Chapter 15: Eating Disorders - In-Depth Notes

Student Learning Outcomes

• Contrast Healthy Attitudes Towards Food vs. Unhealthy Uses: Understand the mental perspectives towards food that foster healthy or unhealthy eating behaviors.
• Origins of Eating Disorders: Describe current hypotheses regarding the reasons behind eating disorders.
• Anorexia Nervosa:
  • Characteristics: Identify both physical and psychological traits.
  • Treatment Best Practices: Outline most effective treatment strategies.
• Bulimia Nervosa:
  • Characteristics: List physical and mental traits.
  • Treatment Best Practices: Describe the best treatment practices for individuals with bulimia.
• Binge Eating Disorder:
  • Characteristics: Identify traits and outline treatment practices.
• Other Specified Feeding Disorders: Explain conditions like pica and their characteristics.
• Patterns of Disordered Eating: Discuss various unhealthy eating behaviors not formally classified as eating disorders.
• Strategy Development: Explore strategies aimed at preventing the development of eating disorders.

Understanding Eating Disorders

Demographics of Eating Disorders

• Eating disorders affect everyone regardless of gender, age, race, ethnicity, body type, and socioeconomic status.
• Emerging evidence shows that external factors, such as the influence of social media, contribute to increased body dissatisfaction across diverse populations.

Ordered vs. Disordered Eating

• Disordered Eating: Mild, short-term changes in eating habits typically triggered by stress or personal events.
• Eating Disorder: Characterized by clinically significant impairments resulting from the sustained presence of disordered eating.

Factors Influencing Eating Disorders

• Genetic Influence: Genetics contribute 50-83% to the risk of developing eating disorders, with identical twins being more likely to share disorders than fraternal twins.
• Environmental Influence: Cultural and social factors also play a critical role in how eating disorders develop, particularly among adolescents.

Anorexia Nervosa

Diagnostic Criteria for Anorexia Nervosa

1. Extreme dietary restriction leading to significantly low body weight.
2. Intense fear of weight gain or behaviors to avoid weight gain despite being underweight.
3. Distorted body image and self-worth heavily influenced by weight or shape.

Physical Effects of Anorexia Nervosa

• Severe malnutrition
• Osteopenia or osteoporosis
• Electrolyte imbalances leading to heart problems
• Amenorrhea
• Dental issues due to acid exposure from vomiting

Treatment Approaches

• Multidisciplinary Treatment Team: Involves physicians, dietitians, psychologists, and social workers.
• Nutritional Therapy Goals: Promote gradual weight gain, stabilize health, and educate about healthy eating patterns.
• Psychological Therapy: Addresses underlying emotional issues and cognitive distortions.
• Pharmacological Therapy: Limited use, primarily focusing on stabilizing mood once a healthy weight is achieved.

Bulimia Nervosa

Diagnostic Criteria for Bulimia Nervosa

• Recurrent episodes of binge eating, with loss of control during binges.
• Following binge, inappropriate compensatory behaviors occur (e.g., vomiting, use of laxatives).
• Behaviors must occur at least once a week for three months and are distinctly different from anorexia.

Key Characteristics

• Episodes often consist of high carbohydrate and sugar foods.
• Purging leads to numerous physical health issues, such as dental erosion and electrolyte imbalance.

Binge Eating Disorder

Diagnostic Criteria

• Recurrent episodes of binge eating where individuals feel a loss of control and experience significant distress.
• Associated with physical health complications such as obesity, cardiovascular disease, and diabetes.

Treatment Approach

• Focus on reducing binge episodes, addressing psychological needs, and encouraging nutritional education on hunger and fullness.
• Cognitive Behavioral Therapy (CBT) is effective in treating emotional triggers related to eating behaviors.

Other Specified Feeding and Eating Disorders

1. Pica: Involves persistent eating of non-nutritive, non-food substances leading to health risks like infections or toxicity.
2. Avoidant/Restrictive Food Intake Disorder (ARFID): Severe restrictive eating patterns often co-occurring with anxiety or autism spectrum disorders.
3. Purging Disorder: Involves purging behaviors without binge eating episodes, distinguishing it from bulimia nervosa.
4. Night Eating Syndrome: Characterized by consuming the majority of daily calories post-evening meal and feelings of guilt around eating habits.

Prevention Strategies

• Education on Nutrition: Teach children about normal changes during puberty, healthy eating, and body diversity.
• Promote Self-Acceptance: Encourage a positive body image and respect for different body shapes and types.
• Create Supportive Environments: Foster supportive peer relationships and themes of acceptance rather than focusing solely on weight.

Conclusion

• Early intervention and awareness of the complexity surrounding eating disorders can significantly improve treatment outcomes and promote healthier eating patterns among individuals.