Eating Disorders Leah Shapira, M.A. Jan 4/2011 Leah Shapira, M.A. Jan 4/2011

 “The voice goes on in my head. I call it the anorexic minx. It’s like a little person that gets inside my mind and takes control of my thoughts. The voice tricks me into believing that I am in control but I am not, it’s in control of me. Dictating what I can and can’t eat and how much exercise I should do. It never lets me rest. Being anorexic takes up all my time, it becomes a way of life... Everything is controlled... Life is filled with thoughts of this illness. Anorexia has become my way of life. It is what I know.” (Lucy, 1999)

Anorexia Nervosa  Refusal to maintain body weight above a minimally normal weight for one’s weight and height  Intense fear of gaining weight  Distortions in the perception of one’s body weight or shape  Amenorrhea  Restricting or Binge/purge type  Refusal to maintain body weight above a minimally normal weight for one’s weight and height  Intense fear of gaining weight  Distortions in the perception of one’s body weight or shape  Amenorrhea  Restricting or Binge/purge type

Prevalence  1% will develop anorexia at some point in their lives  90-95% diagnosed are FEMALE  Highest mortality rates of all mental disorders (5 to 10%) –Medical complications  Usually begins in adolescence  1% will develop anorexia at some point in their lives  90-95% diagnosed are FEMALE  Highest mortality rates of all mental disorders (5 to 10%) –Medical complications  Usually begins in adolescence

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Bulimia Nervosa  Recurrent episodes of bingeing: –Eating in a discrete period of time an amount that is definitely larger than what most people would eat –Lack of control over eating during episode  Use of compensatory behaviors to prevent weight gain  Usually normal weight  Self-eval is influenced by body shape and weight  Recurrent episodes of bingeing: –Eating in a discrete period of time an amount that is definitely larger than what most people would eat –Lack of control over eating during episode  Use of compensatory behaviors to prevent weight gain  Usually normal weight  Self-eval is influenced by body shape and weight

A Biopsychosocial Model  Biological –Tends to run in families –Hypothalamus disruption  Serotonin  Biological –Tends to run in families –Hypothalamus disruption  Serotonin

Social  “Western” Societal pressures to be thin and attractive. –Internalization  Upper-class  Family dynamics  Peer pressures  “Occupational Hazards”  “Western” Societal pressures to be thin and attractive. –Internalization  Upper-class  Family dynamics  Peer pressures  “Occupational Hazards”

Promotion of the “Thin Ideal”  Airbrushing in the Media

Ideal Weight  Our “Ideal” shape increases with age  Current > attractive > ideal figure  Women think “thinner” is better, but men think heavier….  Fallin & Rozin, 1985  Our “Ideal” shape increases with age  Current > attractive > ideal figure  Women think “thinner” is better, but men think heavier….  Fallin & Rozin, 1985

Psychological Factors  Overvaluation of appearance  Cognitive factors –Dichotomous rigid thinking  Personality  Self-esteem  Emotional Regulation  Overvaluation of appearance  Cognitive factors –Dichotomous rigid thinking  Personality  Self-esteem  Emotional Regulation

Dieting  Dieting is an important onset risk factor –not all dieters end up with an eating disorder!  70% of women are dieting and 40% are continually gaining and losing weight  95% of all dieters regain their lost weight within one to five years  Why diets don’t work!  Dieting is an important onset risk factor –not all dieters end up with an eating disorder!  70% of women are dieting and 40% are continually gaining and losing weight  95% of all dieters regain their lost weight within one to five years  Why diets don’t work!

Celebrities and E.D.  Princess Diana  Paula Abdul  Katherine McPhee  Kelly Clarkson  Jamie Lynn Sigler (Sopranos)  Yeardley Smith –(Lisa from the Simpsons)  Alanis Morissette (Perfect)  Mary Kate Olsen  Victoria Beckham (et al.)  …and sadly, many more…  Princess Diana  Paula Abdul  Katherine McPhee  Kelly Clarkson  Jamie Lynn Sigler (Sopranos)  Yeardley Smith –(Lisa from the Simpsons)  Alanis Morissette (Perfect)  Mary Kate Olsen  Victoria Beckham (et al.)  …and sadly, many more…

Help?  National Eating Disorders Information Centre (NEDA) –  In Toronto…. –Centre for Addiction and Mental Health –Toronto General Hospital  National Eating Disorders Information Centre (NEDA) –  In Toronto…. –Centre for Addiction and Mental Health –Toronto General Hospital