Transcript Bulimia ppt - WordPress.com

Bulimia nervosa is an eating disorder
characterized by
recurrent binge eating, followed by
compensatory behaviours.
The most common form is defensive
vomiting,
sometimes called purging; fasting, the
use of laxatives,
and over exercising are also common.
Categories
•
•
There are two sub-types of bulimia nervosa:
Purging type bulimics self-induce vomiting to rapidly remove food from the body
before it can be digested, or use laxatives, diuretics, or enemas
•
Non-purging type bulimics (approximately 6%–8% of cases) exercise or fast
excessively after a binge to offset the caloric intake after eating. Purging-type
bulimics may also exercise or fast, but as a secondary form of weight control.
Diagnosis
•
•
•
•
•
According to the World Health Organisation, the criteria for a diagnosis of
bulimia nervosa include the following:
constant obsession with eating and an irresistible craving for food.
episodes of overeating in which large amounts of food are consumed in short
periods of time.
excessive exercise, induced vomiting after eating, starving for periods of time
or taking medicines such as laxatives or diuretics to counteract the bingeing.
fear of obesity, which is also seen in people with anorexia nervosa, and there is
some overlap in the symptoms of these two diseases.
•
•
•
•
•
•
•
•
•
•
•
Common signs that a person may have bulimia are when the person:
Is very secretive about eating and does not eat around other people.
Sneaks food or hides food in the house. You may notice that large amounts of
food are missing.
Often talks about dieting, weight, and body shape.
Looks sick or has symptoms such as:
Tooth decay or erosion of tooth enamel.
– Sore gums or mouth sores.
– Dry skin.
– Loose skin.
– Thin or dull hair.
– Swollen salivary glands.
– Lack of energy.
– Teeth marks on the backs of the hands or calluses on
the knuckles from self-induced vomiting.
Feels depressed, anxious, or guilty.
Symptoms
Repeatedly eating large amounts of food in a short period of time (less than 2
hours).
Frequently getting rid of the calories you've eaten (purging) by making yourself
vomit, fasting, exercising too much, or misusing laxatives, diuretics, ipecac syrup,
or enemas. Misuse of these medicines can lead to serious health problems and
even death.
Feeling a loss of control over how much you eat.
Feeling ashamed of overeating and very fearful of gaining weight.
Basing your self-esteem and value upon your body shape and weight.
Facts and figures
• Studies have shown that up to 1 per cent of the population in UK
is suffering from bulimia nervosa at any one time, and this may
well be an underestimate.
• Other studies show that up to 7 per cent of young women
consulting their GP have the symptoms of bulimia nervosa.
• Every year there are as many as 18 new cases of bulimia nervosa
per 100,000 population per year.
• Approximately 4 percent of women suffer with bulimia during
their lifetime, but it is less common in men.
• Bulimia affects mainly women between the ages of 16 and 40,
and is most likely to begin at about 19 years of age.
'Bulimia need not be a way of life'
For eight years, Suzannah Jackson suffered from a debilitating
eating disorder.
“I was 18 and it was triggered by personal problems I had at the
time,” she says. “Not eating takes your mind off your problems
and gives you something else to focus on. By the time you realise
what damage you are doing, it is too late – you can’t stop.”
Throughout those years, bulimia took over her life and, as she
desperately fought to overcome it, she found a lack of
understanding surrounding the illness.
“When I was trying to get better I just wanted someone who
understood what it was like; all the experts I saw just didn’t seem
to understand.”
Amy Winehouse
Amy confesses that she’s struggled with disordered eating since 2004. Her confession was made
after pictures were published of her looking very thin, opposed to her naturally curvy figure. She
is firm that she is in recovery but is still insecure.
“I went through every eating disorder you can have. A little bit of anorexia, a little bit of
bulimia,” she said, “I’m not totally okay now but I don’t think any woman is.”
"I've had a flirtation with every eating disorder there is, I wouldn’t tie myself down to one,
and then i realise that I have to eat and I will fatten myself up and put on half a stone in
a week, because I’m good like that."
The tabloid News of the World reported that Whitehouse and her husband Fielder-Civi, l
cut their arms together. Spin.com reports that the couple "have matching crisscross scars
and scratches up and down their left arms," though says the marks are "presumably from a
misbehaving house cat.“
Amy Winehouse shocked a journalist from Spin Magazine when she started to carve the
words "I Love Blake" into her own stomach during an interview.
"I went through every eating disorder you can have. A little bit of anorexia, a little bit of
bulimia," she said. "I'm not totally OK now but I don't think any woman is." Her confession
comes after recent pictures show the singer looking gaunt and very thin. According to the
Daily Mirror, her record label, Island Records, has told her to cut back on her drinking.
This has been revealed after Amy turned up to The Charlotte Church Show last week
bleary-eyed and slurring her words. The 23-year-old has admitted to drinking excessively in
the past due to a painful split with an ex-boyfriend. An inside source told the Daily Mirror:
"We're worried that she's going off the rails."
A video explaining what Bulimia is, including symptoms
and the impact on a person who is suffering from this diagnosis
http://www.nhs.uk/Livewell/eatingdisorders/Pages/Bulimiarealstory.aspx
Other Celebrities suffering from Bulimia
http://www.casapalmera.com/blog/top-10-celebrities-with-eating-disorders/
Hypothalamic dysfunction is a
problem with the area of the
brain called the hypothalamus,
which helps control the
pituitary gland and order
many body functions.
