Eating disorders

Eating disorders
What are eating disorders?
Eating disorders are serious mental health conditions that involve unhealthy eating habits and
preoccupations with food, body weight, and body shape. They can manifest in various ways
and often lead to significant physical and emotional problems.
Types of Eating Disorders:
The most common types include:

i. Anorexia Nervosa
ii. Bulimia Nervosa
iii. Binge Eating Disorder
Anorexia Nervosa
The term anorexia refers to loss and appetite, and nervosa indicates that the loss is due to
emotional reasons.
Anorexia Nervosa is an eating disorder characterized by an intense fear of gaining weight and
a distorted body image, leading individuals to restrict their food intake severely.
For instance, People with anorexia often see themselves as overweight, even when they are
underweight, and may engage in excessive exercise or other behaviors to lose weight.
Proposed DSM-5 criteria for Anorexia Nervosa
• Restriction of food to promote healthy weight; body weight is significantly below

normal
• Intense fear of weight gain
• Body image disturbance
➢ Anorexia Nervosa typically begins in the early to middle teenage years.

➢ Lifetime prevalence of anorexia is less than 1 percent, and it is at least 10 times more
frequent in women than men.
➢ Women with anorexia Nervosa are frequently diagnosed with depression, obsessive
compulsive disorder, phobias, Panic disorder, substance use disorder and various
personality disorders.
➢ Men with anorexia Nervosa are also likely to have a diagnosis of a mood disorder,
schizophrenia or substance use.
➢ Suicides rates are quite high for people with anorexia, with as many as 5 percent
completing suicide and 20 percent attempting suicide.
Physical consequences of Anorexia Nervosa
➢ Self starvation and use of laxatives produce numerous undesirable biological

consequences.
➢ Blood pressure often falls, heart rate slows, skin dries out, nails become brittle,
hormone levels change, and mild anemia may occur.
➢ Some people lose hair from the scalp and they may develop lanugo a fine soft hair
on their bodies.
Prognosis
➢ Between 50 and 70 percent of people with anorexia eventually recover. However,

recovery takes 6 to 7 years.
➢ Anorexia Nervosa is a life threatening illness; death rates are 10 times higher among
people with the disorder.
➢ Morality rates among women with anorexia range from 3 to 5 percent.
➢ Death most often results from physical implications of the illness for example,
congestive heart failure and from suicide.
Etiology of Anorexia Nervosa
Genetic factors
➢ Anorexia Nervosa run in families.

➢ First degree relatives of young women with anorexia nervosa are more than ten times
more likely than average to have the disorder themselves.
➢ First degree relatives of men with anorexia nervosa were at greater risk for having
anorexia nervosa than relatives of men without anorexia.
➢ Research has shown that non shared environmental factors, like different interactions
with parents or different peer groups, also contribute to the the development of eating
disorders.
Neurobiological factors
➢ Neurotransmitter imbalance, such as serotonin and dopamine, which regulate mood

and appetite.
➢ Changes in brain structure, where the activity of certain areas, like the prefrontal
cortex and amygdala, is altered, affecting decision-making and emotional responses.
➢ Dysfunction of the hypothalamus, which controls hunger and satiety signals, leading
to issues in appetite regulation.
➢ Genetic predisposition, which influences brain function and behavior, increasing the
risk of eating disorders.
➢ Dysregulation of the stress response system, which affects levels of stress hormones
like cortisol, impacting eating behavior as well.
Cognitive behavioral factors
➢ Emphasize fear of fatness and body image disturbance as the motivating factors that
powerfully reinforce weight loss.
➢ Many who developed anorexia symptoms report that the oneset followed a period of
weight loss and dieting.
➢ Producing a strong drive for thinness and a disturb body image is criticism from peers
and parents about overweight.
Treatment
Medications
➢ Antidepressants: Such as fluoxetine, which can help improve mood and reduce
anxiety. They may also support weight gain in some patients.
➢ Atypical Antipsychotics: Such as olanzapine, which help with weight gain and can
also be helpful in addressing body image issues.
➢ Mood Stabilizers: These medications can assist with emotional regulation and may
be beneficial for some patients.
Psychological treatment
➢ Cognitive Behavioral Therapy (CBT): This therapy helps patients understand and
change their negative thoughts and behaviors. It focuses on weight gain and healthy
eating habits.
➢ Family-Based Therapy (FBT): This involves the family, where parents are actively
involved in the treatment process. This approach is particularly effective for
adolescents.
➢ Interpersonal Therapy (IPT): This therapy focuses on interpersonal relationships

