Eating disorders

cultural context
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Terms in this set (33)
- eating disorders are more common in industrialized nations
- eating disorder rates have increased in the 20th century

we are obsessed with
- appearance
-dieting and excercise
- image

- for some reason everyone is dissatisfied
-38% of normal weight women think they are overweight; 2/3rds of college women
- $30 billion/ year spent on weight loss products
bulimia nervosa- binge eating and compensatory behaviors -1x per week for minimum of 3 months - cannot occur exclusively during AN - undue influence of weight/ shape on self image - not underweightcompensatory behaviors-fasting/ dieting restriction -vomiting - misuse of laxatives - excessive exercisewhat is a binge- eating within a two hour period an amount of food that is larger than most people would eat in similar conditions - a sense of loss of control over eating during the episodeBN prevalence and course- 1-3% lifetime prevalence - 2x more common in women - white individuals more common - onset between 15 and 29 years old - chronic: 50% remission rate -7.5x suicide rate - comorbidity with depression and nonsuicidal self injuryBN medical complications- electrolyte imbalance - erosion of dental enamal - hypersensitive gag reflex - enlarged salivary glands - results in puffy appearance of face - ruptured espophogas or stomachbinge eating disorder- recurrent episode of binge eating in the absence of inappropriate compensatory behaviorsBED features- eating more rapidly than normal - eating until uncomfortably full or not hungry - eating alone because of embarrassment - feeling disgusted, depressed, or guilty about overeatingBED prevalence and course-2-3 lifetime prevalence - 30% of people with BED are in weight loss programs - more common in women (but more comparable) - no racial / ethnic differences - chronic: duration 8-15 years on averageother specified eating disorder-Clinically significant eating disorder that does not meet criteria for AN, BN, BED -The majority of individuals who seek treatment for EDs are diagnosed with this!sociocultural and environmental factors- thin ideal internalization - childhood abuse - modeling from parents/ siblings/ peers - athletic environment - being overweight as a child - these types of factors can lead to body dissatisfaction, which is another big risk factorbiological theories- genetics: - heritability rates of 40- 60% - personality variables - brain areas: - hypothalamus: regulates body temperature, hunger and thirst, and secretion of hormones - neurotransmitters dysregulation in: - dopamine: reward/ reinforcement - serotonin: appetitepsychological theories- emotion regulation: food restriction, purging -personality factors: high achievers - cognitive models: rigid thinkers, cognitive distortions about the importance of weight and shape - family dynamics: - when individual is allowed little autonomy or personal boundaries - results in deficits in the sense of self/ identity - families often have high conflict, negative emotion is discouragedappearance related safety behaviors- appearance SB: mirror checking, reassurance seeking, camouflaging - SBs are strongly related to beliefs about the importance of appearanceSummers and Cougle study- FSU women with low appearance concerns asked to increase appearance related SBs for a week - compared to the control groups, those in SB increase group reported greater body dissatisfaction, depression, appearance importance, and fear in repsonse to having their picture taken at postWilver and Cougle- FSU women with elevated appearance concerns asked to reduce SBs for two weeks - reported marked reduction in body dissatisfaction, appearance importance, depression, ED symptomstreatment for ED- impatient or partial hospitalization - weight restoration in AN - BN when binge/ purge very severe (after each meal)psychotropic medications- SSRI show efficacyCBT- exposure to feared foods - emotion regulation strategies - coping strategies - cognitive factorsfamily therapy- most effective for adolescents with AN - patient given more autonomy and challenged on perfectionistic idealsadressing the over evaluation of shape or weightthe core psychopathology of eating disorders is the over evaluation of shape and weight - self worth is judged largely or exclusively in terms of shape and weight and the ability to control them - other modes of self evaluation are marginalized - most other features appear to be secondary to the core psychopathology - dieting - repeated body checking and/ or body avoidance - pronounced feeling fatadress the over evaluaton using two strategies1. develop new domains for self evaluation 2. reduce the importance of shape and weightdevelop new domains for self evaluation- encourage patients to identify and engage in (neglected) interests and activities, especially those of a social naturereduce the importance of shape and weight- monitor and eliminate body checking comparisons with others - appearance related safety behaviors also relevant here