Eating Disorder

Anorexia
Nervosa
Bulimia
Nervosa
Binge-
Eating
Disorder
Characterized by severe disturbances in eating
behavior and in ones perception about body
shape and weight.

The most culturally specific psychological
disorder yet identified.
What is Eating Disorder?
Not or seldom found in developing countries
People with eating disorders tend to have a
dichotomous thinking style
Anorexia Nervosa
Anorexia nervosa
Literally means, nervous loss of appetite
Often occur in girls who have been unusually
good girls
People with AN starve themselves subsisting
on little or no food for very long periods of
time, yet they remain sure that they need to
lose more weight.
Diagnostic criteria: Anorexia Nervosa
A. Refusal to maintain body weight at or above
a minimally normal weight for age and height
(e.g., weight loss leading to maintenance of
body weight less than 85% of that expected;
or failure to make expected weight gain
during period of growth, leading to body
weight less than 85% of that expected).
Body Mass Index - BMI
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmic
alc.htm
Diagnostic criteria: Anorexia Nervosa
B. Intense fear of gaining weight or becoming
fat even though underweight.

Diagnostic criteria: Anorexia Nervosa
C. Disturbance in the way in which one's body
weight or shape is experienced, undue
influence of body weight or shape on self-
evaluation, or denial of the seriousness of the
current low body weight.
Diagnostic criteria: Anorexia Nervosa
D. In postmenarcheal females, amenorrhea, i.e.,
the absence of at least three consecutive
menstrual cycles.
Types of Anorexia Nervosa
1. Restricting Type: during the current
episode of Anorexia Nervosa, the person has
not regularly engaged in binge-eating or
purging behavior.
Types of Anorexia Nervosa
2. Binge-Eating/Purging Type: during the
current episode of Anorexia Nervosa, the
person has regularly engaged in binge-
eating or purging behavior (i.e., self-
induced vomiting or the misuse of laxatives,
diuretics, or enemas)
Bulimia Nervosa
http://www.youtube.com/watch?v=Um2vbpZa0_I
Bulimia Nervosa
The hallmark of bulimia nervosa is eating a larger
amount of food than most people would eat
under similar circumstances.

The individual attempts to compensate for binge
eating and potential weight gain, almost always by
purging techniques.
Diagnostic criteria for Bulimia Nervosa
A. Recurrent episodes of binge eating. An
episode of binge eating is characterized by
both of the following:
(1) eating, in a discrete period of time (e.g.
within any 2-hour period), an amount of food
that is definitely larger than more people
would eat during a similar period of time and
under similar circumstances
Diagnostic criteria for Bulimia Nervosa
A. Recurrent episodes of binge eating. An
episode of binge eating is characterized by
both of the following:
(2) 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)
Diagnostic criteria for Bulimia Nervosa
B. Recurrent inappropriate compensatory
behavior in order to prevent weight gain.
such as self-induced vomiting; misuse of
laxatives, diuretics, enemas, or other medi-
cations; fasting; or excessive exercise.
Diagnostic criteria for Bulimia Nervosa
C. The binge eating and inappropriate
compensatory behaviors both occur, on
average, at least twice a week for 3 months.
Diagnostic criteria for Bulimia Nervosa
D. Self-evaluation is unduly influenced by body
shape and weight.
Diagnostic criteria for Bulimia Nervosa
E. The disturbance does not occur exclusively
during episodes of Anorexia Nervosa.

Types of Bulimia Nervosa
1. Purging Type: during the current episode of
Bulimia Nervosa, the person has regularly
engaged in self-induced vomiting or the
misuse of laxatives, diuretics, or enemas

Types of Bulimia Nervosa
2. Nonpurging Type: during the current
episode of Bulimia Nervosa, the person has
used other inappropriate compensatory
behaviors, such as fasting or excessive
exercise, but has not regularly engaged in
self-induced vomiting or the misuse of
laxatives, diuretics, or enemas
BINGE-EATING DISORDER
It resembles bulimia nervosa except that a
person does not regularly engage in purging,
fasting, or excessive exercise to
compensate for binges
EATING DISORDER NOT OTHERWISE
SPECIFIED
The Eating Disorder Not Otherwise Specified category is
for disorders of eating that do not meet the criteria for
any specific Eating Disorder. Examples include

A. For females, all of the criteria for Anorexia Nervosa are
met except that the individual has regular menses.
B. All of the criteria for Anorexia Nervosa are met except
that, despite significant weight loss, the individual's
current weight is in the normal range.
EATING DISORDER NOT OTHERWISE
SPECIFIED
C. All of the criteria for Bulimia Nervosa are met except
that the binge eating and inappropriate compensatory
mechanisms occur at a frequency of less than twice a
week or for duration of less than 3 months.
D. The regular use of inappropriate compensatory
behavior by an individual of normal body weight after
eating small amounts of food (e.g., self-induced
vomiting after the consumption of two cookies).

EATING DISORDER NOT OTHERWISE
SPECIFIED
E. Repeatedly chewing and spitting out, but not
swallowing, large amounts of food.

Get crosswise
Review: Anorexia Nervosa Restricting Type
a. Body weight:
b. Body Image:
c. Binges:
d. Purges or other
compensatory behavior
e. Lack of Control over eating
f. Amenorrhea
Must be underweight by more than 15%
Severely Disturbed
NO
NO
NO
YES
Review: Anorexia Nervosa Binge/Purge Type
a. Body weight:
b. Body Image:
c. Binges:
d. Purges or other
compensatory behavior
e. Lack of Control over eating
f. Amenorrhea
Must be underweight by more than 15%
Severely Disturbed
YES
YES
During binges
YES
Review: Bulimia Nervosa Purging Type
a. Body weight:
b. Body Image:
c. Binges:
d. Purges or other
compensatory behavior
e. Lack of Control over eating
f. Amenorrhea
Often normal or somewhat overweight
Overconcerned with weight
YES
YES
YES
Not usually
Review: Bulimia Nervosa Nonpurging Type
a. Body weight:
b. Body Image:
c. Binges:
d. Purges or other
compensatory behavior
e. Lack of Control over eating
f. Amenorrhea
Often normal or somewhat overweight
Overconcerned with weight
YES
No
YES
Not usually
Review: Binge-Eating Disorder
a. Body weight:
b. Body Image:
c. Binges:
d. Purges or other
compensatory behavior
e. Lack of Control over eating
f. Amenorrhea
Often significantly overweight
Often disgusted with overweight
YES
No
YES
NO
Causes of Eating Disorder
It tends to run in families. Disordered eating behavior
might be caused by imbalances in or deregulation of any
of the neurochemicals involved in this systems or by
structural or functional problems in the hypothalamus

Inherited vulnerabilities
Abnormalities in the
neurotransmitter, serotonin.
Causes of Eating Disorder
Overvaluation of physical appearance
Certain groups within culture, such as athletes, may
have standards for appearance that put them at greater
risk for developing eating disorders.
People who feel they need a perfect body, dissatisfied
with their body, and have low self esteem are more
likely to develop eating disorder symptoms.
TREATMENT OF EATING DISORDERS
1. Maudley model
2. CBT