Serotonergic dysfunction may be
associated with negative mood states
and with number of
neurotransmitters.
Biological explanations
Genetic origin: Family studies have
shown that first-degree
relatives of bulimia nervosa have an
increased risk of developing
an eating disorder (Holland et al.
1988)
Set Weight or Point” Theory:
The set-point
theory essentially
argues that an individual's
metabolism will adjust
homeostatically to maintain
a weight at which
the body is comfortable.
Link: Increase in serotonin makes you
happy and suppresses hunger
Biological explanations
Disturbances of the serotonin pathways within the brain have
been linked to the onset and maintenance of eating disorders.
In particular, it seems that increased serotonin activity in
the brain may be responsible for this type of behavior. There
is considerable evidence that increased serotonin activity in
the brain is associated with appetite suppression. In fact,
drugs which act on serotonin pathways in the brain are
commonly used for the short-term management.
Psychological explanations:
Behavioural explanations
The individual avoids food to gain a reward
such as feeling positive about themselves
In early stages – individuals can be
admired or congratulated for losing
weight and looking slim and healthy
(positive regard)
Gain the reward or satisfaction of
being in control of their food intake
Eating can be associated
with anxiety since it
can make people overweight
Losing weight ensures
that the individual reduces
these feelings of anxiety
People imitate
and copy people
they admire
– vicarious reinforcement
Psychological explanations:
Psychodynamic explanations
-Adolescents don’t want to grow up and separate from
their parents
– They become fixed at oral stage when they were
completely dependent on their parents
– Anorectics lose weight, lose secondary sexual
characteristics, become childlike again (asexual) and
return to the safety of the family
– In Freudian terms, eating and sex are symbolically
related
• A refusal to eat (the only control, they feel they
have) represents a refusal of sexuality
Psychological explanations:
Cognitive explanations
• This explanation is based on the fact that individuals with
bulimia nervosa have incorrect beliefs about their weight
problem, which leads to an exaggeration of the
consequences of gaining weight
• At first the individual may think that they are a little
overweight and decide to go on a diet.
• However, as time passes they begin to feel that the weight
problem is more serious than it really is
• They begin to selectively attend to information about
losing weight, which leads to more incorrect beliefs,
excessive dieting, binge drinking leading to Bulimia Nervosa
Therapy for Bulimia Nervosa
•
•
•
Poor body image and low self-esteem are at the core of bulimia,
therefore, psychotherapy is an important part of recovery. Here’s what
to expect in bulimia therapy:
Breaking the binge-and-purge cycle – The first phase of bulimia
treatment focuses on stopping the vicious cycle of bingeing and purging
and restoring normal eating patterns. You learn to monitor your eating
habits, avoid situations that trigger binges, cope with stress in ways
that don’t involve food, eat regularly to reduce food cravings, and fight
the urge to purge.
Changing unhealthy thoughts and patterns – The second phase of
bulimia treatment focuses on identifying and changing dysfunctional
beliefs about weight, dieting, and body shape. You explore attitudes
about eating, and rethink the idea that self-worth is based on weight.
Solving emotional issues – The final phase of bulimia treatment involves
targeting emotional issues that caused the eating disorder in the first
place. Therapy may focus on relationship issues, underlying anxiety and
depression, low self-esteem, and feelings of isolation and loneliness.
Medications
Some medications can be extremely
helpful in treatment a person who
suffers from bulimia.
• As always, the medication should be
carefully monitored, especially since
the patient may be vomiting or
taking large amounts of laxatives,
which may impact on the
medication's use and effectiveness
(ethical issues)
•
A trusting and honest relationship
must be established between the
physician and the individual or
mediation compliance will almost
certainly become an issue.
Antidepressants (such as
desipramine, or phenelzine) are the
usual drug treatment and may speed
up the recovery process.
• Phenytoin and carbamazepine may
also help reduce the frequency of
the binging behaviors.
Self-help
•
•
•
Bulimia can sometimes
be treated with a selfhelp manual and
occasional guidance
from a therapist. This
treatment allows you
to develop skills that
will help you manage
your bulimia.
Keeping a diary of
eating habits and
learning about healthy
eating and sensible
weight control may be
helpful.
Support groups may
also be helpful. It's
often comforting to
talk to other people
who have been through
the same thing, and
who can offer
understanding and
acceptance without
blame or guilt.
Other treatments
•
•
A type of talking therapy, or psychotherapy, called cognitive
behavioural therapy (CBT) is frequently used. CBT allows you to talk
through the issues that upset you and that may lie at the heart of your
eating disorder. CBT can help you to learn healthier ways of thinking
about food and rebuild your self-esteem.
Interpersonal therapy (IPT) is another talking therapy which allows you
to discuss your relationships with other people. Rebuilding these
relationships may stop you turning to food for emotional support
.
Hospital treatment
Most people who have bulimia can be successfully treated without being
admitted to hospital. But if the person has serious health problems that
puts their life at risk, or if they are at risk of suicide or self-harm,
they may need to be admitted to hospital.