EATING EATING DISORDERSDISORDERSa disruption of eating habits outside the normal range (usually a compulsion to eat or avoid eating), that negatively affects both one's physical and mental health.

EPIDEMICEPIDEMICIn their lifetime, an estimated 15-16 million adults will suffer from an eating disorder (about 30% of worldwide total according to http://www.ndsu.edu/fileadmin/counseling/Eating_Disorder_Statistics.pdf

)

Women 3 times more likely than men

1 in 20 Anorexics will die from Anorexia; about 12 times higher than the annual death rate for all other causes of death among females ages 15-24.15

From the National Institute of Mental Health (NIMH)

Types of Eating DisordersTypes of Eating DisordersAnorexia Nervosa

Anorexia Athletica

Bulimia Nervosa

Non-associated eating disorders

Anorexia Nervosa definedAnorexia Nervosa defined

a psychophysiological (meaning

emotional AND physical) disorder characterized by an abnormal fear of becoming fat & a distorted self-image

believing one is fat when in reality the individual is at least 15% below healthy body weight.This causes a persistent unwillingness to eat, and severe weight loss.

What are the causes of What are the causes of Anorexia?Anorexia?

Body image issuesMediaPeers

Associated with high Cortisol & Serotonin levels

Addictive personalities more susceptible

Associated with BPD & OCDBorderline Personality DisorderObsessive Compulsive Disorder

Those w/family history are more vulnerable

Dangers of AnorexiaDangers of AnorexiaAbnormal menstruation or loss of menstruation/fertility

Dry hair and skin; hair loss is common.

Growth of a layer of hair called lanugo all over the body, including the face to keep the body warm.

Osteoporosis, which results in dry, brittle bones, increased potential for serious breakage.

Muscle loss and weakness.

Severe dehydration, kidney failure.

Fainting, fatigue, and overall weakness.

Heart muscle changes causing abnormally slow heart rate and low blood pressure

Death from heart failure

Signs of AnorexiaSigns of Anorexia

Sudden, severe weight lossObsession with food

Preparing far in advanceCutting food a certain wayOnly eating certain foods

Stimulants (caffeine, pills)Lying about weight or food intakeAvoiding social situations, especially those associated with foodAnxiety over interruption of their normal routine/rituals.Lanugo (fine body hair)

Bulimia Nervosa definedBulimia Nervosa defined

A psychophysiological disorder characterized by abnormal fear of becoming fat and a distorted self-image. This causes binge eating followed by purging of food through self-induced vomiting or other means.

Bulimia vs. “Non-specific Bulimia vs. “Non-specific eating disordereating disorder”

A minimum of two binge-and-purge episodes a week for at least three months is necessary for diagnosis as Bulimic

What is “Binge eating”?Eating, in a discrete period of time (e.g., within a two-hour period), an amount of food that is definitely larger than most people would eat in a similar time period/similar circumstances.

A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what/how much one is eating).

Non-purging BulimiaNon-purging Bulimia

A person may not engage in vomiting, but may use other inappropriate compensatory behaviors, such as:

Fasting

Laxatives, Enemas, diuretics or other medications

excessive exercise

Dangers Dangers of of BulimiaBulimia

What are the causes of What are the causes of Bulimia?Bulimia?

Associated with DepressionLow natural serotonin levels are compensated for by overeating (which releases serotonin)

Body image issues (role of media?)Addictive personalities are more susceptibleThose w/family history are more vulnerable

Dangers of Binge eatingDangers of Binge eatingGastric rupture

Nausea

Abdominal pain and distention

Prolonged digestion

Weight gain

Cardiac arrhythmias§

§--Hospitalization required.

Dangers of PurgingDangers of PurgingDental erosion Enlarged salivary glandsOral/hand traumaEsophageal/pharyngeal damageIrritation of esophagus and/or pharynx due to contact withgastric acids Heartburn and sore throatUpper gastrointestinal tearsPerforation of upper digestive tract, esophagus or stomach*Excessive blood in vomitus and gastric pain†Electrolyte imbalancesHypokalemia‡FatigueMuscle spasmsHeart palpitationsParesthesias§Tetany§Seizures§

*--A rare but potentially lethal complication. †--Should be evaluated on an urgent basis. ‡--A potential medical emergency. §--Acute care required.

Signs of BulimiaSigns of Bulimia

Regular trips to the bathroom (alone) after meals, may be followed by

bloodshot eyes/broken blood vessels in eyesBad (vomit) breath or gum to hide itVoice changes

Swollen cheeks or jaw area Darkened or raw fingernails or fingertipsCalluses or scrapes on the knuckles (if using fingers to induce vomiting) Teeth that look clear, brown or black Obsession with exercise, even when injured or in odd circumstances Weight fluctuations over time

How are they treated?How are they treated?

Lots of different therapies for lots of different problems

Medication for Psychiatric conditionsTreated w/Prozac, other anti-depressants

Compulsive actions

Overcoming Addiction

Body image issues

Family issues

Control issues

How can I help?How can I help? C.O.N.F.R.O.N.T.

C = Concern (express genuine concern)

O = Organize (who, what, when, where, why, how)

N = Needs

F = Face to Face

R = Respond

O = Offer

N = Negotiate

T = Time