Eating Disorders: Manos, Bencio, Fernandes, Paraiso
Eating Disorders: Manos, Bencio, Fernandes, Paraiso
Eating Disorders: Manos, Bencio, Fernandes, Paraiso
DISORDERS
BEALAURA BENCIO
• People with anorexia nervosa starve themselves,
subsisting in little or no food for very long periods of
time, yet they remain convinced that they need to lose
more weight.
• As a result, their body weight is significantly below
SUMMARY:
relentless pursuit of thinness and unwillingness to
maintain a normal or healthy weight, a distortion of body
image and intense fear of gaining weight, a lack of
menstruation among girls and women, and extremely
disturbed eating behavior
Restricting Type of Anorexia Nervosa
Simply refuse to eat and/or engage in excessive exercise
as a way of preventing weight gain
ANOREXIA
than that minimally expected.
NERVOSA:
DSM 5 Criterion B
• Intense fear of gaining weight or of becoming fat, or
persistent behavior that interferes with weight gain, even
though at a significantly low weight.
CRITERIA
• Disturbance in the way in which one’s body weight or
Criterion C shape is experienced, undue influence of body weight or
shape on self-evaluation, or persistent lack of recognition
of the seriousness of the current low body weight
• Specify whether:
(F50.01) Restricting type: During the last 3 months, the individual has
not engaged in recurrent episodes of binge eating or purging behavior
(i.e., self-induced vomiting or the misuse of laxatives, diuretics, or
enemas). This subtype describes presentations in which weight loss is
accomplished primarily through dieting, fasting, and/or excessive
exercise.
(F50.02) Binge-eating/purging type: During the last 3 months, the
individual has engaged in recurrent episodes of binge eating or purging
DIFFERENTIAL • Major depressive disorder. In major depressive disorder, severe weight loss
may occur, but most individuals with major depressive disorder do not have
DIAGNOSIS
either a desire for excessive weight loss or an intense fear of gaining weight.
• Schizophrenia. Individuals with schizophrenia may exhibit odd eating
behavior and occasionally experience significant weight loss, but they rarely
show the fear of gaining weight and the body image disturbance required for a
diagnosis of anorexia nervosa.
• Substance use disorders. Individuals with substance use disorders may
experience low weight due to poor nutritional intake but generally do not fear
gaining weight and do not manifest body image disturbance. Individuals who
abuse substances that reduce appetite (e.g., cocaine, stimulants) and who also
endorse fear of weight gain should be carefully evaluated for the possibility of
comorbid anorexia nervosa, given that the substance use may represent a
persistent behavior that interferes with weight gain (Criterion B).
• Social anxiety disorder (social phobia), obsessive-compulsive disorder, and
body dysmorphic disorder. Some of the features of anorexia nervosa overlap
with the criteria for social phobia, OCD, and body dysmorphic disorder.
Specifically, individuals may feel humiliated or embarrassed to be seen eating
in public, as in social phobia; may exhibit obsessions and compulsions related
to food, as in OCD; or may be preoccupied with an imagined defect in bodily
appearance, as in body dysmorphic disorder. If the individual with anorexia
nervosa has social fears that are limited to eating behavior alone, the diagnosis
of social phobia should not be made, but social fears unrelated to eating
behavior (e.g., excessive fear of speaking in public) may warrant an additional
DIFFERENTIAL
diagnosis of social phobia. Similarly, an additional diagnosis of OCD should be
considered only if the individual exhibits obsessions and compulsions unrelated
to food (e.g., an excessive fear of contamination), and an additional diagnosis
DIAGNOSIS of body dysmorphic disorder should be considered only if the distortion is
unrelated to body shape and size (e.g., preoccupation that one's nose is too
big).
• Bulimia nervosa. Individuals with bulimia nervosa exhibit recurrent episodes
of binge eating, engage in inappropriate behavior to avoid weight gain (e.g.,
self-induced vomiting), and are overly concerned with body shape and weight.
However, unlike individuals with anorexia nervosa, binge-eating/purging type,
individuals with bulimia nervosa maintain body weight at or above a minimally
normal level.
• Avoidant/restrictive food intake disorder. Individuals with this disorder may
exhibit significant weight loss or significant nutritional deficiency, but they do
not have a fear of gaining weight or of becoming fat, nor do they have a
disturbance in the way they experience their body shape and weight.
4 FACTS
ABOUT
ANOREXIA
1. The Cause
Isn’t Fully
Known
Anorexia nervosa is a complex disease, and
the cause isn’t fully known. However, some
of the factors that may lead to eating
disorders include genetics, psychological
health, environment, trauma, and
biology.
2. Most People
Don’t Seek
Treatment
Only one out of every 10 people with
anorexia will ever seek treatment. Part of
the problem is that the general population
believes that anorexia isn’t a real disease. In
turn, people are afraid to ask for help
because they feel ashamed or don’t feel as
though they’ll be taken seriously.
3. Men Make Up
10% Of Those
Suffering From
Anorexia Nervosa
Although anorexia is far more common in
women,. men make up approximately 10%
of those suffering from the disease All too
often, men are under and undiagnosed
with anorexia because of its prevalence in
females.
