PSY240H1 Lecture 7: lecture 7 pt 1
Eating Disorders
• Functions of eating
o – Sustenance and survival
o – Pleasure
o – Comfort
o – Stimulation on/novelty or routine
o – Social engagement and bonding
• When is eating “disordered”?
o – Chronic yo-yo dieting
o – Frequent weight fluctuations
o – Extremely rigid or unhealthy diet regime
o – Preoccupation with food, body, or exercise that causes distress and has a
negative impact on quality of life
o – Compulsive or emotionally-driven eating
o – Rigid use of compensatory measures, such as exercise, food restriction, fasting
to "make up for" food consumed
o – Feelings of guilt and shame when unable to maintain diet and exercise habits
Diets work by reducing or eliminating certain foods. For example:
– No carbs
– Gluten-free
– No fat
– No meat
– No dairy
– Nothing cooked
– Nothing white (flour, sugar) – No solid foods!
The paradox – when we consciously deny ourselves something, our cravings only increase, and
we become preoccupied with food/controlling our cravings
Keys, Brozek, Hsu, McConoha, & Bolton – The Biology of Human Starvation (1950)
– “The Minnesota Starvation Experiment”
Study participants were 36 male conscientious objectors (men who didn’t want to go to war so
they had to be experimented on instead).
-mean age 25.5 years
– Ate a total of 1,500 calories/day for 6 months (meals mainly consisted of potatoes, turnips,
bread, and macaroni)
– Maintained activity levels, including 35km of walking/week
– Results:
Lost 25% of body weight (on average)
All became preoccupied with food (interesting behavior in men were observed like they started
obsessively reading cookbooks) – You see this in irritable bowel disorder as well.
Reported 21% reduction in strength, fatigue,
poor concentration, difficulty making decisions, lack of sexual interest, irritability, depression,
insomnia, social withdrawal, emotion dysregulation
Notable physical/medical symptoms
Eating Disorder Development and Onset:
Affect both males and females but more prevalent in females.
Occur across the lifespan
-Typical age of onset of anorexia nervosa and bulimia nervosa is adolescence to early adulthood
Onset before puberty or after age 40 is very rare.
Typical age of onset of binge-eating disorder is also adolescence to early adulthood but can also
begin in late adulthood.
Occur in all races and ethnicities
Incidence rates may be related to economic development, urbanization, and industrialization
Course is typically chronic (relapsing)
– Most individuals with anorexia nervosa experience remission within 5 years
Highly comorbid with mood, anxiety, and substance use disorders
Bulimia nervosa also comorbid with personality disorders, frequently borderline personality
disorder
Although substance abuse disorders often start out as a weight control strategy and then happen.
Male eating disorders have historically been perceived as very rare.
Eating disorders research has focused almost exclusively on women
Thus, our understanding of eating disorders has evolved based on female symptom profiles
because almost always women were recruited for the eating disorder research.
Absence of a male equivalent of the amenorrhea diagnostic criterion for anorexia nervosa in
(until DSM 4)
Actually, males account for 1/3 to 1/4 of cases of anorexia nervosa and bulimia nervosa
Characteristics of males with EDs
Greater variety of comorbid disorders (e.g., substance use, psychotic symptoms)
– Slightly later age of onset
• History of previous obesity (Experience of weight-related teasing)
Emerging symptom profiles of male EDs
Anorexia nervosa
1. Goal of dietary restraint is enhancing visibility of muscles rather than
thinness/emaciation
2. Compulsive exercise is more central to presentation, often last symptom to remit and
first to relapse
Bulimia nervosa
Greater hedonic preference for high protein and high fat foods, such as
meats or casseroles
Less likely to report loss of control or distress during binge-eating
Risks Associated with Eating Disorders.
Premature Death:
-Anorexia nervosa has the highest mortality rate of all mental disorders (10-15%)
-10% of individual diagnosed with anorexia nervosa die within 10 years diagnosis
-1.000 – 1,500 Canadians die each year from anorexia nervosa and bulimia nervosa
High Suicide Rates:
-Suicide is cause of death in 1/5 deaths attributable to anorexia nervosa
-35% of eating disorder patients attempt suicide, and patients with binge-eating or purging
behaviors at highest risk
Multi-systemic medical comorbidities
– Severe medical complications in every organ system in the body
Medical Complications slide online
Caution with Weight Loss as Defining Characteristic
• Weight loss is a defining characteristic of anorexia nervosa, but not bulimia nervosa or
binge-eating disorder
• Most individuals with eating disorders do not appear emaciated (only in most severe
cases)
• Eating disorders are present in people of all weights, and individuals with bulimia
nervosa and binge-eating disorder can be normal weight, overweight, or obese
• On average, the BMI of anorexia nervosa < bulimia nervosa < binge-eating disorder
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Document Summary
Functions of eating: sustenance and survival, pleasure, comfort, stimulation on/novelty or routine, social engagement and bonding. Diets work by reducing or eliminating certain foods. Nothing white (flour, sugar) no solid foods! The paradox when we consciously deny ourselves something, our cravings only increase, and we become preoccupied with food/controlling our cravings. Keys, brozek, hsu, mcconoha, & bolton the biology of human starvation (1950) Study participants were 36 male conscientious objectors (men who didn"t want to go to war so they had to be experimented on instead). Ate a total of 1,500 calories/day for 6 months (meals mainly consisted of potatoes, turnips, bread, and macaroni) Maintained activity levels, including 35km of walking/week. All became preoccupied with food (interesting behavior in men were observed like they started obsessively reading cookbooks) you see this in irritable bowel disorder as well. Reported 21% reduction in strength, fatigue, poor concentration, difficulty making decisions, lack of sexual interest, irritability, depression, insomnia, social withdrawal, emotion dysregulation.
