PSY240H5 Lecture Notes - Lecture 8: Bulimia Nervosa, Binge Eating Disorder, Binge Eating

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6 Jan 2017
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Lecture 8
Substance and Eating Disorders
Prevalence of Weight Problems
¼ women diet
Why Diet?
Health concerns= obesity, diabetes, high blood pressure
Attractiveness= western culture values being thin, think it increases self-worth
Dieting Consequences
Failure and cycling
Eating regulation issues
Types of Eating Disorders
1. Anorexia Nervosa
Fear of eig fat, thik they are fat ad dot desere food
Think they are fat but actually underweight
Ritualistic eating
Excessive exercise
Purging
DSM Criteria
Refuse to maintain healthy body weight
Distortions in body perception
Amenorrhea= absence of 3 consecutive menstrual cycles
Sub types
Restricting type= refuse to eat, can last days
Binge/ purge type= vomiting
o Binge types: subjective, objective
Anorexia vs Bulimia
Binge/ purge different from bulimia
1. Binge/purge 15% under healthy body weight
2. Develop amenorrhea, bulimia do not
2. Bulimia Nervosa
Binge eating then compensatory behaviour to prevent weight gain
Normal weight or slightly overweight
DSM Criteria
Binging= eating a lot of food in a short amount of time, lack of control
Behaviour to prevent weight gain (vomiting)
Occurs twice a week for 3 months
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Subtypes:
Non-purging type= excess exercise/ fasting to control weight
Purging type= use self- induced vomiting or meds
3. Binge- Eating Disorder
Compensating behaviours do not follow
Can be obese or normal- but fear of being fat
DSM Criteria
Eat quickly, large amounts when not even hungry
Feeling guilty after bingeing
1/week, 3 months
Prognosis (expected outcome)
mortality rates: 5-8%
causes of death: starvation, malnutrition, suicide
Medical Problems with Anorexia Nervosa
cardiovascular problems
expansion of stomach (rupture)
affected immune system
hair loss
Medical Problems with Bulimia Nervosa
electrolyte problems= heart failure
dental problems
osteoporosis
decreased fertility
Diagnosis Issues
disorders on a spectrum
differential diagnosis= rule out medical diseases
Assessment
eating disorder examination= clinical interview
self report
Cultural Views
in wealthy countries with a lot of food, when being thin is valued
anorexia nervosa seen through all cultures
Theories of Eating Disorders
Biological
o Heritable
o disruption of hypothalamus
o imbalance of serotonin, norepinephrine, or dopamine (neurotransmitters)
o imbalance of cortisol/ insulin (hormones)
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Sociocultural/ Psychological
o norms of what is considered attractive
o media
o binge eating to regulate emotion= stressed, sad
o Cognitive models: over value appearance, others opinions
Family Dynamics
Personality/ Individual
o Perfectionism, obsessiveness
o Low self esteem
Maturational Issues
o Males build muscle, females add body fat
Adversive Events
o Abuse
o Traumatic events
Integrative Models
Predisposing factors= events that trigger the eating disorder (a death)
Perpetuating factors= physical, psychological symptoms that maintain disorder (reduced
metabolism, social isolation, depression)
Treatments
Anorexia Nervosa
Hospitalization
Behaviour therapy= relaxation, reward methods
Family therapy
Nutrition therapy= weight restoration
Emotion control= underlying reasons
Bulimia nervosa
CBT
o 3 phases
o Psychoeducation: self-monitoring, identify triggers
o Problem solving skills
o Strategies to prevent relapse
Interpersonal therapy= maladaptive relationships
Meds= tricyclic antidepressants, serotonin reuptake inhibitors
Supportive- expressive psychodynamic therapy= express feelings
Substance Use Disorders
History
Mead= first alcohol consumed
Opium= to relieve pain, induce sleep, enhance pleasure
Substance intoxication= reversible, temporary condition due to ingestion of substance
Clinically maladaptive behaviour and cognitive changes
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Document Summary

Health concerns= obesity, diabetes, high blood pressure. Attractiveness= western culture values being thin, think it increases self-worth. Fear of (cid:271)ei(cid:374)g fat, thi(cid:374)k they are fat a(cid:374)d do(cid:374)(cid:859)t deser(cid:448)e food. Think they are fat but actually underweight. Amenorrhea= absence of 3 consecutive menstrual cycles. Restricting type= refuse to eat, can last days. Binge/ purge type= vomiting: binge types: subjective, objective. Develop amenorrhea, bulimia do not: bulimia nervosa. Binge eating then compensatory behaviour to prevent weight gain. Binging= eating a lot of food in a short amount of time, lack of control. Occurs twice a week for 3 months. Non-purging type= excess exercise/ fasting to control weight. Purging type= use self- induced vomiting or meds: binge- eating disorder. Can be obese or normal- but fear of being fat. Eat quickly, large amounts when not even hungry. Mortality rates: 5-8% causes of death: starvation, malnutrition, suicide. Eating disorder examination= clinical interview self report.

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