Lecture 11 - Eating Disorders and Weight Management PDF

Lecture 11: Eating Disorders & Weight Management KIN 150 Fall 2024 Sophia Williams, MS, RD  Outline Disordered Eating Eating Disorders Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Orthorexia Nervosa Weight Mana...

Lecture 11: Eating Disorders & Weight Management KIN 150 Fall 2024 Sophia Williams, MS, RD  Outline Disordered Eating Eating Disorders Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Orthorexia Nervosa Weight Management Weight loss strategies Stages of weight management Factors in weight maintenance and weight regain  Eating Disorders vs. Disordered Eating Disordered Eating: eating that sits on a spectrum between normal eating and an eating disorder, and may include symptoms and behaviors of eating disorders, but at a lesser frequency or lower level of severity May include restrictive eating, compulsive eating, or irregular or inflexible eating patterns Dieting is the most common form of disordered eating Can easily become an eating disorder Eating Disorder (ED): any range of a mental condition in which there is a persistent disturbance of eating behaviors, often presenting with impaired mental or physical health  Disordered Eating At-Risk Populations: Athletes Females People with anxiety, perfectionism, high- achievers People whose self-worth is largely tied to appearance Being around people with negative relationships with food (parents, siblings) Major concern is the development into an eating disorder  Eating Disorders “Any range of psychological disorder characterized by abnormal or disturbed eating habits.”  EATING DISORDERS Primary Disorders: Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Orthorexia Nervosa Common themes: Body dysmorphia Need for control Mental illness Perfectionism  General ED Statistics 9% of the US population, or 28.8 million Americans, will have an ED in their lifetime Overall prevalence of EDs: 8.60% among females, 4.07% among males Every 52 minutes, 1 person dies as a direct consequence of an ED 22% of children and adolescents worldwide show disordered eating habits Over 3.3 million healthy life years worldwide are lost yearly due to EDs 1 traumatic event in their lives Students: ED risk among US college students increased by 13% from 2013 to 2023 Body Image: 69-84% of women in the US experience body dissatisfaction, desiring to be a lower weight than they currently are  Anorexia Nervosa Anorexia Nervosa: inadequate food/calorie intake, leading to a weight that is too low Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain 2 Main Types: Binge-Eating/Purging Type: involves binge eating and/or purging behaviors Restricting Type: does not involve binge eating or purging, but excessive restriction  Anorexia Nervosa Warning Signs & Symptoms: Physical Symptoms: Dramatic weight loss Dry skin, thinning hair Denies feeling hungry Fine facial hair Consistently makes excuses to avoid Muscle wasting meals Limited social spontaneity Health Impacts: Constipation, abdominal pain, cold Dangerously low body weight intolerance, lethargy Electrolyte imbalances Preoccupied with weight, food, calories, fat Poor immunity grams, dieting Loss of menstrual cycle (women), low Dresses in layers to hide weight loss or testosterone (men) stay warm Intense fear of weight gain  Bulimia Nervosa Bulimia Nervosa: recurrent, frequent episodes of consuming very large amount of food followed by compensatory behaviors to prevent weight gain A feeling of being out of control during the binge-eating episodes Compensatory behaviors: self-induced vomiting, misuse of laxatives, diuretics, fasting, excessive exercise Occur at least 1x/week every 3 months  Bulimia Nervosa Warning Signs & Symptoms: Physical Symptoms: Skipping meals or taking small portions of Self-injury signs (bloody or food at regular meals bruised knuckles, cutting) Drinking excessive amounts of water or non- Bad breath Bloodshot eyes caloric beverages Excessive use of mouthwash, mints, gum Health Impacts: Hides body with baggy clothes Dry skin, dry and brittle nails Maintains excessive, rigid exercise regimen Dental problems Self-esteem overly related to body image Poor wound healing Frequently body checks Electrolyte imbalances Unusual swelling of the cheeks or jaw area Appears uncomfortable eating around others  Binge Eating Disorder (BED) Binge Eating Disorder: recurrent, frequent episodes of eating very large quantities of food (often