BODY IMAGE & EATING DISORDERS
Messages about Food What messages have you received (from
parents, peers, media, etc.) about food? What is the Philippine standard of being
healthy? How did this affect you?
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 young women and 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.
Anorexia Nervosa Begins with individuals
restricting certain foods, not unlike someone who is dieting Restrict high-fat foods first Food intake becomes
severely limited
The fear of gaining weight
More on anorexia nervosa May exhibit unusual behaviors
with regards to food. preoccupied with thoughts of food,
and may show obsessive-compulsive tendencies related to food may adopt ritualistic behaviors at
mealtime. may collect recipes or prepare
elaborate meals for others.
DSM-VAll of the following symptoms are present: Restriction of energy intake relative to requirements, leading to significantly low body weight in the context of age, sex, development trajectory and physical health. Significantly low weight is defined as a weight that is less than minimally normal or for children and adolescents, less than minimally expected.
Intense fear of gaining weight or of becoming fat or of persistent behavior that interferes with weight gain, even though at significantly low weight.
Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation or persistent lack of recognition of the seriousness of the current body weight.
Specify current subtype: Restricting type: During the last 3 months, the
individual has not engaged in recurrent episodes of binge eating or purging behavior (self-induced vomiting or misuse of laxatives, diuretics or enemas). Weight loss is accomplished primarily through dieting, fasting and/or excessive exercise.
Binge-eating/Purging type: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior.
Subtypes of anorexia nervosa Restricting subtype: does not
regularly engage in binge eating or purging
Binge eating/purging subtype: regularly engages in binge eating or purging
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
DSM-VAll of the following symptoms are present:A.Recurrent episodes of binge eating. An episode of binge eating is characterized by both the following:1. Eating, in a discrete period of time (within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time under similar circumstances.2.A sense of lack of control over eating during episode (a feeling that one cannot stop eating or control what or how much is eating)
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting or excessive exercise.C. The binge eating and inappropriate compensatory behaviors both occur on average at least per week for 3 months.D. Self-evaluation is unduly influenced by body shape and weight.E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Subtypes of bulimia nervosa Purging subtype: regularly engages in
self-induced vomiting and/or misuse of laxatives, diuretics or enemas
Nonpurging subtype: the person uses inappropriate compensatory behaviors like fasting or excessive exercise but not regularly engaged in purging
Bulimia Nervosa Common triggers for a binge
dysphoric mood interpersonal stressors Intense hunger after a period of intense
dieting or fasting feelings related to weight, body shape, and
food are common triggers to binge eating
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
More on bulimia nervosa Later age at the onset of the disorder Are able to maintain a normal weight Will not seek treatment until they are
ready Most deal with the burden of hiding
their problem for many years, sometimes well into their 30’s
Binge-eating Disorder resembles bulimia nervosa, except that
the person with binge eating does not regularly engage in purging, fasting or excessive exercise to compensate for binging
DSM-VA. Recurrent episodes of binge eating. An
episode of binge eating is characterized by both of the following:
1. Eating in a discrete period of time (within any 2-hour period) an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
2. A sense of lack of control over eating during episode (feeling that one cannot stop eating or control what or how much one is eating.)
B. The binge eating episodes are associated with three (or more) of the following:1. Eating so much more rapidly than normal.2. Eating until feeling uncomfortably full.3. Eating large amounts of food when not feeling physically hungry.4. Eating alone because of feeling embarrassed by how much one is eating.5. Feeling disgusted with oneself, depressed or over guilty afterward.
C. Marked with distress regarding binge eating is present.D. The binge eating occurs, on average, at least once a week for 3 months.E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
Anorexia
Risk of Death:
The Deadliest of all Psychological Disorders
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 Rigid thinking Perfectionism Poor impulse control Inadequate coping skills
Protective personality Factors
Nonconformity Having a feminist ideology High self-esteem Belief that body weight and shape are
out of one’s control Self-perception of being thin
Media and Cultural Factors
Culture bound syndrome
Belief that being thin is the answer to all problems is prevalent in western culture
Media and Cultural Factors Bulimia can be influenced by social
norms It can be seen as a behavior, which is
learned through modeling
Women who are seen as being attractive by societies standards can be very susceptible to eating disorders as well
Media and Cultural Factors Media images are inescapable
devastating when we see idealized images in the media and feel they do not meet the expectations of our society
Frequent readers of fashion magazines are two to three times more likely than infrequent readers to be dieting
The Celebrity Thin Ideal
The Thin-Ideal The avg. model weighs 23%
less than the avg. American woman
Longitudinal study from 1979-1988 showed that 69% of playboy models and 60% of Miss America contestants met weight criteria for anorexia
Women’s bodies in the media have become increasingly thinner
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
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.
Treatment of Eating Disorder1. Biological Treatment Controlled weight gain Medication2. Family Therapy3. Cognitive-Behavioral Therapy
1 minute essay…Think about models/television/film stars that seem markedly underweight or overweight. DO you think they have symptoms of an eating disorder? Which disorders and why?
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