Transcript Eating Disorders

Body Image and
Eating Disorders
Parent Forum
April 17, 2013
From the About-Face organization:
"400-600 advertisements bombard us
everyday in magazines, on billboards,
on TV, and in newspapers. One in
eleven has a direct message about
beauty, not even counting the indirect
messages."
 Muscle
and fitness magazines
 Action figures have become increasingly
muscular and devoid of body fat
 Adonis Complex
 obsessed
with bulk and muscle mass
 over exercise
 dietary restriction
 abuse of anabolic steroids
Fiji in 1995 - Ethnic Fijians have traditionally
encouraged healthy appetites and have
preferred a more rotund body type, which
signified wealth and the ability to care for one’s
family
 One case of anorexia nervosa reported on the
island prior to 1995.
 In 1998, rates of dieting skyrocketed from 0 to
69%, and young people routinely cited the
appearance of the attractive actors on shows
like “Beverly Hills 90210” and “Melrose Place” as
the inspiration for their weight loss.
 For the first time, inhabitants of the island
began to exhibit disordered eating.

 Anorexia
Nervosa
 Bulimia Nervosa
Eating disorders
have the highest
mortality rate of
any mental illness.
FACTS
•It is estimated that 8 million Americans have an eating
disorder – seven million women and one million men
•One in 200 American women suffers from anorexia
•Two to three in 100 American women suffers from bulimia
•Nearly half of all Americans personally know someone with an
eating disorder (Note: One in five Americans suffers from
mental illnesses.)
Binge eating and
inappropriate compensatory
methods to prevent weight
gain
 Excessively influenced by
body shape and weight
 Must occur, on average, at
least twice a week for 3
months
 Typically within normal
weight!
 Between binges, individuals
usually restrict the number
of calories consumed.

 Binge:
eating in a discrete period of time an
amount of food that is larger than most
individuals would eat under similar
circumstances
 Purge: engagement in self-induced vomiting
or the misuse of laxatives, diuretics, or
enemas
 Typically
ashamed of their eating problems and
attempt to conceal their symptoms
 Binge eating usually occurs in secrecy
 Binge eating typically continues until the
individual is uncomfortably, or even painfully,
full.
 Binge eating us typically triggered by dysphoric
mood, interpersonal stressors, intense hunger
after dietary restraint, feelings related to body
weight, shape and food.
 Disparaging self-criticism and depressed mood
often follow.
 Recurrent
use of inappropriate compensatory
behaviors to prevent weight gain.
 Most commonly vomiting, which is employed by
80-90% of individuals with bulimia.
 Can also include misuse of laxatives and
diuretics.
 Some will also misuse enemas following episodes
of binge eating.
 Excessive exercise is another compensatory
behavior often used by those with bulimia.
 Increased
frequency of depressive
symptoms
 Increased frequency of anxiety symptoms
 Depression and anxiety frequently
diminish following effective treatment
 Lifetime prevalence of substance abuse is
at least 30% among those with Bulimia.
 Many have personality features that meet
criteria for personality disorders, most
frequently Borderline Personality
Disorder.
 Fluid
and electrolyte abnormalities
 Loss of stomach acid through vomiting
 Significant and permanent loss of dental
enamel, chipped teeth, increased frequency
in cavities
 Enlarged salivary glands
 Calluses or scars on the hands
 Loss of cardiac and skeletal muscle tissue
 Menstrual irregularities or amenorrhea
 Esophageal tears, gastric rupture, and
cardiac arrhythmias, and rectal prolapse
Similar frequencies in most industrialized countries:
U.S., Canada, Europe, Australia, Japan, New
Zealand, and South Africa.
 Individual with the disorder are primarily white.
 90% are female.
 Lifetime prevalence for women is 1%-3%
 Prevalence for men is one tenth of that.
 Usually begins in late adolescence or early
adulthood.
 Periods of remission longer than a year are
associated with better long-term outcomes.

Refusal to maintain a
minimally normal body
weight
 Intense fear of gaining
weight
 Significant disturbance in
the perception of shape or
size of his/her body
 Amenorrhea: the absence
of a menstrual period in a
woman of reproductive
age.
 Weigh less than 85% of
weigh that is considered
normal for age and height

 Weight
loss is usually accomplished by
reduction in total food intake
 Most eventually end up with a very restricted
diet that is sometimes limited to only a few
foods
 Intense fear of becoming fat not alleviated
by weight loss
 Concern about weight gain often increases as
weight decreases
 Self
esteem is highly dependent on body
shape and weight
 Weight
loss is seen as an impressive
achievement and a sign of extraordinary
self-discipline
 Weight
gain is perceived as an
unacceptable failure of self-control
 May
acknowledge being thin, but typically
deny serious medical implications.

