Eating Disorders

 

Eating Habits

Anorexia Nervosa

  • Stems form psychological conflict between consuming food and body image
  • 7% people with anorexia die (from sucide) within 10 years of diagnosis
  • 25% recover within 6 years
  • The rest diagnosed have a continual battle the rest of their life
  • Early roots of the disease:

    • Simple attempt to loose weight

    • Stress from changes in body image

    • transition into adulthood

    • Physical changes associated with puberty

    • Stress from sexual and social tensions

    • Stress from loss of a loved one

  • Progression

    • Extreme dieting

    • Self enforced starvation

  • Profile

    • Refusal to eat enough to maintain acceptable weight

    • Typically white female, middle to upper socioeconomic class

    • Often described as responsible, meticulous, obedient

    • Competitive and obsessive

    • Complains of delayed puberty, fatigue, and depression

    • May have conflicts with family structure 

    • Early warning signs:

      • Dieting becomes main focus
      • Abnormal self perceptions and eating habits
      • Range of foods consumed narrows
      • Withdrawing socially
      • Becomes hypercritical
      • Limits consumption to 300-600 kcals per day

  • Physical Affects

    • Weight less than 85% expected

    • BMI less than 17.5

    • Growth charts used to assess children under 18

    • Physical/physiological effects:

    • Lowered body temperature

    • Slower metabolic rate

    • Decreased heart rate

    • Iron deficiency anemia

    • Rough, dry, scaly, and cold skin

    • Low white blood  cell count

    • Loss of hair

    • Lanugo (downy hairs)

    • Constipation

    • Low blood potassium

    • Loss of menstrual period

    • Change in neurotransmitter function

    • Loss of teeth

    • Muscle tears and stress fractures


Bulimia Nervosa


  • First described in 1979 and classified as a clinical psychological disorder in 1980

  • Profile:

    • Common in young adults

    • Individuals predisposed with genetic and lifestyle patterns conducive to weight gain

    • More commonly female

    • Individuals usually slightly overweight

    • Half of bulimic patients suffer from major depression

    • Turn towards food in critical situations

    • Recognize their behavior as abnormal

    • Tend to be impulsive

  • Typical behavior:

    • Person binges at least twice a week for 3 months

    • Recognizing behavior and patterns nearly impossible because individuals hide their habits

    • Alternation between food intake and food restriction is common

    • Binging occurs usually at night and may last ˝ hour to 2 hours

    • Up to 12,000 kcals may be consumed in on session

    • Food is purged after session BUT a percentage of food is absorbed

      • 33-75% of food absorbed though vomiting occurred

      • 90% of food absorbed though laxatives or enemas used

    • Some patients undergo excessive exercise (hypergymnasia) to expend a large amount of energy due to high absorption of foods

    • Binging produces amplified feeling of depression

  • Health Effects

    •  Demineralization of teeth

    • Blood potassium levels drop – may cause irregular heart rhythms

    • Salivary glands swell

    • Stomach ulcers and esophageal tearing

    • Constipation

    • Ipecac poisoning

  •  Treatment

    • 16 weeks of treatment – hospitalization in cases of severe laxative abuse, regular vomiting, and substance abuse

    • Psychotherapy

    • Antidepressant, Fluoxetine (Prozac), has been approved for administration

    • Nutritional counseling

Eating Disorders Not Otherwise Specified (EDNOS)

Biologocal Involved in Eating Disorders

Psychological Factors?