1. Disordered Eating

2. 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

3. 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

4. Intimately tied to body image
Body image: the way you feel about your body

5. Factors contributing to Eating Disorders
Family environment
Unrealistic media images
Sociocultural values
Personality traits
Genetic & Biological factors

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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
% of those diagnosed will die from complications within 10 years.
Leading cause of death in females aged 15-24

12. 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

13. 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?

14. 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

15. 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

16. 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

18. 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

19. Disordered Eating patterns
Binge eating
Chronic dieting
Chronic overeating

20. 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

21. 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

22. 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

23. 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

24. Reduced BMR with dieting

25. 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?