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Lecture 8

Lecture 8 For those of you who missed class, these notes have all the lecture slides and my own notes taken integrated together in one neat word document. Great for last minute studying!

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University of Toronto Mississauga
Ayesha Khan

PSY240 Lecture 8 Chapter 9: Eating Disorders and Obesity Eating Disorder= Not a healthy body mass, making an effort to make sure your weight is at an abnormal level -Abnormality w/ the amount of calories that you are consuming. -Maladaptive behaviours that lead to obesity -Obesity is not an anxiety disorder. Eating Disorders • The two most common forms of eating disorders are – Anorexia nervosa – Bulimia nervosa • In both disorders people feel – An intense and pathological fear of becoming overweight – A pursuit of thinness that is relentless and sometimes deadly • Person becomes consumed by what is their “ideal” weight Anorexia Nervosa • Characterized by – A fear of gaining weight – A refusal to maintain a normal weight – Person is already excessively thin • Two types of anorexia nervosa: – Restricting type • Avoid eating infront of others, restricting food calories, eating really slow – Binge-eating/purging type • Consume excessive amounts of food, then purge • 30-50% of individuals who start w/ restrictive move to binge/purge type • DSM-IV – Females: Requires that postmenarcheal females stop menstruating • One major characteristic of anorexia is that they stop menstruating. – Males: Diminished sexual appetite and low testosterone levels • Use urine test to measure level • DSM Limitations – Subtypes not useful – Females classification – Transition from restrictive to binge/purging = DSM is not as useful in this. – Redundant to categorize anorexia b/c usually progresses from restrictive to binge/purging type • The mortality rate for females with anorexia nervosa is more than twelve times higher than the mortality rate for females aged 15–24 in the general population Anorexia=excessive thinness -hair loss -nails becoming brittle -skin is very dry -yellowish tinge -chronic low BP -Vitamin deficiencies (vitamin B1 = sustaini brain function, low levels can result in neuronal death) -irregular heartbeats PSY240 Lecture 8 Bulimia Nervosa • Characterized by – Frequent episodes of binge eating – Lack of control over eating – Recurrent inappropriate behaviour to prevent weight gain • Taking laxatives, throwing up – Unlike patients with anorexia nervosa, bulimic patients are typically of normal weight • Less fatal than anorexia • The person is maintaining a better weight than the anorexic individual • Since the mortality rate is higher for anorexia than bulimia, a person who shows signs of bulimia but LOOKS very thin will automatically be diagnosed as anorexic. – (Provided that the person has stopped menstruating, low sexual appetite, etc) Anorexia & Bulimia Nervosa National ballet school. -roughly 26% have anorexia -15% have bulimia or some other type of maladaptive eating pattern. **look at this chart to find distinction** Bulimia can have purging and nonpurging another way they lose weight is by exercising or rigorous fasting fasting is kinda like restricting, but if the person is a relatively healthy rate then it’s bulimia, not anorexia **TEST** = give ~3 classifications ex. Maintaining low weight, amenorrhea, etc. Anorexia: DENIAL • Denial of condition • Denial of seriousness Bulimia: GUILT • Preoccupation with guilt & self-deprecation • Shame/self deprecation • Pain associated with inability to master the frequent impulse to binge PSY240 Lecture 8 Age of Onset and Gender Differences • Pathological patterns of eating date back several centuries, but did not attract much attention until the 1970s and 1980s – Women mvt to push funding for research. • The average age of onset for anorexia nervosa is 18.9 years old – Point at which it is diagnosed • The average age of onset for bulimia nervosa is 19.7 years old • There are 10 females for every male with an eating disorder Medical Complications of Anorexia Nervosa and Bulimia Nervosa • Anorexia can lead to – Death from heart arrhythmias (+ other cardiovascular disturbances) – Kidney damage – Renal failure • Bulimia can lead to – Electrolyte imbalances – Hypokalemia (low potassium) – Damage to hands, throat, and teeth from induced vomiting Male Eating Disorders • Tend to diet when their weight is 15% higher than the weight at which women begin to diet • Four major reasons: – Avoid being teased – Improve sports performance – Avoid weight-related medical illness – Improve a homosexual relationship • Established risk factors – Sexual orientation – Premorbid obesity and being teased as a child – Highly involved in sports (“make weight” sports) • • Idea of thinness is rising in males (anorexia) because of new ideals – Males will diet more – Excessive diet that is maladaptive will bring upon eating disorder – All the problems start w/ diet Other Forms of Eating Disorders • The DSM-IV-TR includes the diagnosis eating disorder not otherwise specified (EDNOS) – Given to 40% of patients • Binge-eating disorder (BED) – Similar to bulimia – Without any form of compensatory behaviour – Not listed formally in the DSM (in appendix) – Not classified as a complete eating disorder – Differences w/ bulimia: Purging, laxatives, exercising, etc. – Just eat and eat, no compensation to get rid of the excessive amounts of food coming into the system PSY240 Lecture 8 Eating Disorders and Other Forms of Psychopathology • Eating disorders are assoc
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