PSYC 4430 Lecture Notes - Bulimia Nervosa, Binge Eating Disorder, Cognitive Behavioral Therapy
10 Jun 2018
School
Department
Course
Professor
Chapter 8: Eating and Sleep-Wake Disorders
1. Bulimia Nervosa
a. Overview and defining features
i. Binge eating—hallmark of bulimia nervosa and binge eating disorder
1. Eating excess amounts of food in a discrete period of time (e.g.
one hour)
2. Eating is perceived as uncontrollable
3. May be associated with guilt, shame, or regret
4. May hide behavior from family members
5. Foods consumed are often high in fat, sugar, or carbs
ii. Copesato ehaios desiged to ake up fo ige eatig
1. Purging
2. Excessive exercise
3. Fasting or food restriction
4. Laxatives
5. Enema
b. Associated features
i. Medical
1. Most are within 10% of normal body weight
2. Purging methods can result in severe medical problems
a. Erosion of dental enamel, electrolyte imbalance
b. Kidney failure, cardiac arrhythmia, seizures, intestinal
problems, permanent colon damage
ii. Psychological
1. Most are overly concerned with body weight
2. Fear of gaining weight
3. Most have comorbid psychological disorders
c. Facts and statistics
i. Majority are female—90+%
ii. Onset typically in adolescence
iii. Lifetime prevalence is about 1.1% for females and 0.1% for males
iv. 6-7% of college women suffer from bulimia at some point
v. Tends to be chronic if left untreated
vi. Lifetime prevalence—approximately 1%
vii. Cross-cultural factors
1. Develop in non-Western women after moving to Western
countries
2. Rare in African-American women
d. Medical and psychological treatment
i. Psychosocial treatments
1. Cognitive behavioral therapy (CBT)
a. Treatment of choice
find more resources at oneclass.com
find more resources at oneclass.com
b. Basic components: identifying maladaptive thinking
patterns and behavioral habits, then gradual practice of
new habits
ii. Medical and drug treatments
1. Antidepressants
a. Can help reduce bingeing and purging behavior
b. Usually not effective long-term
2. Anorexia Nervosa
a. Overview and defining features
i. Extreme weight loss—hallmark of anorexia
1. Restriction of calorie intake below energy requirements
2. May also involve binging and purging
3. Defined as 15% below expected weight
4. Intense fear of weight gain and losing control over eating people
suffering from anorexia show a relentless pursuit of thinness
5. Often begins with dieting
ii. Associated features
1. Most show marked disturbance in body image
2. Most are comorbid with other psychological disorders
3. Most deadly mental disorder
a. Starving borrows energy from internal organs, leading to
organ damage
b. Most serious consequence is cardiac damage which can
lead to heart attack and death
b. Facts and statistics
i. Majority are female and white
ii. Middle to upper middle class families
iii. Usually develops around early adolescence
iv. More chronic and resistant than bulimia
v. Lifetime prevalence—approximately 1%
vi. Cross-cultural factors
1. Develop in non-Western women after moving to Western
countries
2. Rare in African-American women
c. Goals of psychological treatment
i. General goals and strategies
1. Weight restoration—first and easiest to achieve
2. Psychoeducation
3. Behavioral and cognitive interventions—target food, weight, body
image, thought, emotion
4. Treatment often involves the family
5. Long-term prognosis for anorexia is poorer than for bulimia
ii. Preventing eating disorders
3. Causes of Bulimia and Anorexia—toward an integrative model
find more resources at oneclass.com
find more resources at oneclass.com
a. Media and cultural considerations
i. Media portrayals
ii. Cultural emphasis on dieting
iii. Standards of ideal body size
1. Change as much as fashion
2. Difficult or impossible to achieve
b. Biological considerations
i. Partial genetic component
ii. Deficits in serotonin may contribute to bingeing
c. Psychological and behavioral considerations
i. Low sense of personal control and self-confidence
ii. Perfectionistic attitudes
iii. Distorted body image
iv. Preoccupation with food
v. Mood intolerance
d. Must consider interacting factors
i. Dietary restraint
ii. Family influences
iii. Biological dimensions
iv. Psychological dimensions
4. Binge eating disorder
a. Overview
i. New disorder in DSM-5
ii. Binge eating without associated compensatory behaviors
iii. Associated with distress and/or functional impairment
b. Associated features
i. Many persons with binge-eating disorder are obese
ii. Some, but not all, have concerns about shape and weight
iii. Often older than bulimics and anorexics
iv. More psychopathology vs. non-binging obese people
c. Medical and psychological treatment
i. Previously used medications for obesity are now not recommended
ii. Psychological treatment
1. CBT
a. Similar to that used for bulimia
b. Appears effacious
2. Interpersonal psychotherapy—equally as effective as CBT
3. Self-help techniques—also appear effective
5. Obesity
a. Background and overview
i. Considered BMI of 30+
ii. Not DSM disorder, but may be a consequence of other disorders
iii. Statistics
1. Mortality rates are close to those associated with smoking
find more resources at oneclass.com
find more resources at oneclass.com
