EATING DISORDER AND OBESITY
(e.g., a feeling that one cannot stop eating or control
According to the DSM-5 (APA, 2013), eating disorders
are characterized by a persistent disturbance in eating
behavior.
CLINICAL ASPECTS OF EATING DISORDER
1. ANOREXIA NERVOSA
- intense fear of gaining weight or becoming fat, or
persistent behavior that interferes with weight gain, even
though at a significantly low weight.
- self starvation
- insist they are overweight.
- Weight loss is an achievement, gaining is failure of self
control.
Two types:
• Restricting type- Accomplishes weight loss through
dieting or exercising. Constant Fasting.
• Binge- Eating/Purging type- Loses weight through
sef-induced vomiting, diuretics, laxatives, often after
binge.
Treatment:
• Medication- Antidepressants , Antipsychotic
medication (which help with disturbed thinking) and
Olanzapine (side effect is weight gain)
• Family therapy- Has 3 phases: Refeeding phase,
New pattern of relationship phase and Termination
phase.
• Cognitive behavioral therapy- Involves changing
behavior and maladaptive styles of thinking.
2. BULIMIA NERVOSA
-is characterized by uncontrollable binge eating and
efforts to prevent resulting weight gain by using
inappropriate behaviors such as self-induced vomiting
and excessive exercise.
-Eating, in a discrete period of time (e.g., within any 2-
hour period), an amount of food that is definitely larger
than what most individuals would eat in a similar period
of time under similar circumstances.
-A sense of lack of control over eating during the episode
what or how much one is eating).
-Recurrent inappropriate compensatory behaviors in
order to prevent weight gain, such as self-induced
vomiting; misuse of laxatives, diuretics, or other
medications; fasting; or excessive exercise.
-The binge eating and inappropriate compensatory
behaviors both occur, on average, at least once a week
for 3 months.
-Self-evaluation is unduly influenced by body shape and
weight.
-The disturbance does not occur exclusively during
episodes of anorexia nervosa.
Types of Bulimia:
• Purging- Regularly vomits or uses laxatives,
diuretice or enemas.
• Non purging- Excessive exercise or fasting are
used in an attempt to compensate for binges.
Treatments:
• Medication
• Cognitive behavioral therapy- focuses on
normalizing eating patterns.
3. BINGE EATING DISORDER
-Eating, in a discrete period of time (e.g., within any 2-
hour period), an amount of food that is definitely larger
than what most people would eat in a similar period of
time under similar circumstances.
-A sense of lack of control over eating during the episode
(e.g., a feeling that one cannot stop eating or control
what or how much one is eating).
-The binge-eating episodes are associated with three (or
more) of the following: Eating much more rapidly than
normal. Eating until feeling uncomfortably full. Eating
large amounts of food when not feeling physically
hungry. Eating alone because of feeling embarrassed by
how much one is eating. Feeling disgusted with oneself,
depressed, or very guilty afterward.
-Marked distress regarding binge eating is present.
-The binge eating occurs, on average, at least once a
week for 3 months.
-The binge eating is not associated with the recurrent use
of inappropriate compensatory behavior as in bulimia
nervosa and does not occur exclusively during the course
of bulimia nervosa or anorexia nervosa.
RISK AND CAUSAL FACTORS IN EATING DISORDERS:
BIOLOGICAL FACTORS
• Genetics
• Brain Abnormalities- damage to frontal &
temporal cortex did seem to be linked to the
development of eating disorder. Temporal
cortex is known to be involved in body image
perception. Parts of frontal cortex also plays a
role in monitoring the pleasantness of stimuli such
as smell and taste.
• Set point- anyone intent on achieving and
maintaining a significant decrease in body mass
below his or her individual set point may be
trying to do this in the face of internal
physiologic opposition which is aimed at trying to
get the body back close to its original set- point
weight.
• Serotonin- is a neurotransmitter that has been
implicated in obssessionality, mood disorders,
and impulsivity. It also modulates appetite &
feeding behavior.
SOCIO- CULTURAL FACTORS
• Social pressures toward thinness may be
particularly powerful (majority goals).
Magazines, models, media in creating pressures.
FAMILY- INFLUENCES
• Many of the parents of patients with eating
disorder have long standing, pre occupations
regarding the desirability of thinness, dieting
and good physical appearance.
INDIVIDUAL RISK FACTORS
• Gender- More on women
• Internalizing the thin ideal- thin is highly
desirable. Maybe an early component of the
causal chain that culminates in disordered eating.
• Perfectionism- “perfect body”
• Negative body image- Sociocultural influences
are implicated in the discrepancy between the
way many young girls and women perceive their
own bodies and the “ideal” female form as
represented in the media.
• Dieting- Fail to meet standard of body.
• Negative Emotionality- when we feel bad, we
tend to become very self-critical.
• Childhood Sexual Abuse- having a negative
body image or high levels of negative affect.
OBESITY

• Having BMI above 40 or more than 100 pounds,

overweight is called Morbid obesity. This is the point
at which excess weight begins to interfere with basic
activities such as walking and creates many health
problems. (is not currently viewed as an eating
disorder or as a psychiatric condition in the DSM.)

RISK AND CAUSAL FACTORS IN OBESITY

• ROLES OF GENS
• HORMONES IN APPETITE AND WEIGHT
REGULATION- Leptin is produced by fat cells and it
acts to reduced our intake of food. Grehlin us a
hormone that is produced by the stomach, it is a
powerful appetite stimulator.
• SOCIOCULTURAL INFLUENCE- High and ready
access to high fat, high sugar, encourages over
consumption and makes it easy to avoid exercise.
(time pressure, walk vs drive and stairs vs elevator.
• FAMILY INFLUENCES- family attitudes toward food.
Family members could lead us to change our attitude
about weight or perhaps influences our eating
patterns.
• STRESS AND COMFORT FOOD- reducing feelings of
distress or depression by comfort food or cravings.
Conditioned to eat in response by environment
stimuli. Anxiety, anger, boredom, depression can
lead to overeating.

Treatments:
• LIFESTYLE MODIFICATIONS- Low calorie diet,
Exercise and Behavioral Intervention/Therapy
• MEDICATIONS- (Sibutramine, Orlistat and etc)
• BARIATRIC SURGERY- Reduced the storage
capacity of the stomach. Levels of the appetite
hormone grehlin are also suppressed.