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NTR 109 EATING DISORDER OUTLINE Lecture 8 - Lecture 8...

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Unformatted text preview: Lecture 8 Lecture : severe alterations in eating patterns linked to physiological changes associated with severe food restriction, binge eating, purging and weight fluctuations 0. Pica 0. Eating Disorders Eating 1. Anorexia Nervosa 2. Bulimia Nervosa . Female Athlete Triad 3. Binge Eating Disorder Pica 0. The regular consumption of 0. 1. Ice NON FOOD items 2. Clay (Geophagia :clay, dirt eating) 3. Stones (lithophagia) Stones 4. Cigarette butts 4. 5. Tire inner tubes Pica – Groups at Risk Children, Pregnant women (usually in first pregnancy), rural areas, Family history Pica - Theories Pica * Relieves nauseas Relieves * Deficiency of essential nutrient - Ice – Iron deficiency * Clay helps baby slide out????????? Types of Pica Geophagia – eating clay or dirt Pagophagia – eating ice Amylophagia – eating cornstarch or laundry starch Pica – Complications Pica * Intestinal blockages * Bacterial infections * Parasite * Damage to teeth Pica – Plumbism * Eating lead (paint chips) * Homes prior to 1978 used lead in paint * Can cause mental retardation and death * Reduced intelligence * Iron, Calcium and Zinc deficiency The Ideal Body Image The Ideal Body Image 0. Media promotion 1. Need for social acceptance 2. Influence and stress on young individuals 3. Eating is a necessity 4. Dieting may lead to a disorder Food: More Than Just Nutrients 5. Linked to Personal emotions 6. Source of comfort 7. Release of neurotransmitters and natural op ioids 8. Food used as a reward or bribe 9. Can lead to disordered eating Overview of Eating Disorders Overview of Eating Disorders 6. Affects more than 7million people 7. Females outnumber males (5 to 1) 8. 85% of cases develop during adolescence 9. Co­occurs with other psychological disorders (depression) 10. Recognition of disorder is critical to treatment 11. Diagnostic and Statistical Manual of Mental Disorders Genetic Link? * Identical twins are more likely to share eating disorders * Fraternal twins are less likely to share eating disorders Anorexia Nervosa – Diagnosis * Refusal to maintain body wt -< 85% of ideal wt * Intense fear of gaining * Distorted body image * Amenorrhea – stopping of menstrual cycle Anorexia – Signs Anorexia * Loose clothing * Excessive weight loss * Amenorrhea – 3 consecutive cycles *Dry, cold skin *Vomiting *Lanugo : fine hair on face/arms *Extreme exercise *Excessive water intake *Social isolation bc of family dysfunction Profile of an Anorexic Profile of an Anorexic * Usually Caucasian female * Middle-upper socioeconomic class *Responsible, meticulous, obedient * Competitive and obsessive * May have conflicts with family * High family expectations * Expression of self control (self worth = self control of food) Anorexia – Society 4. Middle and upper class disease ??? 5. Images and messages in media 6. US average female 5’4” 145# 7. Model 5’10” 110# Anorexia – Complications * Death 10-15% * Weakened immune system * Heart Failure – electrolyte imbalance * Suicide *Dehydration *Amenorrhea -> DECREASE estrogen * Bone Loss - Osteoporosis Anorexia – Treatment Anorexia 10.Cognitive behavior therapy – doctor, psychiatrist, dietician 11.Determine underlying emotional problems 12. Reject sense of accomplishment associated with weight loss 13. Family therapy, support group Anorexia – Treatment * Slow wt gain 1-2 lbs/week Slow * Adequate calcium * Multivitamin * Decrease exercise * Feeding tubes in some cases Anorexia – High Risk Groups 8. Youth with chronic illness Youth kids w/asthma – type 1 diabetic 9. Sexual abuse 9. 10. Dietetic majors 11. Child with anorexic parent Muscle dysmorphia -> seen mostly in men 12.Athletes – Males (runner, wrestler, gymnast, figure skaters ) Bulimia – Diagnosis Bulimia * Binge Eating: a typical abnormal large amount of food consumed in a short amount of time *Lack of control over binge *Purging – vomiting, laxatives, etc * Behaviors occur 2 x/wk for at least 3months * Distorted body image They are always unhappy with their body images * Eating in secret * vomiting * laxative and diuretic abuse *fasting Ipecac syrup Bulimia – Signs Bulimia * Excessive exercise * Overconcern with body shape and size * Swollen: salivary glands * Normal or slightly overweight Profile of a Bulimic 13. Young adults (commonly female college students) 14. Predisposed to becoming overweight 12. At or slightly above normal weight 15. Frequent weight­reduction diets as a teen 16. Impulsive behavior 17. Usually from disengaged families Bulimia – Society 18.Same as anorexia (middle to upper class) Bulimia – Complications 19.Electrolyte imbalance (sodium, potassium…..) 20. Dehydration 21. Esophageal tears Esophageal 22. Broken blood vessels in eyes 22. 23. 24.Dental problems (acid cause demineralization) 25. Laxative dependency 26. Heart failure 27. Suicide Suicide Bulimia – Treatment Bulimia 28.Multi team – effect ~16weeks 29.Anti-depressants -> prozac 30.Therapy – psycho therapy to improve a person’s self acceptance Therapy Bulimia – Treatment Bulimia * Structured: Eating plan normal eating patterns and habits * Avoid: binge foods * Record keeping * Recognize hunger and fullness : Characterized by binge eating without purging at least 2 times a week for 6 months (aka compulsive over eating ) Profile of a Binge­Eater Binge Eating Disorders (BED) 13.Considers self as hunger than normal 13. 14.Isolates self to eat larger quantities 15. Suffers from stress, depression, anxiety, loneliness, anger, frustration that can trigger binge 16.Uses food to reduce stress, provide feeling of power and well being 17.Usually binges on junk foods 18. Eats without regard to biological need Treatment of Binge­Eating * Eat in response to: hunger, not emotions * Learn to: eat in moderation * Avoid restrictive diets that can intensify problems * Avoid restrictive diets that can intensify problems * Address: hidden emotions * “overeaters anonymous“ * Antidepressants Anorexia ­ Complications Profile of Female Athlete Triad 31. Female athletes in appearance­based and endurance sports 19. 15% swimmers; 62% gymnasts; 32% other 32.1. Disordered eating 33.2. Irregular menses or amenorrhea 34. 3. Osteoporosis and loss of estrogen 34. 20. Bone density similar to 50­60year olds 21. Bone loss is largely irreversible Treatment of Female Athlete Triad 14. Reduce preoccupation with food, weight, and body fat 15. Gradually increase meals and snacks 16. Rebuild body to healthy weight 17. Establish regular menses 18. Decrease training by 10%­20% Dying To Be Thin * It is normal to be concerned about diet, health & body wt * Wt typically fluctuates * Treat: physical, emotional problems early * Discourage: restrictive diets * Correct: misconception about foods, diet * Thin is not necessarily better ...
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