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Block 4 Unit 4 Eating Disorder

1. Define and describe eating disorders.

• An eating disorder occurs when a person eats, or refuses to eat, to satisfy a psychological need rather than a physical need.
• Individuals with eating disorders may not be aware of or listen to their body's signals of hunger and satisfaction.
• Normal eating involves eating when hungry and stopping when the body is satisfied.
• Eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorders. However, an individual may exhibit symptoms of an eating disorder without fitting neatly into these categories.
• Losing weight because of illness is not considered an eating disorder.

2. Elucidate the prevalence of eating disorders.

• Over 90% of those affected by eating disorders are adolescents and young adult women.
• This is partly due to women's tendency to go on strict diets to achieve an "ideal" figure.
• Traditionally, eating disorders were associated with Caucasian upper socioeconomic groups, but studies have found more cases among lower and middle-class individuals, particularly those with cultural attitudes about the importance of food.
• Eating disorders do not seem to manifest as Anorexia Nervosa and Bulimia in non-Western cultures like India, but occur infrequently in milder forms with fewer symptoms.

3. Present eating disorders in countries other than USA.

• Eating disorders do not manifest as Anorexia Nervosa and Bulimia in non-Western cultures like India, but occur infrequently in milder forms with fewer symptoms.
• In the absence of major eating disorders, standard questionnaires for detecting severe disorders may not identify milder forms.

4. Discuss eating disorders as prevalent in India.

• Eating disorders do not seem to manifest as Anorexia Nervosa and Bulimia in non-Western cultures like India, but occur infrequently in milder forms with fewer symptoms.
• Anxiety about weight and a fear of obesity cause some individuals to starve themselves to achieve a lean look.
• Some individuals also exercise compulsively to compensate for calorie intake.

5. What are the various types of eating disorders? Explain.

• The main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.
• Anorexia Nervosa is characterised by a refusal to maintain a minimal normal body weight, voluntary self-starvation, and an intense fear of becoming fat.
• Individuals with anorexia achieve abnormally low weight by severely dieting, fasting, and often exercising compulsively.
• Anorexia nervosa has two subtypes: the restricting type (focus on limiting food) and the binge-eating/purging type (regular binge eating followed by purging).
• Bulimia Nervosa is characterised by episodes of compulsive binge eating, followed by compensatory behaviours to prevent weight gain, such as self-induced vomiting or laxative use.
• Bulimia nervosa has two subtypes: the purging type (vomiting or laxative use) and the non-purging type (fasting or excessive exercise).
• Binge Eating Disorder is characterised by recurrent episodes of binge eating without compensatory behaviours.
• Binge eating may involve compulsively snacking over long periods or consuming large amounts of food at one time.

6. Discuss bulimia nervosa in terms of diagnostic criteria and impact.

• Diagnostic criteria for bulimia nervosa include:
  • Frequently occurring episodes of binge eating, characterised by eating an unusually large amount of food in a short period, and feeling a loss of control over eating during the episode.
  • Recurrent inappropriate compensatory behaviours to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics or other medications, fasting, or excessive exercise.
  • The binge eating and compensatory behaviours occur, on average, at least twice a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • Bulimic behaviour does not occur only during episodes of anorexia nervosa.
• Impact of Bulimia:
  • Puffy cheeks due to swelling of the parotid glands.
  • Tooth enamel decay due to stomach acid from vomiting.
  • Calluses on the back of hands from self-induced vomiting.
  • Digestive tract problems, dehydration, and nutritional imbalances.
  • Anxiety, depression, and sleep disturbances.

7. What is binge eating? Discuss the triggers of binge eating.

• Binge eating is characterised by episodes of bingeing without the use of compensatory behaviours such as purging.
• Two common patterns of binge eating include:
  • Compulsively snacking over long intervals.
  • Consumption of large amounts of food at one time.
• Binge eating often leads to problems with weight regulation and sometimes obesity.
• Triggers of Binge Eating:
  • Stressful situations.
  • Upsetting thoughts.
  • Guilt about something one has done.
  • Feeling socially isolated or excluded.
  • Boredom.

