What are the three main diagnoses of EDs from the DSM?
Anorexia Nervosa, Bulimia nervosa, Binge-eating disorder
What are eating disorders characterized by?
Preoccupations with food and weight, usually differences in perceptions of their own bodies
What is the time of life with the highest prevalence of EDs?
mid to late adolescence
What has the highest mortality rate of any psychiatric illness?
Anorexia nervosa - 10% of those diagnosed die within 10 years of onset
What is body image?
How people think about and act towards their bodies
In the DSM 5 what are the two features core to the experience of EDs?
- disturbance of eating or eating related behaviours
- changed eating behaviour which significantly impacts health or functioning
What is the diagnostic criteria for anorexia nervosa?
Over a period of at least three months
- behaviours (food restriction, purging, misuse of meds, over exercising…)
- powerful fear of gaining weight, becoming fat
- inaccurate perception of body size, overestimate
- denial of seriousness of condition and impact
- potentially life threatening
What is the diagnostic criteria of bulimia nervosa?
- food restriction, binging, purging -> to prevent weight gain
- cycle of behaviours at least once a week for at least three months
- extreme feelings of shame->hide behaviours->more guilt
- often are average weight, experience fluctuations
- associated with depression, self harm, suicidality
What is the diagnostic criteria of binge eating?
- consumption of an unusually large amount of food over a short period of time (different from overeating)
- psychological distress
- feels out of control about what they are eating, how much, and when able to stop
- does not feature compensating behaviours
- occurs at least once a week for at least three months
What is Avoidant Restrictive Food intake disorder?
- residual
- infancy or childhood, may involve trauma
- avoidance of types/textures/colours of food
- impair nutrition
- no body dissatisfaction or preoccupations with weight/shape
- can lead to AN or BN
What is rumination disorder?
- Residual
- consistent, effortless regurgitation of chewed and/or partially digested food over a period of at least one month - may be symptom of AN or BN
What is Pica?
- Residual
- persistent consumption of non food items over a period of at least one month - normal during childhood… term to describe presence in other life stages
How does Other Specified Feeding or Eating Disorders differ from An, BN, and BED?
minor differences in diagnostic criteria
What is Anorexia athletica?
- overexercise to the point of neglecting other priorities
- used to control body shape and weight
- used to provide sense of power, control, self-respect
What are some controversies with anorexia athletica?
- would be common in professional athletes…
- our culture could be seen as actively promoting this type of disorder
- might glamourize and pathologize this potential disorder
What is orthorexia?
- not recognized in DSM 5
- obsessive focus on food
- eating foods only to be healthy
relying only on natural remedies for illness - finding more pleasure following food rules than experience of food itself, feelings of despair when failing
- may result in social isolation and ill health
What is Body Dysmorphic disorder?
- under OCD…
- preoccupation with appearance - focusing on non existent or minor flaws
- mirror checking, grooming, skin picking…
- preoccupation impairs daily functioning
- subtypes proposed
What are treatment plans for EDs?
- multidisciplinary
- many types of therapy (CBT, psychoanalysis, nutritional education, equine therapy)
- treat both somatic and psychological
- normalize eating = key goal
- often need to gain weight = challenging
- concurrent treatment for other mental disorders may be necessary
How are physiological symptoms addressed in treatment?
- normalize eating
- learn to eat without dieting
- education about the behavioural, physical, and cognitive effects of ED behaviours
How are psychological symptoms addressed in treatment?
- focusing on individual causes
- acknowledging and promoting body appreciation and acceptance
What are the causes and risk factors associated with EDs?
- Class and Culture (historically white, middle class, young women… may be because of underdiagnosing in other groups… internalization of beauty ideals in this group)
- Internalization of the Ideal ( body dissatisfaction + internalization of beauty standards being thin…. thin associated with happiness, desirability, status….)
- Social Media (media and peer influence.. promote unrealistic body images…)
- Sports pressures (sports emphasize appearance, size, weight, shape… individual performance… low body weight… elite athletes)
- Environmental factors (childhood maltreatment (physical /sexual violence), peer network and pressure, perfectionist tendencies..)
- Biological factors (strong genetic component but no single gene)
- Sex and gender (women more likely diagnosed… gender role endorsement)
What is Gender role endorsement
the extent to which an individual closely identifies with particular norms associated with gender
(female = thinness orientation, masculine = muscularity)
What are current issues and controversies with how society tries to deal with EDs?
- fashion industry responds to critiques of underweight models and photoshop
- restaurants not include calorie counts to go against obesity
- body positive sites sharing stories
- social media perpetuating ED behaviours (ex: pro ana)
What is body image?
How people see, think, feel, and act towards their bodies
