Debunking the Myths Behind Eating Disoders @psych134midtermproject-blog - Tumblr Blog

Myth: Eating disorders is a recent phenomenon.

History of Eating Disorders

Learning about the history of eating disorders is important and having an eating disorder is not a recent phenomenon, these behaviors have actually been reported for centuries. The behavior of people with an eating disorder are influenced through biological factors. Learning more about the history behind eating disorders can give us a better insight on how to best treat it. The symptoms of anorexia nervosa and bulimia nervosa have been accounted for hundreds of years ago. In the 4th,5th-8th centuries there have been accounts describing anorexia where starvation in people was associated with demonic possession for religious purposes. And in ancient texts there have been accounts of bulimia where people thought forcing themselves to vomit was a good thing and saw it as an act of “self cleansing”. These are only some of the beginning accounts that demonstrate that eating disorders is not just a recent phenomenon. It is critical to learn and gain insight about eating disorders because an increasing amount of people have been developing this disorder over the past several decades. Eating disorders have severe negative effects on a person’s health and because very few people are able to recover from this disorder which leads to a high mortality rate.

#Lecture1

Myth: Only people who are underweight can have an eating disorder.

Anyone can have an eating disorder it is a common misconception that only people who are severely underweight can have an eating disorder.

#Myth #Lecture1

Minnesota Starvation Study

Men who chose to not go into the military had an alternative opportunity to participate in a study with severe food intake restrictions. This study was conducted from Nov 19, 1944 through Dec 20, 1945 in order to learn about the biological and psychological consequences of food scarcities due to war and famine. During the first 12 weeks the men were allowed to eat 3200 calories a day. The second phase was a 24 week period where men were essentially starved with a limitation of 1500 calories of food a day with the goal of an overall of a 25% reduction in weight. The effects of not having enough food took a major toll on these men, their sexual drive decreased, there were signs of emotional distress, depression, feelings of anxiousness, development of physical symptoms that have no medical explanation, social withdrawal, isolation, low metabolic rates, body temperature, heart rate, respiration, and swelling due to excess water in extremities. The next 12 week rehab period the men were assigned different caloric intakes with differing amounts of nutrients and proteins. And the last and final stage was an 8 week rehab period where during this time, they unrestricted access to food. The findings of this study was that after the 24 week period when the men were only allowed an extremely restricted caloric intake, they developed behaviors that were comparable to that of an eating disorder. Keys came to the conclusion that “Enough food must be supplied to allow tissues destroyed during starvation to be rebuilt … The character of the rehabilitation diet is important also, but unless calories are abundant, then extra proteins, vitamins and minerals are of little value” (and, "Leah M. Kalm", 2005). Even after 12 weeks of refeeding, the men frequently expressed dissatisfaction of increased hunger right after eating a large meal. They had preoccupations with food and had developed binge eating and compensatory purging.

#Lecture2

Types of DSM-V feeding and eating disorders:

Pica:

Pica is defined as the continual eating of nonfood matter with no nutritional value for over a time span of at least one month. This behavior of eating these non food substances for the person is abnormal to their developmental level meaning that, for example it isn’t a child that doesn’t know any better and is eating crayons. This strange eating behavior not endorsed culturally or socially. Individuals with pica still eat ‘normal’ food in conjunction with other non food sustenance. Instances of pica are noticed when patients go to their doctor and indicate that they suffering from gastrointestinal problems, poisoning, infections, or deficits in nutrients. There is not much research done on this disorder but it is found to exist more in people with developmental deficits and there are also cases of pica in pregnant women but the cause of it hasn’t been linked to any definite biological abnormality.

