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Chapter 10

PS261 Chapter Notes - Chapter 10: Binge Eating Disorder, Anorexia Nervosa, Binge Eating


Department
Psychology
Course Code
PS261
Professor
Kathy Foxall
Chapter
10

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Chap 10
Introduction and historical perspective
Anorexia nervosa-eating disorder, characterized by the refusal to eat because they fear they
will gain weight
In middle ages these girls were known as saints
The socio-cultural context of a beh helps determine how it is perceived and interpreted
Eating disorders have been around for 100`s of years
In the 60`s and 70`s western culture became more obsessed about thinness
In the late 70`s is when a new eating disorder was recognized called bulimia
From anorexia nervosas, ppl have a morbid fear of fatness, they perceive themselves as fat
o There is an overemp on shape and weight for determining self-worth.
In bulimia nervosa, the periods of restriction alternate with periods of binge eating , excessive
amounts of food are consumed, then it is followed by vomiting, laxatives or diuretic abuse or
hyper exercising
Typical characteristics
Anorexia nervosa
It is hard for family and friends of individuals with eating disorders to understand y they do it
o They are more concerned for their health .
o Therefore, they may hid it more
The fear of gaining weight is paradoxical, reality that they are in face underweight.
The reduce weight gain they reduce the calories they eat and abstain from eating food
They think weight gain will occur immediately after they eat something
Many other maladaptive eating beh may also develop
o Eg eating veggies first and then leaving high protein foods untouched
o Some ppl exercises a lot to lose a lot of weight
o Restlessness is common, due to over exertion and under eating
o Other ppl engage in purging beh it includes self-induced vomiting, laxatives abuse
Many ppl who purge also binge eat
o Lac of control over eating
An objective binge - consists of eating a large amount of food in a specific time period
Subjective binge eating is small during episodes of binging
Anorexia nervosa not only is a drive to lose weight but also a disturbance in body image
They have a dissatisfaction of their overall weight or shape- linked to self esteem and
individuals may use body weight or shape as a primary method of determining self-evaluation
Ppl with anorexia may be hyper vigilant meaning they continuously weigh themselves,
measuring their body parts

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Bulimia nervosa
Characterised by episodes of binge eating, followed compensatory behaviours designed to
prevent the gain of weight
They also have low self-esteem , and use weight and shape information as their primary method
of self-evaluation.
Other features such as cortisol isolation, depression are common in both bulimia and anorexia
Individuals with bulimia engage in objective binge eating , they also fast and exercise a lot
Many individuals with bulimia are within the normal weight range
o The amount of purging may not be enough to lose that much weight
These purging beh have serious medical consequence ,
o These include impaired bowels , cardiovascular difficulties eg arrhythmias,
The foods typically binged on are cookies, chips, ice cream
The foods often consumed by bulimic are considered as `forbidden foods `and are avoided
during periods of dieting and food restrictions
This pattern of avoidance sets up the cycle for binging and purging
o After binging they fell physical discomfort, feelings of guilt
And worry about weight gain
Heatherton and baumeister have proposed that episodes of binge eating occur in an attempt to
escape from high levels of aversive self-awareness.
According to this model , individuals who binge eats tend to have higher expectations of them.
Anorexia and bulimia features often overlap, but they both use weight and shape as their
primary source of self-evaluation and have low self esteem
o Bulimics and only some anorexics binge eat then purge.
o The primary difference is that anorexia are always underweight, and individuals with
bulimia are typically within in their normal weight range
Incidence and prevalence
8116 individuals in Ontario fount that the life time prevalance of bulimia was 1.1 % in women
and .1 % in men
Recent research suggested that partial syndrome eating are even more common than either
anorexia or bulimia with a prevalence rate of 2.37 %
There is an increase in anorexia over the past century fombonne has argued that the true
incidence of both anorexia and bulimia has not changed.
Hoek and can hoeken pointed out that regardless of whether the true incidence of anorexia
nervosa is increasing, there has been an increase in the incidence of registered cases.
Prognosis
Eating disorder has the highest mortality rates of other disorders ( 5 and 8 percent )
Most common causes are starvation and nutritional compilations
On avg 50% some show partial improvements and other show no change in the frequency of
binge. Purge episodes at all.
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Relapse rates are high for eating disorders
In terms of rates of relapse, six months after completion of day hospital treatment the relapse
rate was 38 percent, at one year it was 41 percent and at 18 months is increased to 48 percent
Anorexia nervosa
There are two examples of minimal normal weight
o 1. 85% of ones expected weight
o 2. Is having a body mass index- of 17.5
For these individuals the criterion is a failure to make expected weight gain during a period of
growth. The second criterion is tan irrational feat of gaining weight
Finally they must have a distortions of: 1) body weight , 2) denial of seriousness of low weight 3)
determining self-worth based primarily on body weight or shape
The final criterion for anorexia requires that females who are past puberty exhibit amenorrhea.
Amenorrhea is defined as the absence of three consecutive menstrual cycles.
The DSM-IV-TR subtypes anorexia into restricting type and binge eating or purging types
Restricting type individuals attain their extremely low body weights thru strict dieting and
excessive exercise.
Binge eating and or purging type individuals not only engage in strict dieting but also regularly
engage in binge eating and or purging beh
Bulimia nervosa
Three critions
o 1. Self-evasions is influenced by body shape
o Distortion of image
o Requires episodes of binge eating and purging at least twice a week for three months
If they fail to meet these criterions they are still considered to have an eating
disorder but not bulimia
Person with bulimia are classified as purging type or no purging types ( Eg fasting and excessive
exercise)
Eating disorder not otherwise specified (EDNOS)
Binge eating disorder (BED) characterized another subgroup of individuals who are diagnosed
with EDNOS
There is some disagreement as to whether BED is a discrete distort or a type of bulimia
Diagnostic issues
It is not possible to have more than one type of eating disorder
If the patent only uses restriction of food intake to compensate for binges, it is difficult to
determine the degree
Validity of diagnostic criteria and classification
Some researchers have proposed that eating disorder can be conceptualized on a spectrum rather than
as separate diagnostic categories.
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