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Overview of Eating Disorders

The document summarizes eating and sleep disorders discussed in Chapter 8 of Abnormal Psychology 30. It describes the defining features and statistics of major eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. It also discusses obesity, night eating syndrome, and the biological, psychological, social, and cultural factors involved in the development and treatment of these disorders. The two major eating disorders recognized by the DSM-IV-TR are anorexia nervosa and bulimia nervosa, which share features like deviations in eating behavior and fear of weight/appearance.

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11 views5 pages

Overview of Eating Disorders

The document summarizes eating and sleep disorders discussed in Chapter 8 of Abnormal Psychology 30. It describes the defining features and statistics of major eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. It also discusses obesity, night eating syndrome, and the biological, psychological, social, and cultural factors involved in the development and treatment of these disorders. The two major eating disorders recognized by the DSM-IV-TR are anorexia nervosa and bulimia nervosa, which share features like deviations in eating behavior and fear of weight/appearance.

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© Attribution Non-Commercial (BY-NC)
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Abnormal Psychology 30 3/18/09

Chapter 8 - Eating and Sleep Disorders

Eating Disorders: An Overview


 Central characteristic is an overwhelming, all-encompassing drive to be thin.

 Marked by severe disruptions in eating behavior

 Strong sociocultural origins - Westernized views


 Although rates are increasing in parts of Asia
 Two Major Types of DSM-IV-TR Eating Disorders
 Anorexia nervosa and Bulimia nervosa
 Other Subtypes of DSM-IV-TR Eating Disorders
 Binge eating disorder
 A Growing Epidemic
 Obesity

Bulimia Nervosa: Defining Features


 DSM-IV-TR Subtypes of Bulimia
 Purging subtype – Most common subtype
 Non-purging subtype – Rare; 6-8% of bulimics
 No differences between subtypes in severity of psychopathology, frequency of binge episodes, or prevalence of
major depression and panic disorder.
 Binge Eating is the Hallmark of Bulimia
 Binge - Eating excess amounts of food
 Eating is perceived as uncontrollable
 Compensatory Behaviors
 Purging - Self-induced vomiting, diuretics, laxatives
 Some exercise excessively, whereas others fast
 Is actually not a good way to lose weight

Bulimia Nervosa: Associated Features


 Most are within 10% of target body weight
 Associated Medical Problems
 Erosion of dental enamel, electrolyte imbalance
 Kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage
Bulimia Nervosa: Associated Features

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Abnormal Psychology 30 3/18/09
 Associated Psychological Features
 Most are over concerned with body shape
 Fear of gaining weight
 Comorbid psychological disorders
 Anxiety, mood disorders, and substance abuse.

Anorexia Nervosa: Defining Features


 DSM-IV-TR Subtypes of Anorexia
 Restricting subtype – Limit caloric intake via diet and fasting
 Binge-eating-purging subtype – About 50% of anorexics
 Unlike bulimics, binges involve small amounts of food and the purges occur more consistently
 Few differences exist on severity of symptoms or personality
 Successful Weight Loss is the Hallmark of Anorexia
 Defined as 15% below expected weight, typically 25-30%
 Intense fear of obesity and losing control over eating
 Anorexics show a relentless pursuit of thinness
 Often begins with dieting, especially adolescents who are actually overweight or otherwise perceive themselves
to be overweight
Anorexia Nervosa: Associated Features
 Associated Medical Features
 Marked disturbances in body image
 Rarely seek treatment on their own
 Medical consequences
 Amenorrhea, Lanugo
 Dry skin, brittle hair or nails, sensitivity and intolerance for cold temperatures.
 Comorbid psychological disorders
 Anxiety and mood disorders, particularly obsessive-compulsive disorder.

