1. Quick Review  Substance Abuse:  What were the classifications of substances we covered in class?  What were some of the substances we learned about in class?  What were some of the common side effects for each?

2. Non-Substance Related Addictions  We will briefly discuss the top 8 most common non- substance addictions…  Any guesses as to what they are?

3. Non-Substance Related Addictions  Gambling  Hoarding/Collecting  Work  TV/Internet/Video Games/Cell Phone  Pornography/Sex/Masturbation  Exercise/Body Building  Spending/Shopping  Food ** (can be considered a substance)

4. Non-Substance Related Addictions  Pause to discuss:  What are the dangers of each?  What constitutes an “addiction”?

5. Eating Disorders  What are eating disorders?  An illness that causes serious disturbances in your everyday diet  These illnesses can range from eating very little every day to extreme overeating  May have started out just eating less or more food on a daily basis  Then the urge to eat more or less spirals out of control

6. Eating Disorders  Eating disorders can also be characterized by an extreme concern/preoccupation with weight, shape, and/or body image  Commonly appear during teen years but can start in early childhood or even well into adulthood  Affect both men and women, however much more common in women

7. Eating Disorders  Common eating disorders:  Anorexia nervosa  Bulimia nervosa  Binge eating  EDNOS (Eating Disorders Not Otherwise Specified)

8. Eating Disorders  Eating Disorders are real, treatable medical illnesses  Frequently coexist with other disorders such as:  depression, anxiety, substance abuse, childhood trauma/neglect, issues with self-confidence and self-image  If not treated, eating disorders can cause serious health issues and even death

9. Anorexia Nervosa  Characterized by:  Extreme thinness (emaciation)  Extremely restricted eating  Relentless pursuit to lose weight/be thin  Refusal to eat full meals or gain weight  Unwillingness to maintain a healthy weight  Distorted self-image  Low self-confidence  Denial of unhealthy weight  Lack of menstruation for females

10. Anorexia Nervosa  Most people suffering from anorexia consider themselves overweight  Think about looking in a fun house mirror…they don’t see what everyone else sees….they only see flaws and amplify them as “I’m fat” and associate this with worthlessness and ugliness  Eating, food, and weight control become obsessions

11. Anorexia Nervosa  People with anorexia may also engage in binge eating followed by a form of purging:  Extreme dieting/fasting  Extreme exercise  Self-induced vomiting  Misuse of laxatives, diuretics, enemas, and diet pills ** We will discuss purging more when we review Bulimia Nervosa

12. Anorexia Nervosa  Harmful side effects:  Death  Brain damage  Organ failure (leading to death)  Infertility  Weakened and fragile bones (early onset of osteoporosis)  Weakened and wasting muscles (atrophy)  Brittle hair and nails (hair loss)  Loss of teeth  Dry, yellowish skin  Severe constipation  Constant fatigue  Moodiness, irritability, and depression  Lowered core temperature (always feeling cold)

13. Anorexia Nervosa: VIDEOS  http://www.youtube.com/watch?v=VS2mfWDryPE http://www.youtube.com/watch?v=VS2mfWDryPE  http://www.youtube.com/watch?v=RFvb1Hxz4To&feature=rel mfu http://www.youtube.com/watch?v=RFvb1Hxz4To&feature=rel mfu  http://www.youtube.com/watch?v=3Git2_X74_c http://www.youtube.com/watch?v=3Git2_X74_c

14. Anorexia Nervosa: Activity  Go to the following website:  http://www.medicinenet.com/anorexia_nervosa/article.htm  Answer the following questions:  1. What is anorexia nervosa?  2. Who is at risk?  3. What are the causes?  4. How is anorexia diagnosed?  5. What are the signs and symptoms?  6. What is the treatment for anorexia nervosa?  7. What is the prognosis of anorexia?  8. Where can a person get help for anorexia?

