Chapter 11Chapter 11

Eating Eating DisordersDisorders

Overview of Eating Overview of Eating DisordersDisorders

Affects more than 5 million peopleAffects more than 5 million people 85% of cases develop during 85% of cases develop during

adolescenceadolescence Co-occurs with other psychological Co-occurs with other psychological

disordersdisorders Recognition of disorder is critical to Recognition of disorder is critical to

treatmenttreatmentEND-CHAPTER 11 – Very informative: Personal Reflections: -Thoughts of an Anorexic - Thoughts of a Bulimic

Genetic Link?Genetic Link?

Identical twins are more likely to Identical twins are more likely to share eating disordersshare eating disorders– Genetically predisposed?Genetically predisposed?

Fraternal twins are less likelyFraternal twins are less likely

Characteristics: Anorexia & Characteristics: Anorexia & BulimiaBulimia

Helpful ResourcesHelpful Resources

Course TEXTBOOK – Wardlaw 7Course TEXTBOOK – Wardlaw 7thth Edition Edition – Contemporary NutritionContemporary Nutrition

Academy of Eating Disorders-Academy of Eating Disorders-– www.aedweb.orgwww.aedweb.org

National Eating Disorders AssociationNational Eating Disorders Association– www.nationaleatingdisorders.orgwww.nationaleatingdisorders.org

National Institute of Mental HealthNational Institute of Mental Health– www.nimh.nih.gov/publicat/eatingdisorders.cfmwww.nimh.nih.gov/publicat/eatingdisorders.cfm

UCSC – Womens Center UCSC – Womens Center – http://www2.ucsc.edu/wmcenter/body.htmlhttp://www2.ucsc.edu/wmcenter/body.html

Warning Signs of Anorexia Warning Signs of Anorexia

Abnormal, rigid eating habits Abnormal, rigid eating habits Eating very little food (300-600 kcal/day)Eating very little food (300-600 kcal/day) Hiding and storing foodHiding and storing food Exercising compulsivelyExercising compulsively Preparing meals for others, but not Preparing meals for others, but not

eatingeating Withdrawing from friends and familyWithdrawing from friends and family Critical of self and othersCritical of self and others Sleep disturbances and depressionSleep disturbances and depression AmmenorrheaAmmenorrhea

Anorexia Health Problems Anorexia Health Problems

““Skin-and-bone” appearanceSkin-and-bone” appearance Lowered body temperatureLowered body temperature Lanugo and loss of hairLanugo and loss of hair Lower basal metabolism, decreased heart rateLower basal metabolism, decreased heart rate Iron deficiency anemia and other nutrient Iron deficiency anemia and other nutrient

deficienciesdeficiencies Rough, dry, scaly, cold skinRough, dry, scaly, cold skin Low white blood cell count, potassiumLow white blood cell count, potassium Constipation, ammenorrheaConstipation, ammenorrhea < % body fat, shutdown of reproductive < % body fat, shutdown of reproductive

hormoneshormones

Nutrition TherapyNutrition Therapy

Increase food intake to raise Increase food intake to raise basal metabolismbasal metabolism

Prevent further weight lossPrevent further weight loss Restore appropriate food habitsRestore appropriate food habits Restrict excessive activityRestrict excessive activity Ultimately achieve and maintain Ultimately achieve and maintain

weight gain to establish setpointweight gain to establish setpoint

Bulimia NervosaBulimia Nervosa

Bulimia Health ProblemsBulimia Health Problems

Vomiting causes most health Vomiting causes most health problemsproblems

Demineralization of teethDemineralization of teeth Drop in blood potassiumDrop in blood potassium Swelling of salivary glandsSwelling of salivary glands Stomach ulcers and bleedingStomach ulcers and bleeding ConstipationConstipation Ipecac syrup is toxicIpecac syrup is toxic

Treatment of Bulimia Treatment of Bulimia NervosaNervosa

Decrease episodes of bingeing & purgingDecrease episodes of bingeing & purging Psychotherapy to improve self-acceptancePsychotherapy to improve self-acceptance Change “all-or-none” attitude about foodChange “all-or-none” attitude about food Correct misconceptions about foodCorrect misconceptions about food Establish good, normal eating habitsEstablish good, normal eating habits Group therapy Group therapy Antidepressants Antidepressants Long-term therapyLong-term therapy

