chapter 8

Eating Disorders

Major Types of Eating Disorders

• Bulimia Nervosa

  • Characterized by episodes of binge eating followed by compensatory behaviors like vomiting or excessive exercise.

  • Symptoms include:

    • Recurrent binge-eating episodes.

    • Compensatory behaviors to prevent weight gain.

    • Self-evaluation heavily influenced by body shape and weight.

  • Risk of serious health consequences, including electrolyte imbalance and potential death.

  • Psychological factors include low self-esteem and anxiety.

• Anorexia Nervosa

  • Involves extreme restriction of food intake and an intense fear of gaining weight.

  • Symptoms include:

    • Severe weight loss (15% below expected body weight).

    • Distorted body image and extreme concern about weight.

    • Health risks include heart problems, cessation of menstruation, and electrolyte imbalances.

• Binge-Eating Disorder (BED)

  • Characterized by recurrent episodes of eating large quantities of food without purging.

  • Individuals often experience distress regarding their eating behavior but do not resort to compensatory actions.

  • Higher prevalence among those with obesity and psychological distress.

Statistics

• Eating disorders have increased significantly since the 1950s, with high mortality rates particularly associated with anorexia (approximately 20%).

• Bulimia has seen dramatic increases in reported cases over the decades, particularly among young women in Western cultures.

Causes of Eating Disorders

1. Social Dimensions

• Social pressures and cultural ideals promoting thinness contribute to the rise of eating disorders, particularly in competitive environments.

• Young women particularly affected due to societal emphasis on body image.

2. Biological Dimensions

• Genetics may play a role; family history increases risk of developing eating disorders.

• Certain personality traits, such as perfectionism, may predispose individuals to these disorders.

3. Psychological Dimensions

• Low self-esteem, body dissatisfaction, and anxiety are common in individuals with eating disorders.

• Distorted perceptions of body image contribute significantly, causing individuals to view themselves as overweight even when they are not.

Treatment of Eating Disorders

• Psychological Treatments: Cognitive-behavioral therapy (CBT) is the most effective for bulimia and anorexia, focusing on changing harmful thoughts and behaviors related to eating.

• Drug Treatments: Antidepressants may be helpful, particularly in conjunction with psychological therapies, although they are less effective for anorexia.

• Family Therapy: Important for adolescents, as familial dynamics can influence the development and maintenance of eating disorders.

Obesity

Overview

• Not classified as an eating disorder in the DSM, but recognized as a significant public health issue with serious associated health risks.

Statistics

• Approximately 70% of U.S. adults are overweight, with increasing rates over the past decades.

• Associated with risks like cardiovascular disease and type 2 diabetes.

Causes

• Environmental factors promoting sedentary lifestyles and highly caloric diets are major contributors to obesity.

• Genetic factors may explain why some individuals become obese while others do not.

Treatment

• Weight loss programs are common, but long-term success is rare without support.

• Medications and behavioral therapies may be recommended for sustainable weight management.

• Bariatric surgery is an option for individuals with severe obesity.

Sleep-Wake Disorders

Categories of Disorders

1. Dyssomnias: Issues with sleep quantity, quality, or timing.

   • Insomnia Disorder

   • Narcolepsy

   • Hypersomnolence Disorders

   • Breathing-related Sleep Disorders (e.g., sleep apnea)

   • Circadian Rhythm Sleep-Wake Disorders

2. Parasomnias: Abnormal events occurring during sleep.

   • Nightmare Disorder

   • Sleepwalking (Somnambulism)

   • Sleep Terrors

Insomnia Disorder

• Characterized by difficulty falling or staying asleep and non-restorative sleep.

• Significant distress or impairment in daily functioning.

• Often treated with behavioral therapies and lifestyle modifications.

Narcolepsy

• Characterized by excessive sleepiness, cataplexy, and disrupted nighttime sleep patterns.

• Associated with genetic influences and often requires stimulant medications for treatment.

Treatment of Sleep Disorders

• Medical Treatments: Usually involve medications, but psychological treatments like CBT can be more effective for insomnia.

• Environmental Treatments: Adjusting the sleep environment is crucial, including maintaining consistent sleep schedules and addressing sleep hygiene.

• Psychological Treatments: CBT for insomnia is particularly effective, incorporating sleep hygiene adjustments and cognitive restructuring.

Preventive Measures

• Good sleep hygiene practices can help prevent sleep disorders, such as maintaining a consistent sleep schedule, avoiding stimulants, and creating a conducive sleep environment.