and social functioning, which helps address emotional issues.
➢ Motivational Interviewing (MI): This is a client-centered approach that helps

motivate patients for their treatment.
Bulimia Nervosa
Bulimia is a Greek word meaning Ox hunger.
Bulimia Nervosa is an eating disorder characterized by cycles of binge eating followed by
compensatory behaviors like vomiting, excessive exercise, or fasting, often driven by a
preoccupation with body image and weight.
Proposed DSM-5 criteria for Bulimia Nervosa
• Recurrent episode of binge eating

• Recurrent compensatory behaviors to prevent weight gain For example, vomiting
• Body shape and weight are extremely important for self evaluation.
➢ It involves episodes of rapid consumption of large amount of food, followed by a
compensatory behavior, such as vomiting, fasting or excessive exercise to prevent
weight gain.
➢ The DSM defines a binge as having two characteristics.
➢ First, eating an excessive amount of food within a short period of time.
➢ Second, feelings of losing control over eating.
➢ People with Bulimia nervosa may not always lose a significant amount of weight.
Physical consequences of Bulimia Nervosa
➢ Menstrual irregularities, including amenorrhea can occur.

➢ Frequent purging can cause potassium depletion.
➢ Heavy use of laxatives include diarrhea, which can also lead to changes in electrolytes
and cause irregularities in heart beating.
Prognosis
➢ People with bulimia nervosa who binge and vomit more.

➢ People with bulimia nervosa reveal that close to 75 percent recover.
➢ About 10 to 20 percent remain fully symptomatic.
Etiology of Bulimia Nervosa
Genetic factors
➢ Bulimia nervosa run in families.

➢ First degree relatives of women with bulimia nervosa are about four times more likely
than average to have a disorder.
➢ First degree relatives of women with eating disorders are appear to be at higher risk
for Bulimia.
➢ People with bulimia nervosa are thought to be over concerned with weight and gain
and body appearance.
➢ They judge their self worth mainly by their weight and shape.
➢ They also have low self esteem.
➢ They try to follow a pattern of restrictive eating that is very rigid, with strict rules
regarding how much to eat, what kinds of food to eat and when to eat and what to eat.
Treatment
Medications
➢ Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like fluoxetine

(Prozac) are often prescribed. SSRIs can help reduce binge-eating and purging
behaviors, as well as improve mood and anxiety symptoms.
➢ Antidepressants: Other types of antidepressants may also be prescribed to help

manage mood disorders that often accompany bulimia.
➢ Mood Stabilizers: In some cases, mood stabilizers may be used to help manage
emotional dysregulation associated with bulimia.
Psychological treatment of Bulimia Nervosa
➢ Cognitive Behavioral Therapy CBT: is the most effective therapy that helps patients
change unhealthy thinking patterns and behaviors.
➢ Medication: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs),

are sometimes prescribed to reduce the symptoms of bulimia.
➢ Family Therapy: Involving the family provides emotional support to patients and
helps in understanding family dynamics, which can be beneficial for recovery.
Binge Eating
Binge eating refers to an eating disorder in which individuals consume a large amount of
food in a short period, without hunger or control. During this process, they do not pay
attention to the quantity of food and often feel guilt or shame afterward.
Proposed DSM-5 criteria for Binge Eating Disorder
• Reporting binge eating episodes.

