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 Purging 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?