4. Treatment Is
Complex But
Attainable
Recovery from anorexia is possible, even
for someone who has been living with the
disease for many years. Anorexia is often
treated in an outpatient setting, but
hospitalization may be necessary in some
situations. The path to recovery can be long
and challenging, but having the right team
supporting you can make all the
difference..
http://www.bbc.com/news/world-europe-39821036
http://www.scmp.com/comment/insight-
opinion/article/1774159/how-ideal-thin-body-harms-hong-kong-
women-and-girls
The • Korea: Lee Tae Im‘s famous extreme diet of eating only
3 spoons of rice a day gave her some nasty side effects.
motivations for “[Because of my diet], I was losing hearing in my ears and
self-starvation hearing ringing noises instead. Soon after that I had hand
tremors and would sometimes just collapse.” — Lee Tae Im
also vary
across culture
and time
http://kpopline.com/idols-reveal-the-worst-side-effects-of-going-on-
starvation-diets-2507.html
DO YOU:
DEVELOPING
A POSITIVE
BODY IMAGE
https://www.youtube.com/watch?v=IgqMqtnTJeE
BULIMIA
NERVOSA
CLAIRE PARAISO
Eating in a descrete period of time (e.g., within A sense of lack of control over eating during
any 2-hour period) the episode.
Diagnostic Criteria
A Recurrent episode of binge eating
Levels
Shannen Fernandes
Binge-eating Disorder
• Was not officially recognized as a form of eating
disorders in the DSM-IV-TR
• Binge-eating disorder resembles bulimia nervosa,
except that it does not regularly engage in purging,
fasting, excessive exercise to compensate for binges
• People with binge-eating disorder may eat continuously
throughout the day with no planned meal times. Often
in response to stress and to feelings of anxiety or
depression. They may eat very rapidly and appear
almost in a daze as they eat.
• More common in women.
• Tends to be chronic and with a mean duration of 8 years
and another study found a mean duration of 14 years.
Diagnostic Criteria
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1.Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would
eat in a similar period of time under similar circumstances.
2.A sense of lack of control over eating during episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. The binge-eating episodes are associated with three (or more) of the following:
1.Eating much more rapidly than normal.
2.Eating until feeling uncomfortably full.
3.Eating large amounts of food when not feeling physically hungry.
4.Eating alone because of feeling embarrassed by how much one is eating.
5.Feeling disgusted with oneself, depressed, or very guilty afterward.
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur
exclusively during the course of bulimia nervosa or anorexia nervosa.
Specify if:
• In partial remission
• in full remission
Features
D).
• A single episode of binge eating need not be restricted
to one setting.
• An occurrence if excessive food consumption must be
accompanied by a sense of lack of control to be
considered an episode of binge eating.
• Binge eating must be marked by distress and at least
three of following features: eating much more rapidly
than normal; eating until feeling uncomfortably full;
eating large amounts of food when not feeling
physically hungry; eating alone because of feeling
embarrassed by how much one is eating; and feeling
disgusted with oneself, depressed, or very guilty
afterward (criterion B).
Obesity • Defined as a body mass index (BMI) of 30 or over
• Is not designated as an eating disorder by the DSM-IV-
TR, but clearly is a major health hazard.
• The dramatic historical increases in obesity point to
environment causes.
Understanding Eating
Disorders
Factors ●
tend to run in families
Twin studies revealed that:
● Anorexia nervosa- 56% heritability
● Bulimia nervosa- 50-85% heritability
● Binge-eating disorder- 41% heritability
Biological
Factors
The hypothalamus plays a central role in regulating eating
●
lesson?
Athletes
and Eating
Disorders
● One group at increased risk for unhealthy and disordered eating habits is
athletes, especially those participating in sports in which weight is
considered an important factor in competitiveness.
● A research in Norway revealed that those participating in sports classified
as “aesthetic” or “weight-dependent,” including diving, figure skating,
gymnastics, dance, judo, karate, and wrestling, were most likely to have
anorexia or bulimia nervosa.
Emotion ● Eating-disorder behaviors may sometimes serve as
maladaptive strategies for dealing with painful
Regulation emotions.
Depressive symptoms and a history of negative affect
Difficulties
●
Eating
appearance is of primary importance in the development of the
eating disorders.
Disorders
Kathleen Vohs and colleagues (1999, 2001) suggested that
●
Nervosa ●
thoughts about these foods.
The client is also taught to eat three healthy meals a
day and to challenge the thoughts she has about these
meals and about the possibility of gaining weight.
Psychotherapy ● Controlled studies of the efficacy of CBT for bulimia
reveal that about half the clients completely stop the
for Bulimia binge/purge cycle.
for Anorexia
Nervosa
Biological ● The selective serotonin reuptake inhibitors (SSRIs),
such as fluoxetine (trade name Prozac), have been the
Nervosa ●
individual to normal eating habits.
Adding cognitive-behavioral therapy to antidepressant
treatment increases the rate of recovery from the
disorder.
Biological ● A meta-analysis of medications for binge eating found
that a number of drugs, including the SSRIs,
Eating
Disorder