Chapter 8 - Eating Disorders

I. Common feature: Disturbance in eating behavior

II. Specific disorders

A. Anorexia nervosa (lit. Loss of Appetite)

1. severely underweight (guideline = <85% of normal weight)

2. intense fear of gaining weight

3. distorted sense of shape

4. amenorrhea in women

5. subtypes:

a. restricting

b. binge-eating-purging

B. Bulimia nervosa (lit. = ox hunger)

1. binge eating episodes

a. significantly more food than typical at a time

b. feeling lack of control while eating

2. compensatory behavior for binges

3. overly concerned with body shape/weight

4. is NOT diagnosed if diagnosis of anorexia is met

5. binges and compensatory behavior at least 2x/week for at least 3 months

6. subtypes:

a. purging

b. nonpurging

C. Binge-eating disorder

1. not a formal disorder yet

2. binges (as in bulimia)

a. at least 2x/wk, at least six months

b. characterized by factors such as:

i. lack of control while eating

ii. distress/disgust/guilt about eating

iii. often eating alone

iv. eating very quickly

3. does NOT include weight loss or compensatory behaviors

III. Etiological factors in eating disorders

A. Biological factors

1. genetics

2. endogenous opioids and neurotransmitters

3. hypothalamus?

B. Sociocultural and gender-related factors

1. role of gender

2. role of culture and subculture

3. role of developmental processes

4. role of media

5. changes over time

a. in what is seen as beautiful

b. in how thinness etc is viewed

c. in who has eating disorders

C. Psychosocial factors

1. impact of dieting and of dietary restraint

a. abstinence violation effect

2. role of control

3. perfectionism

4. maintaining prepubertal body?

5. cognitive distortions and learned responses

6. tension-reduction (anxiety-reduction)

D. Family systems model

1. “identified patient” vs. disordered system

2. enmeshment, overprotectiveness, rigidity, lack of conflict resolution

IV. Treatments for eating disorders

A. Medical intervention (e.g., hospitalization)

B. Antidepressant meds (for bulimia)

C. Family therapy (esp for anorexia)

D. CBT

1. cognitive challenging

2. psychoeducation

3. exposure + response prevention (for bulimia)

E. Interpersonal therapy (for bulimia)

F. Prevention of eating disorders?

1. providing psychoeducation to high-risk group