Binge-Eating DisorderBinge-Eating Disorder

Profile of a Binge-EaterProfile of a Binge-Eater

Considers self as hungrier than normalConsiders self as hungrier than normal Isolates self to eat large quantitiesIsolates self to eat large quantities Suffers from stress, depression, anxiety, Suffers from stress, depression, anxiety,

loneliness, anger, frustration that can loneliness, anger, frustration that can trigger bingetrigger binge

Uses food to reduce stress, provide Uses food to reduce stress, provide feeling of power and well-beingfeeling of power and well-being

Usually binges on “junk” foodsUsually binges on “junk” foods Eats without regard to biological needEats without regard to biological need

Treatment of Binge-EatingTreatment of Binge-Eating

Eat in response to hunger, not Eat in response to hunger, not emotionsemotions

Learn to eat in moderationLearn to eat in moderation Avoid restrictive diets that can Avoid restrictive diets that can

intensify problemsintensify problems Address hidden emotionsAddress hidden emotions ““Overeaters Anonymous”Overeaters Anonymous” AntidepressantsAntidepressants

Profile of Female Athlete TriadProfile of Female Athlete Triad

Female athletes in appearance-based Female athletes in appearance-based and endurance sportsand endurance sports– 15% swimmers; 62% gymnasts; 32% 15% swimmers; 62% gymnasts; 32%

otherother 1. Disordered eating 1. Disordered eating 2. Irregular menses or ammenorrhea2. Irregular menses or ammenorrhea 3. Osteoporosis and loss of estrogen3. Osteoporosis and loss of estrogen

– Bone density similar to 50-60 year oldsBone density similar to 50-60 year olds– Bone loss is largely irreversibleBone loss is largely irreversible

Bone StructureBone Structure

Treatment of Female Treatment of Female Athlete TriadAthlete Triad

Reduce preoccupation with food, Reduce preoccupation with food, weight, and body fatweight, and body fat

Gradually increase meals and Gradually increase meals and snacks snacks

Rebuild body to healthy weightRebuild body to healthy weight Establish regular menses (find Establish regular menses (find

weight?)weight?) Decrease training by ~10%-20%Decrease training by ~10%-20%

– Normal mensus is good!!!Normal mensus is good!!!

Night Eating SyndromeNight Eating Syndrome

Eating > 1/3 of calories after evening Eating > 1/3 of calories after evening mealmeal

Not feeling hungry in the morningNot feeling hungry in the morning Need to eat to help fall asleepNeed to eat to help fall asleep Waking at night to eatWaking at night to eat DepressedDepressed

Chapter 11- eating Chapter 11- eating disordersdisorders

Moral:Moral:– People who have disorder (psychological)People who have disorder (psychological)

Will continue until organ failure (don’t think it’s a Will continue until organ failure (don’t think it’s a problem)problem)

– e.g. Christy Henrich, promising young gymnast e.g. Christy Henrich, promising young gymnast

Try to get them to seek help (intervention)Try to get them to seek help (intervention) RESOURCESRESOURCES

MY PSA for the day . . .recog. Primarily MY PSA for the day . . .recog. Primarily psychological issue, if feel you are psychological issue, if feel you are close to family/ friend have close to family/ friend have problem . . .problem . . .Seek information and helpSeek information and help

Helpful ResourcesHelpful Resources

Course TEXTBOOK – Wardlaw 7Course TEXTBOOK – Wardlaw 7thth Edition Edition – Contemporary NutritionContemporary Nutrition

Academy of Eating Disorders-Academy of Eating Disorders-– www.aedweb.orgwww.aedweb.org

National Eating Disorders AssociationNational Eating Disorders Association– www.nationaleatingdisorders.orgwww.nationaleatingdisorders.org

National Institute of Mental HealthNational Institute of Mental Health– www.nimh.nih.gov/publicat/eatingdisorders.cfmwww.nimh.nih.gov/publicat/eatingdisorders.cfm

UCSC – Womens Center UCSC – Womens Center – http://www2.ucsc.edu/wmcenter/body.htmlhttp://www2.ucsc.edu/wmcenter/body.html