Transcript long version

Module Nine
EATING DISORDERS

Lesson 1: Anorexia Nervosa
(2 training hours)

Lesson 2: Bulimia Nervosa
(1 training hour)

TOTAL TIME: 3 TRAINING HOURS OF 45 MINUTES
Lesson 1
ANOREXIA NERVOSA
TIME :
90 minutes (2 training hours of 45 minutes)
Step 1: Brainstorming (10΄)
What do you know about Anorexia Nervosa?
Step 2: Theory presentation
(10΄)
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 3: Slide projection (10΄)
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 3 (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 3 (continued)
Cultural
 Society which considers important being fit
 Conflict and fluid expectations regarding
woman’s role
 Use of food as communication mean
Step 3 (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 4: Slide projection
(15΄)
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 5: Exercise (20΄)
Leaflet 9.1.1: Exercise
Look carefully the therapeutical
interventions mentioned used for treating
Anorexia Nervosa and point out the
specific clinical manifestations for which
each one is used.
Step 6: Slide projection
(15΄)
Slide 9.1.3: Therapeutical interventions for
Anorexia Nervosa





Diagnosis and treatment of physical disturbances
Gain of normal weight
Eating training
Psychotherapy
Pharmacotherapy
Step 7: Questions and
comments
(5΄)
Step 8: Lesson’s evaluation
(5΄)
Lesson 2
BULIMIA NERVOSA
TIME :
45 minutes (1 training hour of 45 minutes)
Step 1: Introduction (5΄)



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 (10΄)
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: Discussion (10΄)
Which must be the therapeutical
interventions in Bulimia Nervosa in your
opinion?
Step 4: Slide projection (10΄)
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 4 (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 5: Questions and
comments (5΄)
Step 6: Lesson’s evaluation (5΄)