Rumination Disorder:

Rumination disorder is defined as the recurring behavior of regurgitation of food that takes place in a time span of at least one month. Regurgitated food may be re-chewed, re-swallowed, or spit out.” (Cusack & McGlone, "Eating Disorders 101 Assessment and Diagnosis ", p. 8) This inability to keep food down is not medically explainable and it’s still unknown to what causes this behavior. The age of onset is 3-12 months and infants with this disorder display “a straining and arching posture on the back of their head.” This movement that causes infants to throw up generally happen during breastfeeding so oftentimes parents may not notice this disorder in their baby until they see that the baby is not really gaining weight. Children and adults may also suffer with this. This disease may co-occur with the person limiting their food intake but when the person decides to eat, this disorder may become worsened. A person with rumination disorder might cough and re-swallow the food in order to conceal what had just happened. This disorder is mostly affects individuals with intellectually handicapped but it is not known of how many people are actually affected by this disorder. Anxiety seems to play a role in people with rumination disorder, so anxiety treatments may help combat the effects of this disorder.

Avoidant-Restrictive Food Intake Disorder (ARFID):

Avoidant-restrictive food intake disorder is defined as an upset in eating or feeding behavior that is indicated by continually failing to satisfy normal nutritional and energy necessities. Losing a sufficient amount of weight, not consuming enough nutrients, only relying on enteral feeding or oral nutritional supplements, problems with psychosocial functioning can all be associated with this avoidance and restriction of food. ARFID is not set forth by food scarcities, and there isn’t an indication of a change in a person’s weight, and a person’s medical illness also does not explain this disorder. A negative experience related with food may cause a child to become more particular about what foods they choose to eat. AFRID may be an automatic reaction to this negative experience the child has and this disease may develop into adulthood. If this disease is developed during childhood the child may be malnourished, resulting in an inability to develop healthy and normal functions.

Anorexia Nervosa (AN):

Anorexia nervosa is seen in individuals who severely limit their food intake and become very underweight and unhealthy. There are two types of anorexia one case in which an underweight individual restricts food intake (AN-R) and dreads the thought of putting on any weight. And another case where an individual engages in binging and purging behaviors (AN-BP) and these behaviors are acted upon relentlessly to counteract the gaining of weight when the individual is very under-weight already. Individuals with AN follow very strict protocols they set for themselves. They may act in certain ways around food that is seen as very abnormal or compulsive. They may only allow themselves to slowly eat a certain foods in limited amounts that is really insufficient and may only eat a certain small variety of foods they think are good. This disorder usually develops in adolescents or young adults and seldom will develop before puberty or after the age of 40. Currently no treatment that can entirely cure a person with anorexia and it has the highest mortality rate.

Orthorexia (unofficial diagnosis):

Patients develop orthorexia they become obsessed with foods that are pure and extreme clean eating. This disorder is not just the obsession with healthy eating because patients begin to become hyper-focused and this causes harm socially, occupationally and nutritionally.

Bulimia Nervosa (BN):

Bulimia nervosa consists of repetitive cycles of binging and purging once or more a week for a period of at least 3 months. When individuals are on a binge episode they feel like they cannot restrain themselves and hastily consume immense amounts of food. Individuals experience purging in attempts to counteract the binge. They may feel the need to expel all the food and force themselves to throw up, use medications such as laxatives, participate in fasting, or exercise excessively. The cycle usually appears before puberty and people with this complication show esophagus tears, electrolyte deficiencies, cardiac anthemia’s, gastrointestinal issues, and rectal prolapse.

Binge Eating Disorder (BED):

Binge eating disorder is distinguished when an individual eats an abnormally large amount of food in a set period of time. The session of binge eating needs to correspond to at least three behaviors including unusually fast pace of eating, discomfort due to overeating, eating copious amounts of food when not feeling hungry, feelings of embarrassment because of the large amounts of food which led to eating alone, feelings of disgust, guilt, and depression after overeating. This disorder differs from bulimia nervosa because the individuals don’t experience a desire to purge afterwards.

Other Specified Feeding or Eating Disorder

-Atypical anorexia nervosa is a behavior that resembles anorexia nervosa in all aspects but the person is not underweight.

-Purging disorder is an act of expelling food from the body in order facilitate weight loss without the compulsive overeating in bulimia.

Unspecified Feeding or Eating Disorder

When patients display partial symptoms which don’t fully meet the criteria for the final verdict to be diagnosed with a specific eating disorder. This is not an actual diagnosis, clinicians may use this term as a flag for eating disorders.

