Abnormal Psychology: Feeding and Eating Disorder

• Feeding and Eating Disorders

  Disturbances in eating or eating-related disorders that result in distress or impairment
• Binge

  Consuming a large amount of something
• Purging

  Elimination of unwanted calories in the body by vomiting, use of laxatives, diuretics, or enema
• BMI

  Body mass index, calculated as weight (kg) divided by height (m) squared
• 6 disorders in the category of feeding and eating disorders

  • Pica
  • Rumination
  • Restrictive/Avoidant food intake
  • Anorexia nervosa
  • Bulimia Nervosa
  • Binge-eating disorder
• Pica

  Compulsively needs to eat non-food items, e.g. pregnant women eating dirt
• Rumination

  Associated with anxiety, when an individual eats and swallows, but brings that food back to the mouth after swallowing
• Anorexia Nervosa

  • Voluntarily restricted calorie intake resulting in the body losing weight and inability to maintain sufficient body weight
  • Associated with fear of becoming fat, or gaining weight, denial of the seriousness of low body weight
• Onset of Anorexia Nervosa is during adolescence
• Criteria of Anorexia Nervosa

  • A: Restriction of energy calories that the body needs and unable to maintain sufficient body weight
  • B: Scared of becoming fat, or gaining weight, despite low body weight
  • C: Undue influenced by body weight/shape on self-evaluation, lack of recognition of the seriousness of low body weight
• Specifiers of Anorexia Nervosa

  • Restrictive type: no purging behavior
  • Binge/Purging type: a recurrent episode of binge-eating or purging behavior
• Remission status of Anorexia Nervosa

  • In partial remission: After full criteria are met, low body weight remits Criterion A, but Criteria B-C remain
  • Full remission: After full criteria are met, all criteria are remitted for a sustained period
• Anorexia Nervosa Severity

  • Mild: BMI 17
  • Moderate: BMI 16-16.99
  • Severe: BMI 15-15.99
  • Extreme: BMI < 15
• Health complications of Anorexia Nervosa

  • Amenorrhea, dry skin, brittle hair, organ failure, weak or impaired immune system, heart attack, starvation, bone loss, hypothermia
• Prognosis of Anorexia Nervosa: 50% will recover in 3 years, 5-10% die from substance abuse, suicide, starvation; mortality rate is 6 times higher than the general population
• Anorexia Nervosa, In partial remission, moderate, binge/purging type

  A 24-year-old woman is 5'2 and weighs 87 lbs (A BMI of 16.0) had been dieting and using laxatives to lose weight. She enters therapy and after a year, her weight is nearly 100 lbs, which her PCP believes is healthy. Despite the change, she is still worried about getting fat and places much of her self-esteem on her image.
• Bulimia Nervosa

  • Binge eating behavior accompanied by an attempt to prevent weight gain due to binge
  • Onset is during adolescence and young adulthood
• Bulimia Nervosa Criteria

  • A: Episode of binge-eating, described as both 1) Eating abnormally large amounts of food in one sitting and 2) Sense of loss of control during episode
  • B: Presence of compensatory behaviors to prevent weight gain such as using laxatives, diuretics, enemas, and exercise
  • C: A and B are present at least once a week for 3 months
  • D: Self-evaluation influenced by body weight/shape
  • E: Not Anorexia Nervosa
• Bulimia Nervosa Remission Status

  • In partial remission: After full criteria are met, some, but not all criteria remit for a sustained period
  • Full remission: After full criteria are met, all criteria are remitted for a sustained period
• Bulimia Nervosa Severity

  • Mild: 1-3 episodes per week
  • Moderate: 4-7 episodes per week
  • Severe: 8-13 episodes per week
  • Extreme: 14 or more episodes per week
• Prevalence of Bulimia Nervosa is 0.5-1% in females, with a female to male ratio of 10:1
• 10-15% of individuals with Bulimia Nervosa crossover into Anorexia Nervosa
• Related Health Problems of Bulimia Nervosa

  • Stomach ruptures, esophageal decay, enamel erosion, and low potassium potentially leading to heart failure
• Treatment for Bulimia Nervosa involves addressing the shame associated with the disorder
• Lanugo

  Hair growth on cheeks, back, or shoulders during starvation which is a protection of the body to keep warm
• Binge-eating Disorder

  • Binge-eating behavior without accompanying attempt to prevent weight gain or compensatory behaviors
• Binge-eating Disorder Criteria

  • A: Episode of binge-eating, described as both 1) Eating abnormally large amounts of food in one sitting and 2) Sense of loss of control during episode
  • B: Episode contains at least 3 of the following: 1) Eating an overwhelming amount of food, 2) Eating until uncomfortably full, 3) Eating large amounts of food when not hungry, 4) Eating alone because it is embarrassing, 5) Disgusted with self, depressed, guilty following a binge
  • C: Feeling distressed around episodes
  • D: Episode occurs at least once a week for 3 months
  • E: Not Anorexia Nervosa or Bulimia Nervosa
• Prevalence of Binge-eating Disorder is 1-3%, higher than Anorexia and Bulimia Nervosa combined
• Onset of Binge-eating Disorder is typically in late teenage years
• Related Health Risks of Binge-eating Disorder

  • Relationship with obesity, most obese do not have BED, 2/3 of individuals with BED are obese
• Differences between Anorexia Nervosa, Bulimia Nervosa, and Binge-eating Disorder

  • Anorexia Nervosa: dangerous loss of body weight
  • Bulimia Nervosa: Binge-eating with compensatory behaviors
  • Binge-eating Disorder: binge-eating only