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Abnormal FINAL Ch 11

Abnormal FINAL Ch 11 - 1 Chapter 11 Eating Disorders Two...

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Chapter 11 – Eating Disorders Two main diagnoses: Anorexia nervosa Bulimia nervosa Anorexia Nervosa The main symptoms of anorexia nervosa are: A refusal to maintain more than 85% of normal body weight Intense fears of becoming overweight A distorted view of body weight and shape Amenorrhea There are two main subtypes: Restricting type Lose weight by restricting “bad” foods, eventually restricting nearly all food Show almost no variability in diet Binge-eating/purging type Lose weight by vomiting after meals, abusing laxatives or diuretics, or engaging in excessive exercise Like those with bulimia nervosa, people with this subtype may engage in eating binges About 90%–95% of cases occur in females The peak age of onset is between 14 and 18 years Between 0.5% and 2% of females in Western countries develop the disorder The “typical” case: A normal to slightly overweight female has been on a diet Escalation to anorexia nervosa may follow a stressful event Separation of parents Move or life transition Experience of personal failure Most patients recover However, about 2% to 6% become seriously ill and die as a result of medical complications or suicide Anorexia Nervosa: The Clinical Picture The key goal for people with anorexia nervosa is becoming thin The driving motivation is fear: Of becoming obese Of giving in to the desire to eat Of losing control of body shape and weight Despite their dietary restrictions, people with anorexia are extremely preoccupied with food This includes thinking and reading about food and planning for meals This relationship is not necessarily causal It may be the result of food deprivation, as evidenced by the famous 1940s “starvation study” with conscientious objectors 1
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People with anorexia nervosa also think in distorted ways: Often have a low opinion of their body shape Tend to overestimate their actual proportions Adjustable lens assessment technique Hold maladaptive attitudes and misperceptions “I must be perfect in every way” “I will be a better person if I deprive myself” “I can avoid guilt by not eating” People with anorexia may also display certain psychological problems: Depression (usually mild) Anxiety Low self-esteem Insomnia or other sleep disturbances Substance abuse Obsessive-compulsive patterns Perfectionism Anorexia Nervosa: Medical Problems Caused by starvation: Amenorrhea Low body temperature Low blood pressure Body swelling Reduced bone density Slow heart rate Metabolic and electrolyte imbalances Dry skin, brittle nails Poor circulation Lanugo The Vicious Cycle of Anorexia: 2
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Bulimia Nervosa Bulimia nervosa, also known as “binge-purge syndrome,” is characterized by binges: Bouts of uncontrolled overeating during a limited period of time
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