Eating Disorders in Adolescence PDF

Life cycle 2 / level 3 Body Image & Eating Disorders in Adolescence Dr. Alzahraa M. Motawei Food Sci. Dept. Mansoura University What do you know about…. Why disorders happen?  Some statistics  Eating disorders have increased threefold in the last...

Life cycle 2 / level 3 Body Image & Eating Disorders in Adolescence Dr. Alzahraa M. Motawei Food Sci. Dept. Mansoura University What do you know about…. Why disorders happen?  Some statistics  Eating disorders have increased threefold in the last 50 years  10% of the population is afflicted with an eating disorder  90% of the cases are adolescent girls  Up to 21% of college women show sub-threshold symptoms  61% of college women show some sort of eating pathology  Three Types of Eating Disorders  Anorexia nervosa- characterized by a pursuit of thinness that leads to self- starvation  Bulimia nervosa- characterized by a cycle of bingeing followed by extreme behaviors to prevent weight gain, such as purging.  Binge-eating disorder- characterized by regular bingeing, but do not engage in purging behaviors.  Body shape in eating disorders  1- Anorexia Nervosa  Self-starvation  Essential nutrients are denied (no or little food) so the body slows down all normal processes to conserve energy.  Health consequences  Low blood pressure / heart rate  Muscle loss / weakness  Dehydration  Fainting / fatigue  Dry hair and skin  Anorexia Nervosa  90-95% are female so, 5-10% are male.  Similar characteristics:  Preoccupied with weight  Males may have preoccupation with body building, weight lifting or toning.  Compulsive exercise  Frequently weighing oneself  Distorted body image Anorexia Nervosa  Begins with individuals restricting certain foods, not unlike someone who is dieting  Restrict high-fat foods first  Food intake becomes severely limited  2- Bulimia Nervosa  Qualitatively distinct from anorexia  characterized by binge eating  A binge may or may not be planned  marked by a feeling of being out of control  The binge generally lasts until the individual is uncomfortably or painfully full  Bulimia Nervosa  Feelings of being ashamed after a binge are common  behavior is kept a secret  Tend to adhere to a pattern of restricted caloric intake  usually prefer low-calorie foods during times between binges  Later age at the onset of the disorder  Are able to maintain a normal weight  Will not seek treatment until they are ready  Two subtypes  purging type  self-induced vomiting and laxatives as a way to get rid of the extra calories they have taken in  non-purging type  use a period of fasting and excessive exercise to make up for the binge  Bulimia Nervosa  Typically a binge–purge method  Binge – secret periods of quickly eating high- calorie dense foods.  Purge –the typical vomiting.  80% are female  Health consequences:  Irregular heartbeat = heart failure = death.  Tooth decay  Ulcers  Signs and Symptoms (Anorexia & Bulemia)  Weight loss  Continued dieting  No or irregular  Preoccupation with periods food/weight  Fatigue  Frequent trips to  Decreased bathroom during concentration and after meals  Muscle injuries  Using laxatives  Low heart rate/BP  Brittle nails/hair  Heart irregularities  Dental cavities  May even have  Sensitivity to cold chest pain  3- Binge Eating Disorder  Themost common eating disorder.  Affects about 3% of adults.  Signs & symptoms:  Eat a large amount of food quickly during binge.  Eating a large amount until uncomfortable full.  Eating alone because embarrassed about amount of food.  May have feelings of guilt or depression after overeating.  Binge Eating Disorder  Largeamounts of food consumed (binge) but typically NO purging.  This is different than bulimia.  Complications from binge eating disorder:  Type 2 Diabetes  High blood pressure  High cholesterol  Heart disease  Certain types of cancer  Risk Factors for developing an eating disorder  Personality/psychological factors  Family influence  Media  Subcultures existing within our society  Personality/Psychological Factors  Sense of self worth based on weight  Use food as a means to feel in control  Perfectionism  Poor impulse control  Inadequate coping skills Media and Cultural Factors  Culture bound syndrome  Belief that being thin is the answer to all problems is prevalent in western culture  Bulimia can be influenced by social norms  It can be seen as a behavior, which is learned through modeling  The Impact on Women  One study showed that 55% of college women thought that they were overweight though only 6% were  94% of one sample of women wanted to be smaller than they currently were  96% thought that they were larger than the current societal ideal  Half the women in a study said they would rather be hit by a truck than be fat 23 Challenges to treatment  Lack of motivation to change  intrinsically reinforced by the weight loss, because it feels good to them  may deny the existence of the problem, or the severity of it  Lack of insight  Not really about food.  Clinical Management (1): AN  The treatment of AN must focus on three primary issues: (1) Restoring weight; (2) modifying distorted eating behavior; and (3) addressing the psychological and family issues.  Treatment methods typically include nutritional rehabilitation, psychotherapy, and medication.  half of all patients are hospitalized 25  Clinical Management (2): AN  The goals of nutritional rehabilitation are to 1. restore weight 2. normalize eating patterns, 3. reestablish normal perceptions of hunger and satiety, 4. correct the biological and psychological sequences of malnutrition.  Restoring weight  weight gain, which are generally accepted to be 1 – 2 pounds per week for inpatients and 0.5 – 1 pound per week for outpatients.  Physical activity must be monitored as well and restricted if it interferes with weight gain Thank you