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Chapter_09_Summary_Outline - Chapter 9 Overview/Summary...

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Chapter 9 Overview/Summary DSM-IV-TR recognizes three different forms of eating disorder: anorexia nervosa, bulimia nervosa, and eating disorder NOS. A fourth type of eating disorder, binge-eating disorder, is listed in the Appendix and is not yet part of the formal DSM. Both anorexia nervosa and bulimia nervosa are characterized by an intense fear of becoming fat and a drive for thinness. Patients with anorexia nervosa are seriously underweight. This is not true of patients with bulimia nervosa. Eating disorders are more common in women than they are in men. They can develop at any age, although they typically begin in adolescence. Anorexia nervosa has a lifetime prevalence of around 0.5%. Bulimia nervosa is more common, with a lifetime prevalence of 1-3%. Many more people suffer from less severe forms of disturbed eating patterns. Genetic factors play a role in eating disorders, although exactly how important genes are in the development of pathological eating patterns is still unclear. The neurotransmitter serotonin has been implicated in eating disorders. This neurotransmitter is also involved in mood disorders, which are highly comorbid with eating disorders. Sociocultural influences are important in the development of eating disorders. Our society places a heavy value on being thin. Western values about thinness may be spreading, helping explain why eating disorders are now found throughout the world. Finally, individual risk factors, such as internalizing the thin ideal, body dissatisfaction, dieting, negative affect, and perfectionism are implicated in the development of eating disorders. Anorexia nervosa is very difficult to treat. Treatment is long-term and many patients resist getting well. Current treatment approaches include re-feeding, family therapy, and cognitive-behavior therapy (CBT). Medications also are used. The treatment of choice for bulimia nervosa is CBT. CBT is also helpful for binge- eating disorder. Obesity is defined as having a body-mass index of thirty or above. Being obese is associated with many medical problems and increased risk of death from heart attack. Obesity is not viewed as an eating disorder or a psychiatric condition. A tendency to being thin or heavy may be inherited. However, unhealthy lifestyles are the most important cause of obesity. People are more likely to be obese if they are older, female, and from a low SES group. Being a member of an ethnic minority group is also a risk factor for obesity. Obesity is a chronic problem. Medications help patients to lose small amounts of weight; drastic weight loss usually requires bariatric surgery. Because obesity
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tends to be a life-long problem and because the treatment of obesity is so difficult, there now is a focus on trying to prevent people from becoming obese in the first place. Many recommendations will require major changes in social policy. Detailed Outline
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Chapter_09_Summary_Outline - Chapter 9 Overview/Summary...

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