#Lecture2

Some consequences of eating disorders:

Eating disorders warrant many medical complications. People with these disorders experience physical discomfort and every single body system can be at risk of other severe complications. Neurochemistry in patients with eating disorders show different levels of serotonin from that of a normal healthy person. 4% of people with anorexia nervosa commit suicide. This disorder is maintained and continued due to emotion dysregulation.

#Lecture2

Assessment of eating disorders:

First information is broadly collected with a general background of the a model of what the patient eats, recent life events, if they received any treatment in the past, and explanation of their case. Moving on, the patient needs to inform exactly what they eat at each meal of the day, and notify any bingeing, restricting, purging behaviors they might perform. Next is to gain more insight on patients thought process on food, weight, and view on themselves. They are then asked about if they have experienced any other chronic diseases or illnesses. After they were asked if they take any substances, have any stressors in their life, or deal with any medical components. Lastly the issue of safety discussed about.

#Lecture2

Sociocultural Theory

“There are specific messages that reflect a culture's ideology and are conveyed by socialization agents that influence an individual’s behavior.” ( Menzel, p. 5)

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Gender Differences

Eating disorders are seen more in females than males at a ten to one ratio. Objectification theory is where girls are taught to see themselves as objects used to please men. Girls are sexualized at a young age in our culture and are taught the importance attractiveness. This message sets an unrealistic expectation that women think they have to live up to. This message is internalized and women will unconsciously worry about how they look which takes into account a lot of effort and resources that could be better used for other things.

#Lecture3

The Swimsuit Study

The Swimsuit Study was a hallmark objectification study. Subjects were told that they would be participating in a consumer research study for product testing as a cover story. The middle test was an experiment where subjects had to try on clothes and they were randomly assigned to try on a sweater or a swimsuit. The point of this was to be primed to think of their appearance. They then completed questionnaires asking them “I am..” and measures of mood were taken, and they also had to complete a set of math problems. It was found that in the questionnaire asking “I am…” women only wrote down statements about their appearance. In the swimsuit condition the women performed more poorly than the men. The idea behind the math problems is that the women were spending time to worrying about how they look that they had less time to think about things that did matter and this thought negatively impacted performance. Finally at the conclusion of the study cookies were offered and the women in the swimsuit condition were also found to eat less cookies.

#Lecture3

Men are still objectified and scrutinized, while the expectations for men also have risen but the risk for men isn’t as much as women.

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Secular trends

Over the eras there has been a fluctuation of weight but distinct desired features have been becoming more extreme over time. with the rise of eating disorders there is also an overall decrease in the size of the female body.

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The Case of Curacao

This was a qualitative study done in Curacao as citizens were experiencing a socioeconomic transition due to a banking boom in the 1990s Curacao was growing in wealth. In this epidemiological study, there were 11 cases of anorexia nervosa. 2 of the cases were in white women born in the Netherlands, 9 were from women of mixed race, and there were no cases among black women. It was results show that those women of mixed race who had exposure to western culture, had traveled aboard, were higher in socioeconomic status, and lived with western ideals were the ones who mainly developed anorexia.

#Lecture3

The Case of Fiji

Fiji had a lack of exposure to televisions and researchers wanted to see if it would influence eating behaviors. One month before the television was introduced the girls had positive associations with fatness, low body dissatisfaction, purging, and dieting. None had self purging behaviors and there were 13 percent increased scores on a measure of disordered eating. Three years after the introduction of television, researchers came back and found that now the positive associations with fat was gone and now they believed that wealth and success accredited to being thin, 11 percent were purging, and 29 percent had elevated scores on a measure of disordered eating.

#Lecture3

Sources of Messages

The Tripartite Model is the main model that explains how peers, parents, and media affect disordered eating and body dissatisfaction through the internalization of thin ideal and appearance comparison.

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The most common cause of death in Eating Disorders are: 1.Cardiac arrest 2.Suicide

Maya Kumar, MD

#Facts

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