very quickly and to the point of discomfort) Feeling of loss of control during the binge Experiencing shame, distress, or guilt afterwards Not regularly using compensatory measures (i.e., purging) to counter the binge eating Usually involves eating when not hungry and continuing to eat beyond the point of fullness to extreme discomfort  Binge Eating Disorder (BED) Warning Signs & Symptoms: Physical Symptoms: Fear of eating in public or with others  Weight fluctuations eating alone Swollen/puffy cheeks or face Withdraws from friends and activities Bloated stomach Frequently diets Disruption in normal eating behaviors Health Impacts: Hoarding food in strange places Obesity (can be diagnosed at ANY Disappearance of large amounts of food in weight) short periods of time, lots of empty Weight stigma wrappers and containers Weight cycling (yo-yo dieting) Developing food rituals (only eating a Metabolic syndrome specific food group, excessive chewing, not allowing foods to touch) Stomach cramps or non-specific GI complaints (constipation, acid reflux, etc.)  Orthorexia Nervosa Orthorexia Nervosa: obsession with “healthy” eating Known as the “Healthy Eating” Disorder Individual develops an obsessive behavior in pursuit of a healthy diet Includes health concerns and avoidance of foods without medical advice Many parallel symptoms of anxiety disorders  Orthorexia Nervosa Warning Signs & Symptoms: Physical Symptoms: Compulsive checking of ingredient lists Weight loss and nutrition labels Increase in concern about the health of Malnutrition ingredients Cutting out an increasing number of food groups  may consume as few as 10 foods Health Impacts: Guilt over deviating from a strict diet Long-term negative Unusual interest in the health of what relationship with food others are eating Increased overall High level of distress when ‘safe’ or anxiety, especially ‘healthy’ foods aren’t available around eating Spending hours per day thinking about High stress and high what food might be served at upcoming cortisol events Irrational concern over preparation techniques  Eating Disorders Review Recovery can be a lifelong journey An ED is a mental health disorder Normalizing this conversation can make it easier for those struggling to seek help and minimize the shame felt Signs and symptoms are both physical and behavioral  Eating Disorders Signs & Symptoms Review Weight Management  Historical Weight Loss Strategies Diuretics Fad diets Surgery without lifestyle changes Tapeworms Drugs/diet pills: Thyroid extract (1800s) Cigarettes/nicotine (1920s) Amphetamines (WWII soldiers) Dexedrine/benzedrine (70s) Ephedra (70s-90s) Fen-phen (90s)  Modern Weight Loss Strategies Keto Diet Intermittent Fasting 75 Hard Tracking macros Volume eating (eating as much as possible through low-calorie foods, like vegetables) Juicing Apple cider vinegar Pills Ozempic  Weight Management Stages 1. Desire for weight loss 2. Weight loss plateau 3. Weight maintenance 4. Weight regain  1. Weight Loss Initial realistic goal is ~10% loss of Initial weight loss is a predictor for body weight (if overweight or later weight loss and maintenance: obese) > initial weight loss: Once achieved, consider more Better subsequent outcome reduction (practical and realistic) Reflects better adherence to 5-10% weight loss treatment Enough to achieve improvement The longer weight loss is in obesity-associated metabolic maintained -> better chances risk factors for continuation of weight loss Leptin resistance, insulin Should NOT consume 10k steps/day Self-monitoring (habits) Eating breakfast Self-efficacy Regular meal times (consistency) Coping strategies Less dietary fat (for calorie “Right” motivation for weight loss reduction) Able to find ways to handle Balanced, healthful diet cravings  30-30-30 Rule of Weight Loss 30-30-30 Rule: 30g protein within 30 minutes of waking up, followed by 30 minutes of low-intensity exercise Why? This method has gone viral on social media as a proposed successful approach to weight loss. Pros: encourages protein intake, eating breakfast, exercise Cons: 30g protein may not be appropriate for all people in one sitting Can not comfortably or effectively do >low-intensity exercise immediately after eating that much protein. Higher intensity exercise = more calories burned… What you do the rest of the day matters – movement, food choices, etc. What do you think? Is this an approach people should be following for weight loss?