PSY Eating Disorders

Body Dissatisfaction

• Evaluating one’s weight and shape negatively

• Single most powerful contributor to dieting & development of eating disorders

Anorexia Nervosa

1. Restricted energy intake leading to significantly low body weight 

2. Intense fear of gaining weight or becoming fat

3. Disturbance in the way in which one’s body weight/shape is experienced, undue influence of body weight/shape on self evaluation, or lack of recognition of seriousness of low body weight

Restricting Type - Anorexia Nervosa

• Lose weight by cutting out sweets and fattening snacks 

• Eventually eliminating nearly all food 

• Almost no variability in diet 

Bing eating/Purging - Anorexia Nervosa

• Lose weight by forcing themselves to throw up after meals

• Or by abusing laxatives or diuretics 

• May engage in eating binges

Medical Problems of Anorexia Nervosa

• Highest mortality rate of any mental illness 

• Amenorrhea (no period) and Lanugo (little hair grows on arms and legs, bodies way of keeping heat)

• Lowered body temperature, low blood pressure, body swelling, reduced bone mineral density, slow heart rate

• Metabolic and electrolyte imbalances 

• Skin, nail, and hair problems 

Treatment of Anorexia Nervosa

• Immediate Aim - Stabilize 

  • Stop weight loss 

  • Address malnourishment 

• Next Step - Recovery

  • Restore weight 

  • Learn normal eating patterns 

• Final Step - Preventing relapse 

  • Change attitudes about weight/eating 

  • May require long term therapy

  • May require changing family dynamics 

Bulimia Nervosa

• Recurrent episodes of binge eating involving a sense of lack of control

• Compensatory behaviors (purging) to prevent weight gain

• The binge eating and purging occur at least once a week for 3 months 

• Self-evaluation is unduly influenced by body shape and weight 

Binges

• Episodes of uncontrollable eating—very large quantity of food

• May involve 1 to 30 episodes per week and 2,000 to 3,400 calories per

• episode

•  Often in secret, usually with sweet, high-calorie, soft-texture foods

• Usually preceded by great tension, which is relieved by eating

• Followed by extreme self-blame, shame, guilt, depression, and weight gain fear

Treatment of Bulimia Nervosa

• Eliminate binge-purge patterns

• Establish good eating patterns 

• Eliminate underlying causes of bulimic patterns

• Drugs 

  • Antidepressant can help with mood and response to stress 

  • GLP-1s 

Binge Eating Disorder

• Include at least 3

  • Unusually rapid eating 

  • Absence of hunger

  • Uncomfortable fullness 

  • Eating alone because of embarrassment 

  • Subsequent feelings of self-disgust, depression, or severe guilt 

  • Marked distress regarding binge-eating 

  • At least weekly of 3 months 

  • Absence of excessive compensatory behaviors 

Health Problems for Binge-Eating Disorder

• Obesity

• Diabetes 

• Heart Disease

• Cancer

• Sexual/Reproductive Problems 

• Sleep problems 

• GI-Tract Issues

• Kidney and Liver Problems 

Treatment of Binge Eating Disorder

• Similar to bulimia 

• Additional weight management interventions may be needed

• GLP-1s and new medications 

Cause of ED’s?

• Societal

  • Ads

  • Western Beauty Standards

  • Socially accepted prejudice against overweight people

  • Media/Social Media catalyze these factors

• Family Environment

  • Emphasis on thinness, appearances, or dieting 

  • Dieting and perfectionistic mothers

  • Bingeing or dieting modeled behavior 

  • Embellishment - overinvolvement, over functioning, taking responsibility for others problems

Cognitive Behavioral Factors

• Improper labeling of internal sensations/needs

• Cognitive Distortions 

• All-or-nothing 

• Overempasize importance of body shape/weight 

Biological Factors

• Genes - increase susceptibility 

  • Relatives with ED 6x more likely to develop an ED

• Set point

  • Identical twins have similar weights, regardless of raised in the same home

  • Depression: Similar brain dysfunction in depression and ed, Comorbidity, Antidepressants sometimes help both depression and ed

Psychodynamic Factors

• Displacement - can’t control life, so try to control body size

• Ego deficiencies - difficulties in managing oneself 

• Parents fail to accurately attend to a child's needs 

• Child grow up confused about how to meet their own needs