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Note No WIKIPEDIA
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PSYCHOLOGY OF NUTRITION
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Eating Disorders Introduction Anorexia Nervosa Bulimia Nervosa Obesity Attention deficit hyperactivity disorder Mood Disorders Schizophrenia
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Introduction -define eating disorder -a situation where a person eats or overeats non-nutritious amounts of foods and/or deliberately vomits foods -vomiting may include ridding the body of non-nutritious or nutritious amounts of foods -leads to disease or disability -classified on basis of visible end result (extreme thinness or fatness) or on the basis of variation of eating patterns (fasting, binging, food restriction)
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Introduction continued -what causes eating disorders -psychiatric/psychological or biochemical aberration
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Anorexia Nervosa -define -characterised by self-imposed weight loss, hormone function, and distorted psychopathological attitude towards eating and weight -epidemiology -typically occurs in females shortly after puberty or later in adolescence -but can be before puberty or later in life
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Anorexia Nervosa -causes- -biological -unexplained physiological (possibly hormonal changes) with possible genetic predisposition -psychological -family dynamics causing intrapsychic conflicts -social -the belief that the person is too heavy -the view that heavy is ugly and thinness is beautiful -self-esteem may be low -ties in with onset of puberty
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Anorexia Nervosa -consequences -similar to other states of semi-starvation -adaptive responses by the body that allow the person to survive decreased dietary energy intake -such adaptive measures have their costs -such costs are limitations are mental and physical abilities of person -these limitations come about because sparing of utilisation of glucose and proteins and the shift to the utilisation of fat stores in the body
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Anorexia Nervosa Consequences -shift in fluid and electrolyte (mineral) balance in body -disturbances in hormones leading to lack of a period and infertility, cold intolerance, dry skin and hair, and constipation
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Anorexia nervosa Treatments -done jointly with physician and dietitian -mild cases -counselling about adolescent growth and nutrition education and consequences of starvation -more severe cases -psychiatrist and dietitian who specialise in eating disorders and provide psychological and dietary counselling, and general support -very severe-hospitalisation including feeding by other than mouth combined with above
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Anorexia Nervosa outcomes - must follow for at least 4 years - 50-60 % of patients are back to normal weight after 4 years - after 6 years have 50 % recovery from disease (previous point?) - 6- 12 years of illness 75 % recover - after 12 years of illness recovery unlikely - mortality rate- 0 –5 %
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Bulimia nervosa Defined -Characterised by frequent binge eating and purging associated with the loss of control over eating and the persistent overconcern about body shape and weight. Occurs predominately in young adult women -Milder forms of binging and purging (vomit and laxatives) are common in normal weight females.
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Bulimia Nervosa Multiple determinants -Depression -Impaired hormonal regulation suggesting really full when not -Reduced post-prandial satiety - if person once maintained a higher weight and if they are in the normal range due to binge and purge now it will be sub-optimal for them -therefore in a state of semi-starvation -Binge and purge can also occur in in normal weight persons who have never had anorexia nervosa-some may have been overweight or desire slimmer figure. Meal skipping and calorically restricted meals often starts the process.
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Bulimia nervosa Consequences -Clinically changes similar to anorexia nervosa occur -Diversity of eating patterns among bulimics makes it difficult to generalise regarding the physiological consequences Epidemiology -1-9% among young adult women; rare in males -mean age for diagnosis 23 years -among 15-24 yr females bulima nervosa is 2 x as common as anorexia nervosa
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Bulimia nervosa Treatment As per anorexia nervosa Outcomes Few studies that follow patients for more than one year after treatment In the short term there is 66 % recovery.
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Obesity -define -excessive accumulation of fat in the body -body mass index of greater than 30 -body mass index is kg/m 2 -greater than 102 cm males and 88 cm females -epidemiology -children -about 15 % of child population -adults -about 33 % of adult population with young women more likely to be affected than young men
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Obesity -causes -low income -higher percentage of low income population are obese -higher income -lower percentage of affluent population are obese why? - different ethnic groups have different percentage of their respective populations that are obese e.g. among U.S. males- Hispanics > whites > blacks
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Obesity causes -media impact- eat more -hormonal-rare -genetics- it has been suggested that obese parents produce obese children but this is not absolute
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Obesity Consequences -elevated blood pressure -heart disease -stroke -type II diabetes -arthritis -breathing problems -certain cancers
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Obesity Treatments -caloric restriction and exercise- otherwise yo yo effect -appetite suppressing drugs -psychotherapy -behaviour modification- eg only eating in dining room -surgery-stomach stapling Outcomes -highly individual
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Attention deficit hyperactivity disorder -define -developmentally inappropriate activity levels -low frustration tolerance -impulsivity -poor organisation of behaviour -inability to sustain attention and concentration
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Attention deficit hyperactivity disorder -consequences -medication can reduce appetite and hence affect growth -treatments -reduce drug dose
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Mood Disorders -define -depression or manic-depression -causes -brain biochemical disorder -consequences -depression- loss of appetite and anorexia -manic depression- lithium used to treat-gives weight gain
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Mood Disorders Treatments -depression- treat via counselling and medication -manic depression-keep dietary sodium up because lithium rises in blood if dietary sodium is restricted
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Schizophrenia -define chronic hallucinations, delusions, illogical thinking and bizarre behaviour -causes -biochemical disorder in brain -consequences -voices telling people not eat- weight loss -treatments -counselling and medication
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