8. Discuss the biological causes of eating disorders.

• Research suggests genetic factors may contribute to eating disorders.
• Neurotransmitter dysregulation, such as imbalances in serotonin and dopamine, may play a role.
• Brain structure abnormalities, such as in the hypothalamus, may also contribute.

9. Elucidate the family theories as applicable to eating disorders.

• Families can play a role in the development of eating disorders by focusing on thinness, food, and body image.
• Food can become a powerful tool for communication between parents and children.
• Families may come to set their own level of homeostasis, and the presence of someone with an eating disorder may be a symptom of a pre-existing family disturbance.

10. Discuss the other possible causes of eating disorders.

• Cognitive behavioural and psychodynamic theories suggest that eating disorders are linked with dieting behaviour.
• The desire to achieve an ideal weight can lead to a cycle of restrictive dieting and binge eating.
• Reward mechanisms can reinforce disordered eating behaviours, such as receiving praise for weight loss or a reduction in anxiety during a binge-purge cycle.

11. What are eating disorders? Explain their nature and symptoms.

• Eating disorders are characterised by a disturbance in eating patterns, where eating or refusing to eat is driven by psychological rather than physical needs.
• Individuals may not be aware of or respond to normal hunger and satiety cues.
  • These disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder.
• Symptoms of Anorexia Nervosa:
  • Refusal to maintain a minimally normal body weight.
  • Intense fear of gaining weight.
  • Disturbed body image or denial of the seriousness of low body weight.
  • Absence of menstrual periods.
• Symptoms of Bulimia Nervosa:
  • Recurrent episodes of binge eating, and feeling a loss of control over eating during the episode.
  • Recurrent compensatory behaviours to prevent weight gain, like self-induced vomiting, laxatives, excessive exercise.
  • Self-evaluation unduly influenced by body shape and weight.
• Symptoms of Binge Eating Disorder:
  • Recurrent episodes of binge eating without compensatory behaviours.
  • Eating large amounts of food rapidly with a feeling of lack of control.

12. What is the prevalence of eating disorders? Discuss eating disorders as being obtained in India.

• The vast majority of those affected with eating disorders are adolescents and young adult women.
  • Eating disorders are more common in Western societies.
• In India, eating disorders do not appear to manifest as anorexia and bulimia, but may occur in milder forms.
• Some in India may engage in starving themselves due to fear of weight gain.

13. What are the various types of eating disorders?

The main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.

• Anorexia nervosa: Characterised by severe food restriction and a distorted body image.
• Bulimia nervosa: Characterised by binge eating followed by compensatory behaviours, like purging.
• Binge eating disorder: Characterised by recurrent binge eating without compensatory behaviours.

14. Elucidate the causes of eating disorders.

• Biological Factors: Genetic predisposition, neurotransmitter imbalances, and brain structure abnormalities may contribute.
• Cultural Factors: Western cultural emphasis on thinness and media portrayal of ideal body types, influence the development of eating disorders.
• Family Factors: Family focus on thinness, food, and body image, and a history of family dysfunction or conflict contribute to the development of eating disorders.
• Other Factors: Cognitive and psychodynamic theories link eating disorders to dieting behaviours, and the reward mechanisms associated with not eating or binge-purging.

15. Differentiate anorexia nervosa and bulimia nervosa.

• Anorexia nervosa involves severe food restriction and a significant loss of weight, an intense fear of gaining weight, and a disturbed body image.
  • Individuals with anorexia may be severely underweight.
  • The main goal is to achieve and maintain a low body weight.
• Bulimia nervosa is characterised by binge eating followed by compensatory behaviours to prevent weight gain.
  • Individuals with bulimia are often at a normal weight or overweight.
  • They have a fear of gaining weight, but they have a loss of control when bingeing.

