Unraveling Eating Disorders: An In-depth Exploration of Anorexia, Bulimia, and Binge Eating Disorder

Eating Disorders - Eating disorders have dramatically increased as thinness has become a national Obsession - Anorexia nervosa - Bulimia - Binge-eating disorder Anorexia Nervosa - Checklist - Individual purposely takes in too little nourishment, resulting in body weight that is Very low and below that of other people of similar age and gender - Individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain Despite low body weight - Individual has a distorted body perception, places inappropriate emphasis on weight or Shape in judgements of herself or himself, or fails to appreciate the serious Implications of her or his low weight - Two main types - Restricting type - Lose weight by cutting out sweets and fattening snacks, eventually eliminating Nearly all food - Show almost no variability in diet - Binge-eating/purging type - Lose weight by forcing themselves to vomit after meals or by abusing laxatives

Or diuretics - May engage in eating binges - Progression - A normal to slightly overweight female has been on a diet - Escalation toward anorexia nervosa may follow a stressful event - Most patients recover, but as many as 6 percent do not - Clinical picture - Key goal is becoming thin - Driving motivation is fear - Preoccupation with food occurs - Thinking is distorted - Usually have a low opinion of their body shape - Tend to overestimate their actual proportions - Hold maladaptive attitudes and misperceptions - Potential psychological problems - Depression, anxiety, low self-esteem, sleep disturbances - Substance abuse - Obsessive-compulsive patterns and perfectionism - Medical problems - Amenorrhea - Lowered body temperature, low blood pressure, body swelling, reduced bone Mineral density, slow heart rate

- Metabolic, nail, and hair problems Bulimia Nervosa - Checklist - Repeated binge eating episodes - Repeated performance of ill-advised compensatory behaviors to prevent weight gain - Symptoms take place at least weekly for a period of 3 months - Inappropriate influence of weight and shape on appraisal of oneself - Progression - Normal to slightly overweight female has been on intense diet - A with anorexia nervosa, 75 to 90 percent of bulimia nervosa cases occur in females - Begins in adolescence or young adulthood, lasts for years with periodic letups - Weight fluctuates but often stays within normal range - Binges - Episodes of uncontrollable eating during which a person ingests a very large quantity Of food - May involve 1 to 30 episodes per week and 2,000 to 3,400 calories per episode - Often carried out in secret, usually with sweet, high-calorie, soft-texture food - Usually preceded by great tension, which is relieved by eating - Followed by extreme self-blame, shame, guilt, depression, and weight gain fear - Compensatory behaviors - Disorder is also characterized by inappropriate compensatory behaviors - Vomiting

- Laxative or diuretics use - Compensatory behaviors effectiveness - Some temporary positive effects - Caloric binging effects not undone Binge Eating Disorder - Checklist - Recurrent binge eating episodes that include at least three of these features - Unusually fast eating - Absence of hunger - Uncomfortable fullness - Secret eating due to sense of shame - Subsequent feelings of self-disgust, depression, or severe guilt - Significant distress - Binge-eating episodes take place at least weekly over the course of 3 months - Absence of excessive compensatory behaviors - Repeated eating binges during which people fee no control over their eating and do not Engage in inappropriate compensatory behavior. - Found in 2 to 7 percent of the population - At least 64 percent are female - Has a later age of onset - As a result of their frequent binges, half become overweight or even obese - Many shared features with bulimia nervosa or anorexia nervosa, but not the same drive to

Thinness What Causes Eating Disorders? - Most theorists and researchers use a multidimensional risk perspective - Several key factors place individuals at risk - More factors equal greater likelihood of developing a disorder - Leading factors - Psychodynamic - Cognitive-behavioral - Biological - Societal pressures - Family environment - Multicultural - Psychodynamic factors: ego deficiencies - Bruch: Psychodynamic theory of eating disorders - Disturbed mother-child interactions lead to serious child ego deficiencies And severe perceptual disturbances - Children of ineffective parents become confused adults who are unaware Of their internal needs - People with eating disorders inaccurately perceive internal cues and more likely To worry about how they are viewed by others. - Cognitive-behavioral factors - Bruch: Several cognitive factors, such as improper labeling of internal sensations and

Needs, contribute to eating disorders. - Little control over life may result in excess control of body size - This contributes to a broad cognitive distortion that lies at the center of Disordered eating - Depression - Helps set the stage for eating disorders - Many more people with eating disorder are diagnosed with major Depressive disorder than in the normal population - Close relatives with eating disorder have higher rates of depressive disorders - Similar brain circuit abnormalities in those with eating disorders and Depression - Antidepressant drugs sometimes help persons with eating disorders - Biological factors - Certain genes may cause susceptibility to eating disorders - Relatives of people with eating disorders are six times more likely to Develop eating disorders themselves. - Brain circuit dysfunction linked to interconnectivity problems - Larger and more active insula, orbitofrontal cortex, and striatum; smaller Prefrontal cortex - Abnormal activity levels of serotonin, dopamine, and glutamate - Other biological theorists focus on the hypothalamus - Lateral hypothalamus: Produces hunger

- Ventromedial hypothalamus: Reduces hunger - Weight set point - Set by genetic inheritance and early eating practices - Responsible for keeping an individual at a particular weight level - Societal pressures - Western standards for female attractiveness - Socially accepted prejudice against overweight people - Higher risks for eating disorders within certain subcultures - Economic and racial differences in eating disorders prevalence rates - Social networking, internet activity, and television browsing - Family environment - Families may impact and maintain eating disorders - History of emphasis on thinness, appearances, or dieting - Dieting and perfectionist mothers - Enmeshed family patterns - Multicultural factors: gender differences - Different ideals of beauty - Young African American females demonstrate healthier eating behaviors and attitudes, Although a shift is now occurring - Hispanic American female attitudes are more like those of young white American females - Increase in eating disorders in Asian American females noted