Understanding Eating Disorders

Anorexia Nervosa

Diagnosis for people who experience persistent disturbances of eating or eating-related behavior that result in changes in how they eat or retain their food
1. These disorders go beyond dieting or occasional overeating, significantly impairing the individual’s physical and psychosocial functioning.

Characterized by an inability to maintain normal weight, an intense fear of gaining weight, and distorted body perception
Three basic symptoms:
1. Severely restricted eating, which leads to an abnormally low body 
weight
2. Intense and unrealistic fear of getting fat or gaining weight
3. Disturbed self-perception of body shape or weight Classified as “restricting type” of eating disorder.

Results in a series of serious health changes that can even be life-threatening:
1.  Bones, muscles, hair, and nails become weak and brittle
2.  Develop low blood pressure, slowed breathing and pulse
3.  Lethargic, sluggish, and fatigued
4. Infertility and disturbed sexual function
5. Gastrointestinal system functions abnormally 
6. Heart and brain damage 
7. Multiple organ failure

At the heart of AN experience is a core disturbance in an individual’s body image People with AN believe that their bodies are larger than they 
really are, which leads them to believe they are unattractive Women with the restrictive form of AN appear not to value thinness so much as they are repelled by the idea of being overweight Lifetime prevalence is 0.9 percent (women) and 0.3 percent (men) People with anorexia nervosa have higher rates of mood, anxiety, impulse-control, and substance use disorders.

Alternation between the extremes of eating large amounts of food in a short time and then compensating for the added calories by:
1. Vomiting
2.  Laxatives/diuretics
3. Excessive exercise 
4. Fasting 
5. Other extreme actions to avoid gaining weight
6. Known as purging
7. Binge eating: The ingestion of large amounts of food during a short 
period of time, even after reaching a point of feeling full, and a lack of control over what or how much is eaten. Lifetime prevalence is 1.5 
percent (women) and 0.5 percent (men).

1. Ipecac syrup has toxic effectsDental decayLaxatives, diuretics, and diet pills also have toxic effects over time Gastrointestinal damage may be permanent

The ingestion of large amounts of food during a short period of time, even after reaching a point of feeling full, and a lack of control over what or how much is
1. Binges occur at least twice a week for 6 months 
2. Feeling self-disgust or guilt after overeating
Significant weight gain can occur since there are no compensatory behaviors

Eating disorders reflect a complex set of interactions among an individual’s:
• Genetic vulnerability 
• Experiences with eating, body image, and exposure to sociocultural influences Biological
• Dopamine, plays a role in feelings of reward and pleasure including those feelings related to eating
• Serotonin and dopamine receptor genes play a role in altering emotion regulation in individuals with anorexia nervosa

Sociocultural 
1. Clinicians use interventions incorporating a family component for clients with eating disorders who are still in their teens and who have had symptoms for only a brief time.

2. Particularly effective in reducing depressive symptoms in bulimia nervosa

Individuals show an apparent lack of interest in eating or food because they are concerned about the aversive consequences
Food may be avoided based on its sensory characteristics

1. Color, smell, texture, temperature, or tasteAs a result, significant weight loss occurs, and psychosocial function is disturbed People may develop this disorder as the result of a conditioned negative response

Rumination disorder is an eating disorder in which the infant or child regurgitates food after it has been swallowed and then either spits it out or re-swallows it
Five common disturbances include:
1. delayed or absent development of feeding and eating skills,
2. difficulty managing or tolerating food or drink
3. reluctance to eat food based on taste, texture, and other sensory 
factors, 
4. lack of appetite or interest in food
5. the use of feeding behaviors to comfort, self-soothe, or self-stimulate