Download Eating Obesity and Eating Disorders

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
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•
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
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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
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•
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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
Obsessive preoccupation with food and
body size.
Self-imposed starvation despite significant
weight loss.
Intense fear of becoming fat.
Excessive exercise.
Distorted body image.
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
 Psychosocial Treatments
 Bulimia Nervosa
– Education About Eating
Behavior
– Scheduled Eating
– Alter Thinking About Shape,
Eating, and Weight
 Treatment Works!
 Psychosocial Treatments
 Anorexia Nervosa
– Must Restore Normal Weight!
– Most Will Gain Weight (Easy)
– Keeping the Weight On (Hard)
– Treatment Similar to Bulimia
 Treatment Can Work!