16. Discuss the treatment methods used in treating eating disorders.

Treatment approaches can include:

• Biological Treatment: The use of medication such as antidepressants, antianxiety drugs and appetite stimulants.
• Family Treatment: Focusing on family dynamics and communication related to food and body image.
• Cognitive Behavioural Treatment (CBT): Addressing thoughts, feelings, and behaviours related to food and body image. The client and therapist explore society’s perception of physical attractiveness. They also examine the client’s beliefs about body image.
• Psychoanalytic Treatment: Exploring the unconscious motivations behind disordered eating behaviours.

17. Discuss Anorexia nervosa in terms of symptoms, diagnosis and its prevalence.

Anorexia Nervosa: Symptoms, Diagnosis, and Prevalence

• Symptoms: Anorexia nervosa is characterised by several key symptoms.

  • Refusal to maintain a minimal normal body weight: Individuals with anorexia nervosa refuse to keep their body weight at or above 85% of what is generally considered normal for their age and height. This can lead to significant weight loss, making them appear extremely thin and frail.
  • Intense fear of gaining weight: There is an intense fear of weight gain or becoming fat, even when underweight. This fear can be a driving force behind their restrictive eating behaviours.
  • Disturbance in body image: Anorexic individuals experience a disturbance in how they perceive their body weight or shape. They may unduly influence their self-esteem by these factors or deny the severity of their low weight. They may think they are fat even when they are wasting away, and they often hide their bodies in oversized clothes.
  • Amenorrhea: If menstruation has started, there will be an absence of three consecutive menstrual cycles.
  • People with anorexia may be preoccupied with food and may even enjoy cooking for others.

• Diagnosis: People are diagnosed with anorexia nervosa if they meet specific criteria.

  • They weigh less than 85% of the expected weight for their age and height.
  • They exhibit an intense fear of gaining weight, even when underweight.
  • They have a distorted perception of their body image.
  • There are two recognised types of anorexia:
    • Restricting type: Where the main focus is on restricting food intake.
    • Binge-eating/purging type: Where there is regular binge eating followed by purging through methods such as vomiting or laxatives.

• Prevalence: Anorexia nervosa predominantly affects women, with around 15 females affected for every male.

  • It usually begins between the ages of 14 and 16, but cases have been reported in children as young as eight years old.
  • It is estimated that 5% to 15% of people with anorexia die from the disorder or related complications.

18. What are the cultural theories of eating disorders?

Cultural Theories of Eating Disorders

• Societal Pressures: Many theorists believe that pressures in Western societies are mainly responsible for the development and maintenance of eating disorders.
  • Studies have shown that the physical characteristics of women featured in media have become significantly thinner over time.
  • This focus on thinness and a double standard of attractiveness has led to women becoming overly concerned with their appearance, dieting, and body image. The increasing preoccupation of the media with male attractiveness has also led to a rise in eating disorders among men.
• Western ideals of beauty:
  • In Western societies, thinness is valued and considered attractive, leading to a preoccupation with dieting and body image.
  • This contrasts with some non-Western societies where plumpness may be seen as attractive and desirable.
• Cultural changes: Cultural shifts, especially when related to aesthetics, can increase vulnerability to eating disorders.
  • This includes changes within a society over time or changes experienced by individuals who move into a new culture.
• Affluence and freedom of choice for women: Historical and cross-cultural observations suggest that eating disorders are more common in affluent societies with more freedom of choice for women.
  • Cultures with restricted social roles for women tend to have lower rates of eating disorders.
• Culture-bound syndrome: Anorexia nervosa has been described as a possible “culture-bound syndrome” with roots in Western cultural values and conflicts.
  • The "fear of fatness" required for diagnosis may be culturally dependent. For example, in Hong Kong and India, anorexia is sometimes motivated by religious or eccentric nutritional ideas, rather than a fear of fatness.

In summary, anorexia nervosa is a severe eating disorder with specific diagnostic criteria, a significant impact on physical health, and a high mortality rate. Cultural factors, especially those promoting thinness in Western societies, are seen to play a significant role in the development and maintenance of these disorders.