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Eating Disorders (week 12).docx

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Health Studies
HLTH 230
Jeffery Lalonde

Facts and Figures  70% of women and 35% of men are dieting o Women aged between 15 – 25  1-2% have anorexia  3-5% have bulimia  Eating disorders have the highest mortality rate of all mental illnesses o 10-20% die from complications  Almost 3% of women will be affected by an eating disorder in their lifetime  27% of Ontario girls 12-18 years old were reported to be engaged in severely problematic food and weight behaviour Eating Disorders  Many people suffer from eating disorders, rates higher in women o Include anorexia nervosa o Bulimia Nervosa o Binge Eating  Many others do not meet this criteria but still have disordered eating o Do not meet the requirements for eating disorder  Causes include o Sociocultural, psychological, neurochemical factors  Athletes are the most likely group develop eating disorders  Disordered eating habits can develop because of o Desire to improve performance o Enhance aesthetic appeal o Meet unsuitable weight standards Risks for Disordered Eating Amoung Athletes  These risks may cause someone to have an eating disorder o Young age o Pressure to excel at a sport o Focus on achieving an ideal body weight or fat percentage o Sports that require lean appearance, being judges on aesthetic appeal o Weightloss dieting at any age o Unsupervised dieting Female Athlete Triad  Amenorrhea o 2-5% of women o 66% of female athletes  Not considered a normal adaptation to strenuous straining  Characterized by o Low blood estrogen o Infertility o Mineral losses from bone o Loss of menstrual cycle  Contributors o Excessive training o Depleted body fat o Low body weight o Inadequate nutrition  Osteoporosis o Stress fractures are common due to vigorous training o Hormonal imbalance o Poor intakes  Adequate calcium is recommended  Eating Disorders Dangerous Practices of Atheletes  Food and fluid restrictions in order to make weight  Practicing in rubber suits  Training in hot rooms  Extended periods in saunas  Diuretics and laxatives  Muscle Dysmorphia o Psychiatric disorder  Concerning obsession with building body mass Preventing Eating Disorders in Athletes  Follow canada’s food guide for food servings  Eat frequently, healthy  Establish reasonable weight goal  Allow reasonable time to achieve the weight goal Anorexia Nervosa  Distorted body image o Central to diagnosis o Cannot be self diagnoses  Malnutrition o Impacts brain function and judgment o Causes lethargy, confusion, delirium  Denial o Levels are high in anorexics  Need for self control  Protein energy malnutrition o Marasmus  Impact on body o Growth ceases o Normal development falters o Changes in heart size and strength o Organ failure  Criteria o Refusal to maintain body weight o Intense fear of gaining weight or getting fat, even while underweight o Disturbance in the way body weight or shape is looked at, denial of current body weight o Amenorrhea  Absence of 3 menstrual cycle  2 types of Anorexia Nervosa o Restricting Type  Person does not regularly binge eat or purge o Binge Eating / Purging  During episode, person regularly engages in binge eating or purging  Self induced vomiting, laxatives, diuretics  Treatment o Multidisciplinary  Food and weight issues  Relationship issues  Even after recovery energy intakes and eating behaviours may not return to normal  High mortality rate among psychiatric disorders Bulimia Nervosa  Distinct and more prevalent than anorexia nervosa  Difficult to establish o Secretive nature o Not as physically apparent  Criteria o Recurrent episodes of binge eating  Eating in discrete, eating food that is more than normal people would eat  Sense of lack of control over eating (one cannot stop eating) o Inappropriate behaviour to prevent weight gain  Self induced vomiting, laxatives, diuretics, enemas, fasting, excessive exercise o Binge eating and inappropriate behaviours occur twice a week for 3 months o Self evaluation is influenced by body shape and weight o Disturbance does not only occur during an episode of anorexia nervosa  Happens more often  2 types o Purging Type  Regularly engages in self induced vomiting or misuse os laxatives or diuretics o Nonpurging Type  Uses other inappropriate behaviours such as fasting or excessive exercise  Does not regularly engage in self induced vomiting  Binge purge cycle o Lack of control o Consume food for emotional comfort  Cannot stop  Done in secret o Purge  Shame and guilt  Cycle o Negative self perception o Restrictive dieting o Binge eating o Purging  Reoccurring cycle  Physical consequences of binge purge cycle o Subclinical malnutrition o Effects  Tooth erosion, red eyes, calloused hands  Clinical depression and substances abuse rates are high  Treatment o Discontinuing purging and restrictive diet habits o Learn to eat 3 meals a day  Overlap between anorexia nervosa and bulimia nervosa Binge Eating Disorder  Typically no purging o Different from bulimia nervosa  Consume less food during binge, exert less restraint with dieting  Obesity is not the same as binge eating  Behavioural disorder responsive to treatment Eating Disorders in Society  Society plays central role in eating disorders o Only in developed nations o More prevalent as wealth increases  Body dissatisfaction Weight loss Interventions  Potentially dangerous interventions o Fad Diets  Exaggerated or false theories of weight loss  Food sounds good to eat o Over the Counter Weight Loss Products  Non prescription  Herbal products and dietary supplements o St Johns Wort  May inhibit serotonin  Therefore suppressing appetite  Can be combined with ephedrine o Ephedrine  Several species of herbs that grow in desert areas  Stimulates central nervous and cardiovascular systems  Causes long bronchi to dilate  Health Canada authorizes sale of oral products containing recommended or low doses of ephdedral ephedrine  Has to carry 8 digit drug identification number  Indicates it has been approved by health Canada  Used for short periods of time as nasal decongestants  Health Canada warns against unapproved products that are sold for  Weight loss  Increased energy  Body building  Euphoria  These products are usually ephedral ephedrine mixed with stimulants as such caffeine, green tea etc  Adverse effects with ephedrine include  Gastrointestinal distress  Insomnia  Hypertension  Psychosis  Seizure o Sibutramine SUPPRESS  Suppresses appetite by inhibiting serotonin reuptake  Weight was reduced in sibutramine treated patients compared to placebo  Weight was regained  Certain patients with heart disease had a 16% greater chance of experiencing a cardiac event o Orlistat  Inhibits pancreatic and gastric lipase  Lipases are then unable to hydrolyze dietary fats into absorbable free fatty acids and Monoglycerides  Undigested fats are not absorbed resulting in caloric deficit  Fat goes straight through you  Orlistat inhibits dietary fat absorption by about 30% o Herbal Laxatives  Containing senna, aloe, rhubarb, cascara, caster oil, buckthorn  Commonly sold as dieters tea  May cause diarrhea, vomiting, cramping  Absorption occurs in the UPPER GI therefore laxatives will not decrease calorie absorption o Sauna  Weight loss is water weight  Dehydration  1litre of water weight 1kg  Obesity Drugs o Usually taken by  Obese patients with a body mass index over 30  Overweight people with body mass index over 27 with other risk factors  Diabetes, increased abdominal obesity o Not advisable to those with  Malabsorption syndrome  Cholestatis o Adverse effects  Reduced absorption of fat soluble vitamins  Headache  Oily spotting  Abdominal pain  Oily stool, fecal urgency  Weight Loss Surgery o Bariatric Surgery o Liposuction  The removal of unwanted fat using thin suction tubes  Cannulae  Can
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