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Bulimia nervosa & anorexia nervosa. Name some characteristics.
Disruptions in eating behavior (evenly distributed among peers & across the world).
Fear of gaining weight.
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What is the most common eating disorder in our society? (Not a biological disorder)
What % of US adults are overweight?
% obese?
Obesity.
65% overweight
30% obese
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Bulimia Nervosa. What is it?
What are the compensatory behaviors?
Belief that _____ and _____ are determined by _____ and _______.
Binge eating excess amounts of food, perceived as "out of control".
- Compensator behaviors:
- Purging
- Excessive exercise
- Fasting
popularity, self-esteem, weight, body shape.
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Bulimia Nervosa-Clinical Desc.
What are the subtypes of Bulimia Nervosa?
Are most within 10% of normal weight?
- Subtypes:
- 1) Purging (most common but ineffective).
- 2) Non-purging 6-8%
Yes, within 10%
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What are some medical consequences in Bulimia Nervosa?
(SEEKS)
- -Salivary gland enlargement
- -Erosion of dental enamel
- -Electrolye imbalance
- -Kidney failure
- -Seizures
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What are the associated psychological disorders with Bulimia Nervosa?
- Anxiety 75%
- -Social phobia & GAD
Mood disorders (50-70%)
Substance Abuse (36.8%)
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Anorexia Nervosa-Clincal Desc.
Is their weight loss "overly-successful"?
What are they fearful of?
What is Anorexia characterized by?
What does Anorexia often begin with?
Yes, successful.
Gaining weight & losing control of eating.
Characterized by relentless pursuit of thinness.
Begins with dieting.
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Anorexia Nervosa-Clinical Desc.
What are the subtypes?
- Subtypes:
- 1) Restricting (50%)
- 2) Binge-eating-purging (50%)
*Body image disturbance, Pride in diet & control, rarely seek treatment.
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What are the medical consequences of Anorexia Nervosa?
(ABLES)
- Amenorrhea (3+ skipped periods)
- Brittle hair & nailes
- Lanugo (a coat of downy hairs)
- Electrolyte imbalance
- Sensitivity to cold temps.
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What are some associated psychological disorders of Anorexia Nervosa?
- Anxiety
- -OCD (higher rates)
Mood disorders (33-60%)
Substance abuse - suicide
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Do Bulimics or Anorexics have a higher rate of OCD?
Anorexics
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Binge-Eating Disorder. What is it?
Food binges: high calorie intake.
*NO compensatory behaviors
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Associated features of Binge-Eating Disorders?
*Is it equally distributed across the sexes?
- Many are obese.
- Older.
- More psychopathology than non-binging obese.
- Concerned about shape & weight
*Yes, equally distributed across the sexes.
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Bulimia & Anorexia stats.
What % is Bulimic and female?
Onset?
Lifetime prevalence?
Chronic if untreated?
Usually live how many years or less?
90-95% female (caucasian, middle to upper class)
Onset: 16-19
Females: 1.1%; college women: 6-8%
Yes, chronic if untreated.
30 years or less.
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Bulimia in men.
What % in males?
Onset?
5-10% in males (caucasian, middle to upper class)
*Gay or bisexual
Athletes w/ weight regulations
Onset: older
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Bulimia & Anorexia: stats. Anorexia.
What % female is anorexia?
Onset?
90-95% female (caucasian, middle to upper class)
Onset: 13-15
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Cross-cultural considerations.
Immigrants to western cultures
North American minority populations.
- Immigrants to western cultures.
- 1) Increase in eating disorders
- 2) Increase in obesity
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Drug treatments of eating disorders.
In Anorexia?
In Bulimia?
Anorexia: no demonstrated efficacy.
- Bulimia: Anti-depressents (effective)
- 1) May enhance psychological treatment
- 2) No long-term efficacy
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Psychological treatment of Bulimia.
CBT (3)
Interpersonal Pychotherapy
*Which works quicker?
- CBT
- 1) treatment of choice
- 2) target problem eating behaviors
- 3) target dysfunctional thoughts
- IP
- 1) improve interpersonal functioning
- 2) similarly effective, long-term
*CBT may work quicker than IP.
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Psychological treatment of
Binge-eating Disorder.
Medications & efficacy
Prozac: no benefit
Meridia: possible benefits
Weight restoration: may require hospitalization.
Psychoeducation
- Target dysfunctional attitudes
- -body shape
- -control
- -thinness = worth
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Psychological Treatment of Anorexia (contd).
How can the family involve themselves?
Long-term prognosis?
- Families can communicate about eating food.
- Attitudes about body shape.
*Long-term prognosis is poorer than bulimia.
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