Eating Obesity and Eating Disorders Chapter 15 The
Eating Obesity and Eating Disorders Chapter 15
The Issues • We have to eat • Some eat too much given their energy expenditure • Some don’t eat enough • Some use food for coping
Eating • The primary function of eating is to obtain and to store energy – Food contains carbohydrates, fat, protein, minerals – Digestion breaks down ingested nutrients and stores as energy • • Glycogen (short-term) Triglyceride (long-term)
Prevalence of Obesity
Measuring Obesity • >=20% of “ideal” body weight for males • >=30% of “ideal” body weight for females • Body Mass Index – Weight/(Height)2 – BMI >30 = obesity
Diagnosis: Causes of Obesity • Hypothyroidism • Cushing's Syndrome • Medications (antipsychotics, antidepressants) • Other Rare causes: Prada-Willi syndrome (1/20, 000) • Non-pathological - 99%
Obesity Trends Among U. S. Adults (BMI > 30. 0) BRFSS, 1991, 1995, and 2000 1991 1995 2000 No Data <10% 10%-14% 15 -19% 20%
Health Risks of Excessive Fat • Impaired cardiac function • Hypertension, stroke, and deep vein thrombosis • Increased insulin resistance in children and adults and type 2 diabetes (80% of these patients are overweight) • Renal disease • Sleep apnea • Osteoarthritis, degenerative joint disease, gout • Endometrial, prostrate. breast, colon cancers • Abnormal plasma lipid and lipoprotein levels • Menstrual irregularities • Gallbladder disease
Not to Mention • Enormous psychological burden and social stigmatization and discrimination
Pathways to Obesity • • Fat intake (“cafeteria” diet) Inactivity (10% get regular exercise) Metabolic issues Overeating “Thrifty genome” Alcohol intake Combinations of above
The Development of Obesity • The Setpoint Model - Physiolgical • The Positive Incentive Model – Behavioral – Personal pleasure – Social context – Biological factors – Food availability and type
Dieting • • Food Restriction Behavior Modification Exercise Drastic Measures – Surgery, drugs
Eating Disorders • Approximately 7 million females and 1 million males in the U. S. have some type of eating disorder. • Eating disorders affect adults and children of both sexes. • They affect a person's physical and mental health, relationships, and quality of life.
Causes • Socialization • Psychological – Perfectionism – Negative Affectivity – Emotion Dysregulation • Genetic – Runs in families – Bulimia related to alcoholism?
Anorexia Nervosa: Symptoms q. Obsessive preoccupation with food and body size. q. Self-imposed starvation despite significant weight loss. q. Intense fear of becoming fat. q. Excessive exercise. q. Distorted body image. q. Menstrual irregularities in females.
Anorexia Nervosa: Facts • Between 5 -20% of individuals struggling with anorexia nervosa will die. The probabilities of death increases within that range depending on the length of the condition (Zerbe, 1995). • Anorexia nervosa has one of the highest death rates of any mental health condition. • Anorexia nervosa typically appears in early to mid-adolescence.
Anorexia Nervosa: Medical Complications • Abnormally slow heart rate and low blood pressure. • Reduction of bone density (osteoporosis) • Muscle loss and weakness. • Severe dehydration • Fainting, fatigue, and overall weakness. • Dry hair and skin, hair loss • Growth of a downy layer of hair called lanugo all over the body
Bulimia Nervosa: Symptoms • Eating large quantities of food in short periods of time, often secretly, without regard to feelings of “hunger” or “fullness, ” and to the point of feeling “out of control” while eating. • Following these “binges” with some form of purging or compensatory behavior: self-induced vomiting, laxative or diuretic abuse, fasting, and/or excessive exercise. • Extreme concern with body weight and shape.
Bulimia Nervosa: Facts • Bulimia nervosa affects 1 -3% of middle and high school girls and 1 -4% of college age women. • Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997). • People struggling with bulimia nervosa often appear to be of average body weight.
Bulimia Nervosa: Facts • People struggling with bulimia nervosa often develop complex schedules or rituals to provide opportunities for binge-and-purge sessions. • Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.
Bulimia Nervosa: Medical Complications • Electrolyte imbalances • Potential for gastric rupture during periods of bingeing. • Inflammation and possible rupture of the esophagus from frequent vomiting. • Tooth decay and staining from stomach acids • Chronic irregular bowel movements and constipation as a result of laxative abuse. • Peptic ulcers and pancreatitis
²Psychosocial Treatments Bulimia Nervosa – Education About Eating Behavior – Scheduled Eating – Alter Thinking About Shape, Eating, and Weight Treatment Works!
²Psychosocial Treatments Anorexia Nervosa – Must Restore Normal Weight! – Most Will Gain Weight (Easy) – Keeping the Weight On (Hard) – Treatment Similar to Bulimia Treatment Can Work!
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