1. Adolescence and Emotional & Behavioral Problems

2. Eating Disorders
Anorexia Nervosa (AN)
Bulimia Nervosa (BN)

3. Does this look familiar?
Salvador Dali, “Swans Reflecting Elephants”

4. Swans Reflecting Elephants
Dali captured the way that so many of us perceive our bodies…
…we are all amazing in our own unique ways, yet when we look in the mirror we are so consumed with each little flaw that we become unable to appreciate our own beauty.

5. BODY IMAGE
Perception
Evaluation
Importance

6. THE CHANGING FEMALE BEAUTY IDEAL
Body Image
In a recent U.S. study, almost half of the surveyed women had negative evaluations of their own overall appearance.
THE CHANGING FEMALE BEAUTY IDEAL

7. BUT IT’S NOT JUST ADULTS…
By middle school, 20% to 50% of girls in the US say that they feel too fat.
One study found that 40% of adolescent girls believed that they were overweight, despite their normal weight range.

8. It’s NOT just a female issue…

9. It’s NOT just a female issue…
Typical growth for boys:
characterized by quick gains in height
but not necessarily by quick gains in muscle or weight.

10. It’s NOT just a female issue…
This is in striking contrast to the ideal body image for men, which has become increasingly muscular.
MALE BEAUTY IDEAL

11. Cosmetic Surgery
In 2003, there were 8.3 million procedures (surgical and nonsurgical) done:
322,975 liposuctions on women
61,646 liposuctions on men
280,401 breast enlargement procedures
From 2002 to 2003, the number of girls who were 18 years of age and younger who got breast implants increased almost 400%.

12. BODY IMAGE AND EATING DISORDERS Perception Evaluation Importance
distortion
Evaluation
dissatisfaction
Importance
undue influence on sense of self-worth

13. Refusal to maintain minimum weight for height Body image disturbance
EATING DISORDERS IN THE DSM IV
ANOREXIA NERVOSA
Refusal to maintain minimum weight for height
Body image disturbance
Amenorrhea (in females)
Recurrent episodes of binge eating
Over valuation of weight/shape
Recurrent extreme compensatory behaviors
BULIMIA NERVOSA

14. ANOREXIA NERVOSA (AN)

15. Anorexia Nervosa Onset: Early to mid-adolescent period
INTENSE FEAR OF GAINING WEIGHT
DENIAL OF THE SERIOUSNESS of the CURRENT LOW WEIGHT
PRESENCE of AMENORRHEA in post-menarchal females for at least 3 consecutive periods

16. Anorexia Nervosa (AN)
Refusal to maintain minimally normal body weight (weight <85% of expected for age and height)
Self-evaluation is unduly influenced by body shape & weight, or
Weight: underweight

17. AN types
1. Restricting
Restrictive eating patterns and significant weight loss
May change to binge/purge subtype
2. Binge eating/purging
Does regularly engage in binging & purging
Those with binge/purging type more likely to:
Have impulse control problems
Abuse alcohol or drugs
Attempt suicide

18. Anorexia Nervosa: Clinical Aspects WEIGHT: very decreased
FEMALE to MALE ratio = 10 : 1
MENSTRUATION : absent
BINGE-EATING: 25 to 50% of patients
MORTALITY : 5% per decade

19. AN Features
Diet greatly restricted - limited to a few foods, total food intake greatly reduced
Some feel globally overweight, others feel thin but parts of body are “too fat”

20. PHYSICAL SIGNS

22. AN Features
Obsessive weighing, measuring body parts, mirror inspection likely
Insight low – typically AN recognized by family

23. In the name of the Pursuit of thinness
Insufficient energy intake
Delusion of being fat
Obsession to be thinner
Does not diminish with weight loss
Denial
Can be fatal

24. BULIMIA NERVOSA (BN)

25. Bulimia Nervosa (BN) Recurrent episodes of binge eating
Lack of control – can’t stop or control amount
Recurrent compensatory behavior
Self-evaluation is unduly influenced by body shape & weight

26. BULIMIA NERVOSA (Avoidance of obesity)
Awareness that eating pattern is abnormal
Depressed moods and self-deprecating thoughts

27. BN Types 1. Purging – regularly purges
2. Nonpurging – uses other compensatory behaviors
Temporary relief via avoidance of weight gain by ???
Weight: normal

28. BN Features Onset: late adolescence, early adulthood
Abnormality is in amount of food consumed
Binges often secret (easier to hide than AN)
May develop strict rules (diet) regarding eating that are inevitably broken & lead to a binge
Feelings associated with binges?
???

29. PHYSICAL SIGNS

30. Prevalence of Eating Disorders
Prevalence has increased
over the last 50 years.
AN 0.5% to 1%
BN 1% to 3% of adolescent and young adult girls/women.
Female : Male = 10:1

31. Prevalence of Eating Disorders
More common among…

32. Comorbidity AN: Depression, anxiety
Severe medical problems and can lead to death in extreme cases
Depression, anxiety
Dependent on other people’s approval, extreme need for control
Substance abuse and dependence (BN)

33. Etiology SOCIETAL PRESSURE FOR THINNESS
COGNITIVE INTERNALIZIATION OF UNREALISTIC IMAGES
FAMILIAL FACTORS RELATED TO APPEARANCE AND ACHIEVEMENT

34. The Role of Media and Culture

35. DOCUMENTARY
IS IT BARBIE'S FAULT?

36. As you watch… What are the most common words in fashion magazines?
What did you learn about the diet-eating disorder Link?
What are the stereotypes for young teenagers?
How do you see the role of the media in Turkey in terms of promoting an ideal body image?