Lecture 14 - Disordered Eating

history of eating disorders

• 1870s - first report of anorexia

• Ancient times

  • Christmas: semi-starvation + fasts

  • Ramadan: fasting

  • greeks + romans: bingeing + purgeing

Karen Carpenter

• ate only lettuce water and one steak per day

• model of “self control”

• died at 32 from anorexia

eating habits continuum

• food is not an issue

• concerned well

• food preoccupations

• disruptive eating patterns

• eating disordered

body image continuum

• body ownership

• body acceptance

• body preoccupation

• distorted body image

• body hate

eating disorder

psychiatric condition

• extreme body dissatisfaction

• harmful long term eating habits

disordered eating

variety of abnormal eating patterns used to reduce weight

causes of ED

• family environment

• media

• sociocultural values

• personality

• genetics

• PTSD

• (no simple cause)

family environment

• anorexia: rigid family structure

• bulimia: less stable family

• history of anxiety etc.

sociocultural

western cultures values slenderness

personality

specific personality traits different for anorexia vs. bulimia

serotonin + eating disorders

• may be a link

• antidepressants help bulimia

anorexia nervosa definition

unhealthful behaviours used to maintain a body weight less than 85% of expected weight.

anorexia nervosa demographic

• 90-95% are young girls

• 0.5-1% Canadian females will develop

• 5-20% females will die from anorexia

anorexia symptoms

• restrictive eating practices

• self-starvation

• fear of weight gain

• amenorrhea

• unhealthful body image

amenorrhea

no periods for 3+ months

anorexia health complications

• electrolyte imbalance

• cardiovascular problems

• gastrointestinal problems

• bone problems

anorexia warning signs

• cooperative, obedient, good student

• list of acceptable food

• cutting food into small bits

• rearranging food

• planning elaborate meals

• lots of fluids

bulimia nervosa definition

binge eating + purging

• large amount of food in short time

• vomiting, laxatives, fasting, excessive exercise

bulimia demographics

• 1-4% of women

• unmarried caucasian female 20-30 yrs

• destructive relationship

• all or nothing thinkers

• 1:6 -1:10 male:female

• 1% will die

bulimia symptoms

• recurrent bingeing episodes (2x per week for 3+ months)

• recurrent purging

• 40% do both but not enough to have diagnosis

cycle of bulimia

anxiety → binge → fear of fat gain → purge → relief → guilt

bulimia health risks

• electrolyte imbalance (dehydration + low Na, K)

• Gastrointestinal problems

• Dental problems

• swelling of cheeks or jaw

vegetarianism + eating disorders

strong correlation in teens

• 81% female

• more likely to diet, vomit, use laxatives

• sometimes used to mask ED

disordered eating types

• binge eating (ED from 1994)

• chronic overeating

• chronic dieting

EDNOS

eating disorder not otherwise specified

• dont meet strict criteria for anorexia or bulimia

binge eating disorder symptoms

• overweight

• lack of control

• chaotic eating (eating fast or hiding)

• depression, substance abuse, anxiety

what causes binge eating disorder

learned response to stress

• parents use food rather than affection

• begins in grade school

• eat in response to emotions vs. hunger

binge eating disorder health risks

• risk of obesity (high fat + sugar foods)

• psychological effetcs

chronic dieting symptoms

• preoccupation w food + weight

• strict dieting + exerciese

• low concentration + mood swings

• low body image

chronic dieting health risks

• poor nutrient + energy intake

• low vitamin + minerals

• dec energy expenditure from lowered BMR

• inc risk of ED

night eating syndrome

• 25% of kCal after evening meal

• nocturnal awakening + eating

baryophobia

Parents underfeed child as they fear they’ll be obese

orthorexia

Excessive preoccupation with eating healthy food that leads to unhealthy consequences

anorexia athletica

Limited calories despite high energy output

Relative Energy Deficiency in SPort (RED-S)

• broader consequences of lower energy availability

• was renamed to include all genders

female athlete triad

• subset of RED-S

• serious medical syndrome frequently seen in female athletes

  1. disorderd eating

  2. menstrual dysfunction

  3. osteoporosis

RED-S Symptoms

• fatigue

• low libido

• missed periods

• frequent illness

• decreased sport performance

• depression + irritability

who is at risk for RED-S

• sports that strive for “thin body” image

• weigh-in sports

• endurance athletes

• teams that body shame

• teams that only want to win

treatment for ED (4 levels)

1. outpatient

2. intensive outpatient

3. hospitalization

4. residential treatment centre

treatment for anorexia

• restore healthy weight

• treat complications

• correct dysfunctional feelings towards eating

treatment for bulimia

• identify + modify triggers

• monitor and alter thought patterns related to food + body image

ED prevention

• reduce weight criticism in YA and childs

• identify unrealistic body image in media

• particiipating in sports

• modeling healthy diet by parents

physique anxiety

increased risk for engaging in uncontrollable exercise

disordered eating attitudes (DEAS)

continuum of abnormal thoughts + behaviours associated with eating

eating pathology

any symptom of an eating disroder

body dysmorphic disorder

psychiatric disorder defined by a disabling preoccupation with perceived defects in appearance

• 2% of pop.

muscle dysmorphia

type of BDD

• pursuit of increased muscularity

avoidant-restrictive food intake disorder (ARFID)

limitation of food with no body dysphoria

other eating disroders (OED)

• pica

• rumination