1. Note No WIKIPEDIA

2. PSYCHOLOGY OF NUTRITION

3. Eating Disorders Introduction Anorexia Nervosa Bulimia Nervosa Obesity Attention deficit hyperactivity disorder Mood Disorders Schizophrenia

4. 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)

5. Introduction continued -what causes eating disorders -psychiatric/psychological or biochemical aberration

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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 %

12. 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.

13. 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.

14. 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

15. 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.

16. 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

17. 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

18. Obesity causes -media impact- eat more -hormonal-rare -genetics- it has been suggested that obese parents produce obese children but this is not absolute

19. Obesity Consequences -elevated blood pressure -heart disease -stroke -type II diabetes -arthritis -breathing problems -certain cancers

20. 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

21. Attention deficit hyperactivity disorder -define -developmentally inappropriate activity levels -low frustration tolerance -impulsivity -poor organisation of behaviour -inability to sustain attention and concentration

22. Attention deficit hyperactivity disorder -consequences -medication can reduce appetite and hence affect growth -treatments -reduce drug dose

23. 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

24. 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

25. 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