15. Bulimia Nervosa  Characterized by frequent episodes of uncontrollable overeating and purging  These binge-eating episodes are then followed by behaviors to compensate for the overeating such as:  Forced vomiting  Misuse of diuretics, laxatives, enemas  Fasting  Excessive exercise  Or a combination of 2 or more of these behaviors

16. Bulimia Nervosa  Unlike anorexia nervosa, people suffering from bulimia nervosa often maintain a “normal” or “healthy-looking” weight  This makes it hard to identify who is suffering from this disease

17. Bulimia Nervosa  Like anorexia, however, those suffering from bulimia are constantly unhappy with their weight and disgusted with how they look

18. Bulimia Nervosa  Purging is often done in secret because it is accompanied by feelings of shame, embarrassment, disgust, etc.  The binging-purging cycle can occur a few times a week or even a few times a day

19. The Binge-Purge Cycle

20. Binge Eating Signs/Symptoms  Lack of control over eating – Inability to stop eating. Eating until the point of physical discomfort and pain.  Secrecy surrounding eating – Going to the kitchen after everyone else has gone to bed. Going out alone on unexpected food runs. Wanting to eat in privacy.  Eating unusually large amounts of food with no obvious change in weight.  Disappearance of food, numerous empty wrappers or food containers in the garbage, or hidden stashes of junk food.  Alternating between overeating and fasting – Rarely eats normal meals. It’s all-or-nothing when it comes to food.

21. Purging Signs/Symptoms  Going to the bathroom after meals – Frequently disappears after meals or takes a trip to the bathroom to throw up. May run the water to disguise sounds of vomiting.  Using laxatives, diuretics, or enemas after eating. May also take diet pills to curb appetite or use the sauna to “sweat out” water weight.  Smell of vomit – The bathroom or the person may smell like vomit. They may try to cover up the smell with mouthwash, perfume, air freshener, gum, or mints.  Excessive exercising – Works out strenuously, especially after eating. Typical activities include high-intensity calorie burners such as running or aerobics.

22. Physical Signs/Symptoms  Calluses or scars on the knuckles or hands from sticking fingers down the throat to induce vomiting.  Puffy “chipmunk” cheeks caused by repeated vomiting.  Discolored teeth from exposure to stomach acid when throwing up. May look yellow, ragged, or clear.  Not underweight – Men and women with bulimia are usually normal weight or slightly overweight. Being underweight while purging might indicate a purging type of anorexia.  Frequent fluctuations in weight – Weight may fluctuate by 10 pounds or more due to alternating episodes of bingeing and purging.

23. Bulimia Nervosa  Health risks of bulimia nervosa:  Death  Chronically inflamed and sore throat  Swollen glands in the jaw and neck area  Multiple stomach problems  Acid reflux (heart burn)  Decaying teeth (from stomach bile)  Severe dehydration  Electrolyte imbalance (which can lead to heart attack)  Loss of hair, fingernails  Skin discoloration

25. Bulimia Nervosa: VIDEOS  http://www.youtube.com/watch?v=4zuDNSzO3zA http://www.youtube.com/watch?v=4zuDNSzO3zA  http://www.youtube.com/watch?v=qP0twyqBWIk http://www.youtube.com/watch?v=qP0twyqBWIk  http://www.youtube.com/watch?v=0vG9Ixcp06A&feature=fvst http://www.youtube.com/watch?v=0vG9Ixcp06A&feature=fvst  http://www.youtube.com/watch?v=yHZesejU6tU http://www.youtube.com/watch?v=yHZesejU6tU

26. Bulimia Nervosa: Assignment  Go to the following website:  http://www.helpguide.org/mental/bulimia_signs_symptoms_caus es_treatment.htm  Answer the following questions:  1. What is bulimia nervosa?  2. Draw the binge/purge cycle.  3. What are the causes and risk factors?  4. What are the signs and symptoms?  5. What are the effects of bulimia?  6. Where can a person get help for bulimia?  7. Describe the treatment for bulimia.  8. How can you help a person suffering from bulimia?