Restricting Type


Eats very little and loses weight primarily through
dieting, fasting, or excessive exercise. Calories
consumed are insufficient to support bodily functions
and activities.
Binge-Eating/Purging Type




Regularly engage in binge eating or purging
Self induced vomiting or misuse of laxatives, diuretics,
or enemas.
Some do not binge eat, but do regularly purge after
eating small amounts of food.
Has symptoms of anorexia and bulimia. About 50% of
people with anorexia also develop bulimia
 Manifest
depressive symptoms: depressed
mood, social withdrawal, irritability,
insomnia, diminished interest in sex.
 Depressive symptoms may be a result of
semistarvation.
 Obsessive-compulsive features are often
prominent; when related to food, may be
due to undernutrition.
 Can
affect most major organ systems and
produce a variety of disturbances.


Anemia, dehydration, problems with liver
function, low estrogen levels, arrhythmias,
electrolyte disturbances
Constipation, abdominal pain, cold
intolerance, lethargy, excess energy,
hypotension, hypothermia, dryness of skin,
lanugo, bradycardia, edema, yellowing of the
skin, hypertrophy of salivary glands,
cardiovascular problems, dental problems, and
osteoporosis.
 Anorexia
is far more prevalent in
industrialized societies.
 U.S., Canada, Europe, Australia, Japan, New
Zealand, and South Africa.
 Rarely begins before puberty
 Lifetime prevalence is 0.5% among females.
 Prevalence has increased in recent decades.
 Usually
begins between 14-18
 Rarely occurs in women over 40
 Onset may be associated with a stressful life
event
 Hospitalization may be required to restore
weight and to address fluid and electrolyte
imbalances
 Mortality from anorexia is over 10%!
 Death most commonly results from
starvation, suicide, or electrolyte imbalance.
 Concerns
about eating in public, feelings
of ineffectiveness, a strong need to
control one’s environment, inflexible
thinking, limited social spontaneity,
perfectionism, and overly restrained
initiative and emotional expression.
 A substantial portion have a personality
disturbance that meets the criteria for a
personality disorder, often Borderline
Personality Disorder.









Nurturing
Addiction
Trauma
Survival Strategies
Reenactment
Suppression
Disordered eating is an attempt to control, hide,
stuff, avoid and forget emotional pain, stress and/or
self-hate
Short-term relief for long-term destruction
Multi-factorial in origin: While family dynamics are
certainly important, so too are biological
predisposition to anxiety and mood disorders,
interpersonal effectiveness skills, and cultural
expectations of beauty.



"Why are you doing this to yourself?"
"You have good things in your life, what's the problem?"
Not a conscious choice where a person suffering from an
Eating Disorder would prefer that lifestyle as opposed to
one filled with self-love and happiness
Coping mechanism




a means for dealing with depression, stress and self-hate that
has been built up over many years
It is a reflection of how the person suffering feels about
themselves inside
Mothers, fathers, siblings, supportive friends have little
influence in creating the true self-esteem required for
permanent recovery, to cope with life positively, and to
learn to believe that we deserve good things in life and
happiness.
These disorders are about the person suffering and how
they feel about themselves.
Family
•Families where children are not permitted to express emotions and are
prohibited from expression of the natural frustrations and anger related to
daily injustice, rage begins to develop.
•Because the natural responses are suppressed, strong emotions must seek
release in indirect ways. Strong emotion can be suppressed and satisfied by
eating behavior.
"I am frustrated and overwhelmed."="I am hungry."
"I am out of control."=“Control food intake."
"I am lonely and afraid."="I am hungry."
 Research findings indicate the relationship between fathers
and daughters has a significant impact on the long term
mental health of girls.
 Positive reinforcement and lack of body image criticism is
particularly important during a girl’s adolescent years





Positive or negative image reinforcement
Positive or negative behavior modeling
Supportive or critical when a problem is evidenced
Open or secretive
Guiding versus controlling
"With a change in our understanding of the distress found
within families of AN, our view of these families can be
transformed from being part of the problem to being part of
the solution."
Discourage dieting, as it rarely works in the long term.
Model healthy eating without restriction, self-criticism, or
overeating.
Avoid focusing too much on appearance or weight, as perceived
pressure to be thin can lead to disordered eating.
Encourage children to develop strengths such as music, art, or sports
to foster healthy self-esteem.
Focus on mastery of an activity rather than comparing themselves to
others.
Refer promptly for diagnosis and treatment when you suspect mood
disorders or eating problems.
 http://www.youtube.com/watch?feature=pla
yer_embedded&v=jWKXit_3rpQ
 Life
Without Ed, Jenny Schaefer
 Wasted, Marya Hornbacher
 Somethingfishy.org
 http://ap.psychiatryonline.org/article.aspx?articleID=
50181
 http://www.vanderbilt.edu/AnS/psychology/health_p
sychology/famstruc.htm
 http://www.youtube.com/watch?v=U-N2Cv52gB8
 http://www.youtube.com/watch?v=loszrEZvS_k
 Jill
Ahrens, M.Ed., LPC
 Beth Fowler, Ph.D.
 Rev. Adam Greene