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Module Nine
EATING DISORDERS
Lesson 1: Anorexia Nervosa
Lesson 2: Bulimia Nervosa
Lesson 1
ANOREXIA NERVOSA
Step 1: Theory presentation
In reality Anorexia Nervosa is not an eating disorder.
It is a chronic disorder mainly manifested to
young women (10 women to 1 man).
It is manifested in 15 women over 100.000
people..
It is usually manifested in wealthy people.
In some groups, like fitness instructors, dancers
etc. is manifested more often.
Many people with this disorder, manifest during
their life other mental disorders as well, mainly
Depression.
It is estimated that 15% of these cases end up to
death.
Step 2: Slide projection
Slide 9.1.1: Causal factors of Anorexia Nervosa
Psychological
Avoidant personality characteristics.
Perfectionist personality characteristics (“child’s
image”)
Disorder in figure’s perception
Equalize the slim figure with emotion of value or
possibility to control oneself.
Retrogression for fear of adult sexuality.
Step 2 (continued)
Family
High percentages of mental disorders in the
family.
Dominating mother, passive and ineffective
father, inflexible family with over involved
members and avoidance of conflicts.
Step 2 (continued)
Cultural
Society which considers important being fit
Conflict and fluid expectations regarding
woman’s role
Use of food as communication mean
Step 2 (continued)
Biological
Connection with Depression, as it appears
from the manifestation in the same
families.
Neurochemical disorders (serotonin
decrease, hypothalamus abnormalities etc.)
which might also be a result of starvation
Step 3: Slide projection
Slide 9.1.2: Clinical manifestation of Anorexia
Nervosa
The person denies to maintain the appropriate
weight regarding its age and height.
Is afraid of putting on weight.
Cause vomiting after eating.
Takes too much exercise.
Uses diuretics.
Has distorted body image.
Absence of menstruation.
Might manifest depressive symptoms.
In advanced progress states manifest
hypothermia, ankle oedema, low heart rate,
hypotension, thin and soft hair as a newborn’s,
coma, death.
Step 4: Slide projection
Slide 9.1.3: Therapeutical interventions for
Anorexia Nervosa
Diagnosis and treatment of physical disturbances
Gain of normal weight
Eating training
Psychotherapy
Pharmacotherapy
Step 5: Questions and
comments
(5΄)
Lesson 2
BULIMIA NERVOSA
Step 1: Introduction
Bulimia Nervosa, characterized also as “dietetic
chaos syndrome”, is a disorder manifested in
young girls during adolescence or early
adulthood.
About 4% of girls in this age are attacked.
These girls usually have long history of eating
difficulties and about one third of these has
manifested Anorexia Nervosa in the past.
Step 2: Slide projection
Slide 9.2.1: Clinical manifestations of Bulimia
Nervosa
Continuous occupation with food
Normal weight
Recurrent episodes of overeating
Causing vomiting after eating
Alternative periods of starvation
Use of diuretics
Intense fear of weight gain
Step 3: Slide projection
Slide 9.2.2: Similarities and differences between
Anorexia Nervosa and Bulimia Nervosa
Similarities
Gender: mainly women
Age: adolescence or early adulthood
History: long lasting eating problems
Clinical image: fear of weight gain, causing
vomiting, use of diuretics
Etiology: multifactor (psychological, family,
cultural, biological factors)
Therapeutical treatment: versatile (Cognitive,
Behavioral, Family therapy, Eating training,
Antidepressants)
Step 3 (continued)
Differences
Age: BN later than AN
Rate of incidence: BN more frequent than AN
Clinical image: AN : distorted image of oneself, AN : many
physical distortions, BN: normal weight, BN: overeating
episodes
Therapeutical treatment: AN: hospitalization often required,
AN: Chlorpromazine
Expectations (prognosis) : AN: 15% death from
complications BN: much better, but often subsides
Step 4: Questions and
comments (5΄)