27. Excessive Eating  When a person loses control over his/her eating

28. Excessive Eating/Over Eating  Unlike bulimia, these binge episodes are not followed by purging, fasting, or excessive exercise  People suffering from binge-eating/over-eating disorder are usually overweight or obese

29. Excessive Eating  Can affect men and women of any age  Are usually accompanied by psychological disorders/depression

30. Excessive Eating  Binge eating is usually described as a vicious cycle:  Turning to food for comfort  Overeating  overweight  guilt and depression  food for comfort  overeating  “I am fat, so now I am sad…I am sad, so I eat….I eat, so now I am fat”

31. Over Eating  Very high risk of heart disease, high blood pressure, and early death  Additional side effects:  Organ failure  High cholesterol  Little to no physical activity  Limited movement  Low self-confidence  Depression

32. Overweight vs. Obesity  Both terms are labels for ranges of weight that are greater than what is generally considered healthy  **These ranges also represent the increased likelihood of developing certain diseases and illnesses  Overweight = 25-29.9 BMI  Obese = 30 or above BMI  BMI = Body Mass Index  BMI is a calculation of your height compared to your weight

33. Overweight vs. Obese HeightWeight RangeBMIConsidered 5' 9" 124 lbs or lessBelow 18.5Underweight 125 lbs to 168 lbs 18.5 to 24.9Healthy weight 169 lbs to 202 lbs 25.0 to 29.9Overweight 203 lbs or more30 or higherObese -It is important to remember that although BMI compares only height and weight, BMI does not directly measure body fat. -As a result, some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat. -http://nhlbisupport.com/bmi/bminojs.htmhttp://nhlbisupport.com/bmi/bminojs.htm

34. Statistics on Obesity  http://frac.org/initiatives/hunger-and-obesity/obesity-in-the-us/ http://frac.org/initiatives/hunger-and-obesity/obesity-in-the-us/  https://www.heart.org/idc/groups/heart- public/@wcm/@sop/@smd/documents/downloadable/ucm_3 19588.pdf https://www.heart.org/idc/groups/heart- public/@wcm/@sop/@smd/documents/downloadable/ucm_3 19588.pdf

35. Excessive Eating  Video Clip:  http://www.youtube.com/watch?v=GC3BNPZQtk8 http://www.youtube.com/watch?v=GC3BNPZQtk8

36. Group Activity  In groups, you will make a new law regarding food regulations/distribution/production/etc.  You will then share your new law with the class

37. Body Image Activity  What Models Really Look Like:  - http://pinterest.com/lovelylane/see-nobodys-perfect/http://pinterest.com/lovelylane/see-nobodys-perfect/  - http://idealbite.com/100-percent-of-what-you-see-in-fashion- magazines-is-retouched/http://idealbite.com/100-percent-of-what-you-see-in-fashion- magazines-is-retouched/  - http://mashable.com/2011/12/01/before-and-after-photos/http://mashable.com/2011/12/01/before-and-after-photos/

38. Body Image: Activity  Complete the following statements on a sheet of paper:  **DO NOT WRITE YOUR NAME**  I am a (male or female)  When I look in the mirror I like.....  If I could change anything about my weight/body, I would.....  When it comes to eating/food, I wish I knew more about.....  When it comes to exercise/fitness, I wish I knew more about…

39. EDNOS  Eating Disorders Not Otherwise Specified  EDNOS Video:  - http://www.youtube.com/watch?v=1OQbUZeYAikhttp://www.youtube.com/watch?v=1OQbUZeYAik

40. Eating Disorders and Body Image: Activity  1. Go online and find advertisements that display the following:  An unhealthy image  An unrealistic image  A healthy image  A healthy message  An unhealthy message  2. Copy and paste each of these images/advertisements onto a WORD document.  3. Label each advertisement.  4. Give a brief explanation as to why you labeled the image the way you did.

41. Eating Disorder: Documentary  True Life: I Have an Eating Disorder  http://www.youtube.com/watch?v=cwg563Hcjpk http://www.youtube.com/watch?v=cwg563Hcjpk  OR  “THIN” by HBO:  http://www.youtube.com/watch?v=fF0lAlo80fU http://www.youtube.com/watch?v=fF0lAlo80fU  - Fast Food Nation  - The Weight of the Nation  - Morbidly Obese (part 1)  - Fat, Sick, and Nearly Dead  - Hungry for a Change

42. Body Image: Discussion  As a class, talk about the reality show "The Swan"  (Does everyone know the story about the ugly duckling?)  Purpose of the show?  What are contestants competing for?  What type of message does this send?  Look at before and after pictures.  What is your reaction? What do you think?