Binge-Eating Disorder: Overview


 Binge-Eating Disorder – Appendix of DSM-IV-TR
 Experimental diagnostic category
 Engage in food binges without compensatory behaviors
Binge-Eating Disorder: Associated Features
 Many are obese

 Concerns about shape and weight


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Abnormal Psychology 30 3/18/09
 Often older than bulimics and anorexics

 More psychopathology vs. non-binging obese people

Bulimia and Anorexia: Facts and Statistics


 Both Bulimia and Anorexia Are Found in Westernized Cultures

 Most cases of severe eating disorders are found in young, affluent, white females in competitive environments
Bulimia and Anorexia: Facts and Statistics
 Bulimia
 Onset around 16 to 19 years of age
 Lifetime prevalence is about 1.1% for females, 0.1% for males
 6-8% of college women suffer from bulimia
 Chronic if left untreated
 Anorexia
 Majority are white in middle-to-upper middle class
 Usually develops around age 13 or early adolescence
 More chronic and resistant to treatment than bulimia

Causes of Bulimia and Anorexia: Toward an Integrative Model


Media and Cultural Considerations
 Being thin = Success, happiness....really?
 Cultural imperative for thinness
 Translates into dieting
 Standards of ideal body size changes like fashion
 Media standards of the ideal are difficult to achieve

Causes of Bulimia and Anorexia: Toward an Integrative Model


 Familial Considerations
 Successful, hard driving, concerned with external appearances, and eager to maintain harmony.
 Often deny or ignore conflicts and have communication problems.

 Biological Considerations
 Low 5HT in hypothalamus
 Inherited emotional instability and poor impulse control
 Psychological and Behavioral Considerations

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Abnormal Psychology 30 3/18/09
 Low sense of personal control and self-confidence
 Perfectionistic attitudes
 Distorted body image
 Preoccupation with food
 Mood intolerance

Medical and Psychological Treatment of Bulimia Nervosa


 Medical and Drug Treatments
 Antidepressants
 Can help reduce binging and purging behavior but not long-term
 Psychosocial Treatments
 Cognitive - behavior therapy (CBT)
 Treatment of choice
 Interpersonal psychotherapy
 Long-term gains similar to CBT

Goals of Psychological Treatment of Anorexia Nervosa


 General Goals and Strategies
 Weight restoration
 First and easiest goal to achieve
 Psychoeducation
 Behavioral and cognitive interventions
 Target food, weight, body image, thought and emotion
 Treatment often involves the family
 Anorexia has poorer prognosis than for bulimia

Medical and Psychological Treatment of Binge Eating Disorder


 Medical Treatment
 Sibutramine (Meridia)
 Psychological Treatment
 CBT
 Similar to that used for bulimia
 Interpersonal psychotherapy
 Self-help techniques

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Obesity: Overview
 Not a formal DSM disorder

 Statistics
 In 2000, 20% of adults in the United States were obese
 Mortality rates are close to those associated with smoking
 Increasing more rapidly in teens and young children
 Growing rapidly in developing nations
Obesity and Disordered Eating Patterns
 Obesity and Night Eating Syndrome
 Occurs in 7-15% of treatment seekers
 Occurs in 27% of individuals seeking bariatric surgery
 Patients are wide awake and do not binge eat
 Causes
 Obesity is related to technological advancement
 Genetics account for about 30% of obesity cases
 Biological and psychosocial factors
 Treatment
 Greater success with children and adolescents
Obesity Treatment Progression: From least to most intrusive options
 1st step - Self-directed weight loss programs

 2nd step - Commercial self-help programs

 3rd step - Behavior modification programs

 Last step - Bariatric surgery

Review of Eating Disorders


 Two Major Types of DSM-IV-TR Eating Disorders
 Anorexia nervosa and Bulimia nervosa
 Major difference is whether weight loss is successful
 Other Subtypes of DSM-IV-TR Eating Disorders
 Binge eating disorder
 All Eating Disorders Share
 Gross deviations in eating behavior
 Fear or concern about weight, body size, appearance
 Heavily influenced by social, cultural, and psychological factors
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