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Eating Disorders
Workshop Objectives
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Increase knowledge of ED’s symptoms
and classification
Explore theoretical causes, etiology
and epidemiology of ED’s
Increase awareness of available
treatment modalities and techniques
for dealing with ED’s
What are eating disorders?
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ED’s are extreme complex medical
conditions that can surface from
behavioral, emotional, psychological,
social, and interpersonal factors.
Food is used as a means to control life,
or as an escape from feelings,
emotions, or over-whelming situations.
The ED Continuum
Normal
Positive feelings
about self/body,
normal exercise,
eating cues are
related to
hunger/satiety,
no good or bad
food decisions.
Preoccupation
Notices disdain
for certain body
parts, thinks
about losing
weight, feels
guilty about
overeating,
begins dieting.
Distress
Out of Control
Thoughts of
Continuous
food increase
obsessive
with hunger in
thoughts of
reaction to
food, dieting,
increased
and body size
restriction, rigid disrupts daily
eating patterns, routine, work,
compensatory
relationships.
behaviors may
emerge.
Normal>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>ED
Types of Eating Disorders
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Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder (DSM V)
Eating Disorder NOS
Anorexia Nervosa
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Characterized by self-starvation and
excessive weight loss
Refusal to maintain over 85% of normal
body weight for height, body type,
age, and activity level
Intense fear of weight gain or being fat
Loss of menstrual periods
(amenorrhea)
Bulimia Nervosa
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Characterized by a secretive cycle of
repeated binge eating followed by
compensatory behavior such as
vomiting, laxative abuse, fasting,
diuretics, diet pills, or over-exercising
in order to purge system.
Extreme concern with body weight and
shape.
Binge Eating Disorder/
Compulsive Overeating
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Characterized primarily by periods of
uncontrolled, impulsive, or continuous
eating beyond the point of feeling
comfortably full.
No purging but sporadic fasts or
repetitive diets are common.
Body weight may vary from normal to
mild, moderate, or severe obesity.
ED Not Otherwise Specified
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Symptoms are mixed or less severe
Night-Eating Syndrome
Nocturnal Sleep-Related Eating
Disorder
Pica
Rumination Syndrome
The Binge Cycle in BED & BN
http://www.brookes.ac.uk/student/services/health/Images/binge.gif
Theories of Etiology
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Psychoanalytic View
Relation Interaction - Behavioral View
Cognitive Distortions – Behavioral View
Biopsychosocial View
Psychological Factors
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Feelings of low self-esteem/confidence
Inability to regulate emotions properly
Poor coping skills to deal with stress
Depression, anxiety, anger, loneliness,
obsessive-compulsive
Interpersonal Factors
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Difficulty expressing thoughts,
emotions, or feelings openly
History of ridicule or teasing based on
appearance, size, or weight
History of physical, emotional, or
sexual abuse
Either overly dependent or overly selfsufficient in relationships
Social Factors
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Societal / Media pressures that favor
beauty, thinness, and the perfect body
over all else
Cultural norms that value people on
the basis of physical appearance rather
than achievement or inner qualities
and strengths
Biological Factors
Current research is being done on:
biological causes of eating disorders,
and genetic disposition to ED’s
certain chemicals in the brain that
control hunger, appetite, and digestion
addictive qualities in certain foods in
certain people
Dissociation in Binging
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Addiction Model
Escape Theory
Affect Regulation Model
Dieting
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Americans spend more than $40 billion
dollars a year on dieting and dietrelated products.
It is estimated that 40-50% of American
women are trying to lose weight at any
point in time.
Researchers estimate that 40-60% of
high school girls are on diets.
Media
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Media messages are constructed ideals.
They are NOT reflections of reality.
Advertisements are created to do one
thing: convince you to buy or support a
specific product or service.
Epidemiology AN
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AN typically appears in early to midadolescence
AN is the most common psychiatric
diagnoses in young women
Between 5-20% of those struggling with
AN will die, with probabilities of death
increasing with length of the condition
Epidemiology BN
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BN affects 1-2% of adolescent and
young adult women.
Most people with BN recognize that
their behaviors are unusual and
perhaps dangerous to their health.
BN occurs in 1-5% of high school girls
and as high as 19% in college women
Epidemiology BED
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The prevalence of BED is estimated to
be approximately 1-5% of the general
population.
BED is often associated with symptoms
of depression.
People struggling with BED often
express distress, shame, and guilt over
their eating behaviors.
Co-Occurring Disorders
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Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Muscle Dysmorphic Disorder
Orthorexia Nervosa
Anorexia Athletica (Hypergymnasia)
Co-Occurring Disorders
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Alexithymia
Depression
Self Harming Behavior
Substance Abuse Disorder
Goals of Therapy
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1) Correct abnormal eating or purging
patterns
2) Address broader psychological and
situational factors that have led to,
and are maintaining, the eating
problem
Nutritional Counseling
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Need for basic nutritional counseling
Binging caused by restriction & lack of
sense for normal body regulation
Hunger & Satiety (body therapy)
AN often need hospitalization
Psychoanalytic/dynamic
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Talking therapy
Depth psychology to unravel etiology
Primary focus is to reveal the
unconscious content of the psyche in
an effort to alleviate psychic tension
Uncovers inner conflicts & defense
mechanisms
CBT Talking Therapy
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Cognitive-Behavioral
Dialectical Behavioral (DBT)
Acceptance & Commitment (ACT)
Mindfulness Techniques
Interpersonal Therapy
Other ED Treatment
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Body Therapy such as yoga, self-care,
dance, visual imagery, MBSR
Hypnosis / Spiritual / Meditation
Group Therapy
Family Systems
References
Statistics were found at:
National Association of Anorexia Nervosa
& Associated Disorders {www.ANAD.org}
www.eatingdisordersonline.com