictive diets that can intensify problems Avoid restrictive diets that can intensify problems Address hidden emotions Address hidden emotions “Overeaters Anonymous” “Overeaters Anonymous” Antidepressants Antidepressants

Profile of Female Athlete Triad Female athletes in appearance-based and endurance sports Female athletes in appearance-based and endurance sports –15% swimmers; 62% gymnasts; 32% other 1. Disordered eating 1. Disordered eating 2. Irregular menses or ammenorrhea 2. Irregular menses or ammenorrhea 3. Osteoporosis and loss of estrogen 3. Osteoporosis and loss of estrogen –Bone density similar to year olds –Bone loss is largely irreversible

Bone Structure

Treatment of Female Athlete Triad Reduce preoccupation with food, weight, and body fat Reduce preoccupation with food, weight, and body fat Gradually increase meals and snacks Gradually increase meals and snacks Rebuild body to healthy weight Rebuild body to healthy weight Establish regular menses (find weight?) Establish regular menses (find weight?) Decrease training by ~10%-20% Decrease training by ~10%-20% –Normal mensus is good!!!

Night Eating Syndrome Eating > 1/3 of calories after evening meal Eating > 1/3 of calories after evening meal Not feeling hungry in the morning Not feeling hungry in the morning Need to eat to help fall asleep Need to eat to help fall asleep Waking at night to eat Waking at night to eat Depressed Depressed

Chapter 11- eating disorders Moral: Moral: –People who have disorder (psychological)  Will continue until organ failure (don’t think it’s a problem) –e.g. Christy Henrich, promising young gymnast  Try to get them to seek help (intervention)  RESOURCES MY PSA for the day...recog. Primarily psychological issue, if feel you are close to family/ friend have problem... Seek information and help

Helpful Resources Course TEXTBOOK – Wardlaw 7 th Edition Course TEXTBOOK – Wardlaw 7 th Edition –Contemporary Nutrition Academy of Eating Disorders- Academy of Eating Disorders- – National Eating Disorders Association National Eating Disorders Association – National Institute of Mental Health National Institute of Mental Health – UCSC – Womens Center UCSC – Womens Center –