• No compensatory behavior is present.
• Binge eating episodes include:
• Eating more quickly than usual
• Eating until over full
• Eating large amounts even if not hungry
• Eating alone due to embarrassment about large food quantity feeling bad (e.g
disgusted, guilty, or depressed) after the binge
➢ This disorder includes recurrent binges (one time per week for at least 3 months)
➢ Lack of control during the bingeing episode, and the distress about bingeing.
➢ Rapid eating and eating alone.
➢ Mostly people with binge disorder are obese.
➢ Binge eating disorder appear to be more prevalent than either anorexia nervosa or
bulimia nervosa.
Physical consequences of Binge Disorder
➢ Function of associated obesity, including increased 2 types of diabetes.

➢ Cardiovascular problems, breathing problems, insomnia and joint/muscle problems.
➢ Independent from co occuring obesity, including sleep problems, anxiety, depression,
irritable bowel syndrome and for women early onset of mensuration.
Prognosis
➢ Research so far suggest that between 25 and 82 percent of people recover.

➢ One study found that people reported having their binge eating disorder for an
average of 14.4 years.
Etiology of Binge Eating Disorder
Genetic factors
➢ If there is a family history of eating disorders, individuals are more likely to face this
disorder.
➢ Twin studies have shown that identical twins have a higher chance of developing
binge eating disorder.
➢ Environmental influences can also contribute to the development of this disorder.
➢ The pattern of people with binge eating disorder is similar to Bulimia.
➢ Individuals with binge eating disorder often have a poor self-image, leading to
feelings of shame and guilt about their bodies, which can trigger binge eating
episodes.
➢ Many people use food as a way to cope with negative emotions such as stress,
anxiety, or depression.
➢ Some may avoid dealing with their emotions or stressors, using binge eating as a way
to escape or distract themselves from underlying issues.
Treatment
Psychological treatment of Binge Eating Disorder
➢ Cognitive behavioral Therapy (CBT): This therapy helps individuals understand

and change their negative thoughts and behaviors. It assists in controlling eating
habits and emotions.
➢ Interpersonal Therapy (IPT): This therapy focuses on individuals' relationships and

social interactions. It helps in understanding and addressing emotional issues.
➢ Dialectical Behavior Therapy (DBT): This therapy focuses on emotional regulation

and distress tolerance, which can be helpful in managing the triggers of binge eating.

Eating disorders

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Eating disorders

What are eating disorders?

Types of Eating Disorders:

The most common types include:

Proposed DSM-5 criteria for Anorexia Nervosa

• Restriction of food to promote healthy weight; body weight is significantly below

➢ Anorexia Nervosa typically begins in the early to middle teenage years.

Physical consequences of Anorexia Nervosa

➢ Self starvation and use of laxatives produce numerous undesirable biological

➢ Between 50 and 70 percent of people with anorexia eventually recover. However,

Etiology of Anorexia Nervosa

➢ Anorexia Nervosa run in families.

➢ Neurotransmitter imbalance, such as serotonin and dopamine, which regulate mood

Cognitive behavioral factors

➢ Interpersonal Therapy (IPT): This therapy focuses on interpersonal relationships

➢ Motivational Interviewing (MI): This is a client-centered approach that helps

Proposed DSM-5 criteria for Bulimia Nervosa

• Recurrent episode of binge eating

Physical consequences of Bulimia Nervosa

➢ Menstrual irregularities, including amenorrhea can occur.

➢ People with bulimia nervosa who binge and vomit more.

Etiology of Bulimia Nervosa

➢ Bulimia nervosa run in families.

Cognitive behavioral factors

➢ Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like fluoxetine

➢ Antidepressants: Other types of antidepressants may also be prescribed to help

Psychological treatment of Bulimia Nervosa

➢ Medication: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs),

Proposed DSM-5 criteria for Binge Eating Disorder

• Reporting binge eating episodes.

Physical consequences of Binge Disorder

➢ Function of associated obesity, including increased 2 types of diabetes.

➢ Research so far suggest that between 25 and 82 percent of people recover.

Cognitive behavioral factors

➢ The pattern of people with binge eating disorder is similar to Bulimia.

Psychological treatment of Binge Eating Disorder

➢ Cognitive behavioral Therapy (CBT): This therapy helps individuals understand

➢ Interpersonal Therapy (IPT): This therapy focuses on individuals' relationships and

➢ Dialectical Behavior Therapy (DBT): This therapy focuses on emotional regulation

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