Chapter 15

1. Chapter 15 Eating Disorders

2. DSM-IV-TR Criteria for Anorexia Nervosa • Refusal to maintain body weight at or above a minimally normal weight for age and height • Intense fear of gaining weight or becoming fat, despite being underweight • Distortions in the perception of one’s body weight or shape, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight • In females who have reached menarche, amenorrhea (absence of at least three consecutive menstrual cycles)

3. Types of Anorexia Nervosa Restricting type of anorexia nervosa: simply refusing to eat as a way of preventing weight gain. Some might go for days without eating. Binge/Purge type of anorexia nervosa: binging or purging behaviors (e.g., self-induced vomiting or the misuse of laxatives or diuretics). Yet it is different from bulimia nervosa in two main ways: 1.People with the binge/purge type of anorexia nervosa will continue to be at least 15% below a healthy body weight. 2. Women with this type of anorexia may also develop amenorrhea, whereas women with bulimia nervosa do not.

4. Common Medical Complications • Cardiovascular complications • Metabolic complications • Fluid and electrolyte complications • Hematological complications • Dental problems • Endocrine complications • Gastrointestinal complications

5. DSM-IV-TR Criteria for Bulimia Nervosa • Recurrent episodes of binge eating characterized by • 1) eating in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances • 2) a sense of lack of control over eating during the episode • Recurrent inappropriate behaviors to prevent weight gain such as self-induced vomiting or misuse of laxatives. • The binge eating and inappropriate purging behaviors both occur, on average, at least twice a week for 3 months. • Self-evaluation is unduly influenced by body shape and weight.

6. Non-purging type of bulimia nervosa: people who use excessive exercise or fasting to control their weight but do not engage in purging are said to have a non-purging type of bulimia nervosa. Purging type of bulimia nervosa: people who use self-induced vomiting or purging medications. Types of Bulimia Nervosa

7. Common Medical Complications of Bulimia Nervosa • Renalcomplications • Gastrointestinal complications • Electrolyte complications • Dental problems • Laxative abuse complications • Other abnormalities and complications

8. Binge-Eating Disorder • Another eating disorder that resembles bulimia nervosa in many ways, except that the person with binge-eating disorder does not regularly engage in purging, fasting, or excessive exercise to compensate for his or her binges.

9. Contributors to the Eating Disorders • Biological Factors • Genetic predisposition to eating disorders • Predisposition to depression • Dysregulation of hypothalamus • Serotonin imbalances

10. Contributors to the Eating Disorders, continued • Sociocultural and Psychological Factors • Pressures to be thin • Cultural norms of attractiveness • Use of food as a way of coping • Overconcern with others’ opinions • Rigid, dichotomous thinking style, perfectionism • Poor family dynamics • History of sexual abuse

11. Rates of Eating Disorders in Elite Women Athletes

12. Treatments for Anorexia Nervosa

13. Treatments for Bulimia Nervosa