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Lecture 6

Lecture 6 - Eating Disorders

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PSY240 Lecture 6: Eating Disorders
64% of American adults are overweight (BMI>25) or obese (BMI>30)
25% of American children are overweight or obese
The prevalence has doubled over the past 2 decades, a bit higher in boys (5-15%)
than in girls (5-13%), morbid obesity at high especially increase
Increase in availability of inexpensive high-fat processed foods, sedentary behaviour,
office jobs without physical activity
Associated with health problems (ex. CV disease, type II diabetes expensive to
treat, high blood pressure, high cholesterol)
Costs the US $100 billion annually and causes 300,000 deaths annually
Not a mental disorder, although it can be the result of an eating disorder
The Eating Disorder Epidemic
Parallel increase in prevalence of dysfunctional eating practices, including eating
disorders and unhealthy weight loss crash diets, yo-yo diets
In past wasnt associated with body image symbol of strength, protest, spiritual
More prevalent in Westernized cultures simultaneously promotes the thin ideal
and excessive consumption, hard to navigate
45% of women and 25% of men are on diets to control their weight at any given time
16% of women between 19-39 are perpetual dieters
70% of 10 yr old girls have dieted, not seen historically
Americans spend $30 billion per year on weight loss products
Preoccupation with food and weight can lead to a clinical disorder to feel better, but
mainly to look more attractive based on images seen in the media
Overview of Eating Disorders
Anorexia Nervosa
oDrawn to hospitality professions
oBias towards self
oDSM-IV Diagnostic criteria started in 1980s:
Refusal to keep body weight at or above 85% of the general recognized
normal level for age and height
Intense fear of gaining weight or becoming fat even when underweight
Disturbance in experience of body weight or shape, undue influence of
these factors on self-esteem, or denial of the seriousness of the health
risks of the current low body weight weight themselves often
If menstruation has begun, the absence of three consecutive
menstrual cycles might be got ridden of because it doesnt affect men
and the weight when it stops varies, as well for women on birth control

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oTwo types recognized:
Restricting type: main focus in restraining food intake, in general
space food out throughout the day distrustful of people, denial
Binge-eating/purging type: regular binge eating followed by purging by
vomiting, laxatives, etc. more likely to have personality disorders,
drug/alcohol history, suicide attempt history
Prevalence: 0.5-1% (lifetime), more common in high socio class and
Caucasian females
Gender: more than 90% female men less likely to stray from ideals of
being muscular
Onset: typically early to late adolescence (13-18 yrs), often after an
episode of dieting and the co-occurrence of an important life stressor,
common in university students
Course: Highly variable
Significant medical consequences osteoporosis, intolerance of cold,
cardiovascular, drop in blood pressure, electrolyte imbalance from
vomiting, constipation, bad breath, hair loss, brittle and hair and skin,
increased hair growth for warmth on body
High mortality rate 8-15%, as a result of medical complications
Hard to get to invest in treatment and earn trust
Might need to hospitalize against their will if urgent and in denial,
incentive programs with rewards for eating
Weight restoration immediately if very low, need to gain weight to
gain concentration to participate in therapy
Nutritional rehabilitation
Medication if comordity with anxiety/depression but not high evidence
for just treating anorexia
CB T empirically supported treatment(EST) but not as good for AN
as for BN
Family therapy better for younger patients
Interpersonal therapy role conditions, conflict, lack of social support
Motivational Interviewing developed for addictions, tries to target
treatment to where the patient as at pre-treatment to resolve
ambivalence and then start treatment
Bulimia Nervosa
oSometimes hard to define what counts as a binge, context-dependent
oDSM-IV Diagnostic Criteria:
Frequently occurring episodes of binge eating that are characterised
by both (a) eating an amount of food that is definitely larger than most
ppl would eat within a similar specific period of time and in similar
circumstances and (b) a sense of lack of control over eating during the
overeating episode
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