ANOREXIA NERVOSA

(definition)

An intense fear of gaining weight or becoming fat combined with a refusal to maintain even a minimally low body weight

CRITERIA FOR ANOREXIA NERVOSA

1. Refusal to maintain a body weight normal for the person's age and height (i.e. a reduction to 85% of what would normally be expected)
2. Intense fear of gaining weight or becoming fat
3. Distorted perception of body weight and size
4. In post-menarchal females: absence of at least 3 consecutive mentrual periods

What are the two major types of Anorexia Nervosa?

1. Restricting type (limiting food intake)
2. Binge-eating/purging type (DO NOT CONFUSE THIS WITH BULEMIA NERVOSA!)
   

BULEMIA NERVOSA

(definition)

Uncontrollable binge eating coupled with efforts to prevent weight gain by using inappropriate behaviors such as vomiting or excessing exercise or use of laxitives

What are some of the DSM criteria for Bulemia Nervosa?

Recurrent episodes of binge eating

Recurrent an inappropriate efforts to compensate for the effects of binge eating

Self-evaluation is excessively influenced by weight and body shape

What is the major difference between a person suffering form Bulemia Nervosa and a person suffering from the binge-eat/purging type of Anorexia Nervosa?

BODY WEIGHT

The person with Anorexia is severely underweight.

If a person engages in binge-eating and and meets the criteria for Anorexia Nervosa are they Anorexic or ar they Bulemic?

They are ANOREXIC

In this case, ANOREXIA TRUMPS BULEMIA (because there is a far greater mortality [death] rate with Anorexia).

What are the two types of BULEMIA NERVOSA and that is the distinguishing feature between the two?

PURGING and NON-PURGING

The distinguishing feature is whether, in the current episode, the person has used PURGATIVE METHODS (vomiting, laxatives) to prevent weight gain.

TRUE or FALSE:

A person suffering from the purging type of bulemia nervosa is easily recognized due to their thin phsyique

FALSE

BULEMICS are typically of normal weight or even slightly overweight

Which type of BULEMIA NERVOSA is more common?

Purging types or non-purging types?

The most common type of BULEMIC is the PURGING TYPE and accounts for the vast majority of cases.

Which type of eating disorder has the highest mortality rate: ANOREXIA or BULEMIA?

ANOREXIA is the more lethal type of eating disorder.

WHAT ARE THE TARGET AGES FOR ANOREXICS AND BULEMICS?

ANOREXIA: TEENS AGES 15-19

BULEMIA: YOUNG ADULTS AGES 20-24

NAME SOME OF THE MEDICAL COMPLICATIONS ASSOCIATED WITH ANOREXIA NERVOSA:

LOWERED BLOOD PRESSURE

DEPRESSED COGNITIVE DEFICITS

ATROPHY OF MUSCLES

BODILY "WASTING" (FAT USED UP, THEN MUSCLE TISSUE)

Name some of the medical complications associated with BULEMIA NERVOSA:

Heart abnormalities

Damage to teeth, esophagus, oral mucosa and salivary glands due to passage of stomach acid because of vomiting

Damage to blood vessles of eyes due to surge in blood pressure caused by vomiting

Other Eating Disorders

Binge-Eating Disorder

(definition)

Recurrent episodes of binge eating in the absence of the regular inappropriate compensatory behaviors characteristic of Bulemia Nervosa

(in other words, binge-eating by itself, no purging, overcising or use of laxatives)

Give two reasons why distinguishing among the different diagnoses for eating disorders may be difficult to acheive:

1. Many people today follow a "thin-is-in" mentality.
2. A person fitting the criteria for ANOREXIA NERVOSA may begin to exhibit behaviors that fit BULEMIA NERVOSA

What are some biological considerations in dealing with eating disorders?

Eating disorders tend to run in families

The "Set Point Theory" is our body's tendency to remain near a set point (normal) weight (given proper nutrition, rest, and exercise)

What are someof the sociocultural factors to be considered in regard to eating disorders?

What people see in popular media.

How they may be influenced by trends concering weight, beauty, and thinness.

In regard to eating disorders what family influnces should be considered? (what are some known patterns?)

1. Emotionally absent fathers
2. Excessively controlling mothers
3. Over-controlling parents
4. Discouragement of autonomy
5. Poor conflict resolution
6. In some cases, a preoccupation with thinness

What are some of the individual risk factors for ANOREXICS?

Persons who are ANOREXICS may tend to:

AVOID THE UNFAMILIAR

BE SELF-DOUBTFUL

FEAR INTIMATE RELATIONSHIPS

What are some of the indivicual risk factors for persons with BULEMIA NERVOSA?

BULEMICS suffer the same individual risk factors as ANOREXICS (avoid the unfamiliar, be self-doubters, fear intimacy in relationships)

In addition they also tend to exhibit emotional instability, impulsivity, and patters of excessive perfectionism

What is the treatment of choice for adolescents suffering from ANOREXIA NERVOSA?

What is the main difficulty with this type of treatment?

FAMILY THERAPY is the treatment of choice for treating adolescents with ANOREXIA NERVOSA

The main difficulty is CHANGING THE FAMILY DYNAMIC STRUCTURE (in other words, you have to treat everyone, not just the teen)

In addition to Cognitive-Behavioral therapy and changing eating patterns, what must also be considered when treating a person with BULEMIA NERVOSA?

The aspect of DEPRESSION usually associated with BULEMIA

(remember that BULEMICS typically tend to show patterns of emotional instability)

What percentage of the US population is considered overweight?

What percentage of those considered overweight are considered obese?

Approximately 66% (2/3) of the US population is considered overweight

Approximately 31% of those considered overweight are obese

What are some effective treatments for persons with obesity?

Medications

Gastric Surgery

Weight-loss groups

Some forms of psychotherapy

What is the most important aspect of prevention of obesity?

EARLY INTERVENTION of weight management