Eating Disorders

Thomas G. Bowers, Ph.D.

Types of Eating Disorders

• Anorexia Nervosa• Bulimia Nervosa• Binge Eating Disorder• Obesity

Characteristics of Eating Disorders

• Anorexia nervosa– Considerable depression, anxiety– Distorted body image– In females, cessation of menstruation– Fainting spells– Hyperactivity– Constipation

Characteristics of Eating Disorders

• Anorexia nervosa– Growth of fine body hair on arms, legs– Loss of muscle and body fat– Shortness of breath– Heart tremors– May be heart damage– Cold hands and feet– Hair loss

Characteristics of Eating Disorders

• Anorexia nervosa– Shrunken organs– Osteoporosis– Low body temperature– Dry, brittle skin– Low blood pressure– Irregular heart, cardiac arrest

Characteristics of Eating Disorders

• Bulimia nervosa– Cycle of binges and purging with

vomiting or laxatives– May also include compulsive

exercising– Late teen or young adulthood

Characteristics of Eating Disorders

• Bulimia nervosa– Variation of mood and depression– Vomiting blood, enamel decay– Broken blood vessels– Dry, flaky skin– Weakness and exhaustion– Stomach pain– Constipation

Characteristics of Eating Disorders

• Bulimia nervosa Consequences– Dehydration– Damage to liver and kidneys– Electrolyte imbalance can lead to

irregular heart beat, cardiac arrest

Characteristics of Eating Disorders

• Binge Eating– Overeating sometimes motivated by

stress or conflict– Not followed by purging, but feelings

of guilt and shame– Depression– Obesity– Feelings of shame, guilt

Etiology of Eating Disorders

• May be over determined, with multiple causes– Occur during life transitions

• 1. Puberty• 2. Entering high school or college• 3. Major loss

Etiology of Eating Disorders

• May be over determined, with multiple causes– Many family dimensions

• 1. Excessively controlling parents• 2. Poor parent-child boundaries• 3. Some family alienation

– Interpersonal relationships • Perfectionism

Etiology of Eating Disorders

• May be over determined, with multiple causes– Inconsistent evidence of family dysfunction– Family difficulty may reflect the impact

rather than the cause of dysfunction– Some inconsistent findings of sexual abuse

in eating disorders– Not likely to be specific to eating disorders

Treatment of Eating Disorders

• Biological treatments– Antidepressants as Prozac (fluoxetine)

are helpful for Bulimia– No known effective pharmacotherapy

for anorexia– Hospitalization is often required– Cognitive behavioral therapies

Treatment of Eating Disorders

• Psychotherapy– Individual ego-analytical treatment

appears to have some impact– Encourage greater autonomy– Family therapy is a common modality– Some positive research (Eisler et a.,

1997) – Maintained gains for five years

Treatment of Eating Disorders• Psychotherapy

– Bulimia nervosa– Treated by cognitive-behavioral

therapy (Fairburn and associates, 1985)

– Encouraged to challenge social values and views

– Introduced more flexible thinking, assertiveness

– Encouraged interpersonal skills

Treatment of Eating Disorders

• Psychotherapy– Bulimia nervosa– Several studies appear to

demonstrate efficacy of cognitive behavioral approach

– However, a large proportion of individuals do not benefit well