Bulimia Nervosa & Compulsive Bulimia Nervosa & Compulsive OvereatingOvereating

IntroductionIntroduction

What are Eating Disorders? Bulimia Nervosa –

1.)eating in secrecy any amount of food that is a larger portion than a normal person would eat. It usually lasts less than two hours. There is a lack of control of eating during the episodes. The person is literally unable to stop eating or control what is eaten and how much is consumed. Continual snaking throughout the day is not considered would not be considered binging. 2.) The person induces vomiting in order to prevent weight gain. Along with vomiting one may also misuse laxatives, diuretics, enemas, or others medications. They may also fast or do an excessive amount of exercise. 3.) In order to qualify for diagnosis one must engage in the behaviors for at least twice a week for 3 months

Introduction Introduction

Binge Eating: Consumption of large amounts of food in a short period of time

Other: mainly Anorexia Nervosa but there have been more forms classified lately.

How do I know if someone has How do I know if someone has an eating disorder?an eating disorder?

Signs of Bulimia: Dramatic weight loss in a relatively short period of time. Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss. Obsession with weight and complaining of weight problems (even if "average" weight or

thin). Obsession with calories and fat content of foods. Isolation. Fear of eating around and with others. Unusual Food rituals such as shifting the food around on the plate to look eaten; cutting

food into tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or spoon); chewing food and spitting it out, but not swallowing; dropping food into napkin on lap to later throw away.

Hiding food in strange places (closets, cabinets, suitcases, under the bed) to avoid eating (Anorexia) or to eat at a later time.

Hair loss. Pale or "grey" appearance to the skin. Dizziness and headaches. Low blood pressure. Loss of menstrual cycle. Constipation or incontinence. Bruised or calluses knuckles; bloodshot or bleeding in the eyes; light bruising under the

eyes and on the cheeks. Perfectionistic personality.

Warning Signs Cont.Warning Signs Cont.Binge Eating Disorder Fear of not being able to control eating, and while eating, not being able to stop. Isolation. Fear of eating around and with others. Chronic dieting on a variety of popular diet plans. Holding the belief that life will be better if they can lose weight. hiding food in strange places (closets, cabinets, suitcases, under the bed) to eat at a

later time. Vague or secretive eating patterns. Self-defeating statements after food consumption. Blames failure in social and professional community on weight. Holding the belief that food is their only friend. Frequently out of breath after relatively light activities. Excessive sweating and shortness of breath. High blood pressure and/or cholesterol. Leg and joint pain. Weight gain. Decreased mobility due to weight gain. Loss of sexual desire or promiscuous relations. Mood swings. Depression. Fatigue. Insomnia. Poor Sleeping Habits.

DSM-IV Diagnostic CriteriaDSM-IV Diagnostic Criteria

Bulimia Nervosa:1. Defined by recurrent episodes of binge

eating2. Self induced vomiting3. Occurs at least twice a week for 3

months4. Self- evaluation5. Does not occur exclusively during

episodes of Anorexia Nervosa

DSM-IV Diagnostic Criteria DSM-IV Diagnostic Criteria continuedcontinued

Purging type:Self induced vomiting or misuse of

laxatives or other medications

Nonpurging type:Person fasts and exercises excessively

and does not partake in self- induced vomiting or misuse laxatives or other medications

Prevalence RatePrevalence Rate

-About 1 in every 181 in the US are affected by bulimia nervosa

-Binge eating disorder affects 0.7-4% of the general population

-Binge eating usually occurs during or after a period of dieting

Environmental CausesEnvironmental Causes

Family DynamicsSocial FactorsCultural PressuresThe Media

Genetic CausesGenetic Causes

Eating Disorder behaviors are a symptom of underlying emotional distress.

Parents can add a lot of pressure on a child to excel by setting high standards and negative emotions are taught to be suppressed. In keeping with these high standards, people with eating disorders strive to be model students and lead perfect lives.

Biological factors that are associated with clinical depression can lead to the development of bulimia nervosa

Studies have shown an increased frequency of eating disorders if they are present in first degree biological relatives

Societies ImpactSocieties Impact

Thought to be around middle and upper classes Not completely true—increasing numbers of cases are seen in all types of

classes A studies results showed that Anorexia Nervosa was predominant in higher

classes while bulimia was distributed consistently throughout all classes Most prevalent in industrialized countries Western Vs. Nonwestern

Medscape's General Medicine 6(3) 2004, prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects.

Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing, presumably because of the influence, at least in part, of Western media: movies, TV shows, and magazines. Researchers conclude that the prevalence of eating disorders in non-Western countries is lower than that of Western countries, but it appears to be increasing.

Unrealistic ExpectationsUnrealistic Expectations

Average Woman Barbie Store Mannequin

Height 5’4” 6’0” 6’0”

Weight 145 lbs 101 lbs N/A

Dress Size 11-14 4 6

Bust 36-37” 39” 34”

Hips 40-42” 33” 34”

Waist 29-31” 19” 23”

Diversity: RaceDiversity: Race

Over the past few years there has been increasing evidence of disordered eating occurring among racial and ethnic minorities in the U.S. Contrary to the persistent belief that eating disorders affect only young white women. A study found that dieting was associated with weight dissatisfaction, perceived overweight, and low body pride in all ethnic groups.

African American girls may be especially vulnerable to develop a binge eating disorder African American girls age 11-14 scored higher on the Eating

Disorder Inventory than most white females. This scale measures features commonly associated with eating disorders.

A telephone survey found that African American women were just as likely as white women to report binge eating

Studies have also shown binge eating to be the most severe in Hispanics

Diversity: AgeDiversity: Age

2-3% of females affected by the illness are late adolescent to early adulthood

Lifetime prevalence in females is 1-3% Incidence and prevalence has increased in all age groups Prevalence is increasing among pre-pubertal girls A study has shown that 70% of sixth grade girls first became

worried about their weight at age 9 Eating disorders mainly affect people in their teens and twenties,

but studies have reported children as young as 6 and individuals as old as 76!

As baby-boomers in the U.S. grow older, there seems to be an increase in incidence of middle-aged women with an eating disorder, possibly because this group has consistently considered image to be of major importance.

In the U.S. the lifetime prevalence of bulimia is reportedly 3%. Bulimia Nervosa affects about 6% of adolescent girls and 5% of college women.

Diversity: GenderDiversity: Gender

Prevalence of bulimia nervosa in females is 1.1 to 4.2%

The prevalence rate in males is one tenth of that of females

5-15% of cases of eating disorders involve men in the US

85-95% of cases of eating disorders are among women in the US

Binge eating is prominent in females to males with a 3:2 ratio

The Good, the Bad, the UglyThe Good, the Bad, the Ugly

Positives

Initial weight loss can improve athletic performanceTemporary positive feedback from friends, coaches, and family.Gives a false sense of controlGives temporary relief to anxiety

Negative

Heart problemsThreat of Female TriadMuscle deteriorationImbalance electrolytesDehydrationKidney ProblemsMood swingsDepressionIsolationDeath………..and the list goes on and on

TreatmentTreatment

The treatment team that usually consists of a Dietitian, Psychiatrist, and a Physician

There are also treatment facilities available but good ones are hard to find around the U.S.

***One of the major ongoing debates with treatment of an eating disorder is that most insurance will not cover it. This puts families in a hard position if they cannot afford the treatment****

Community ProgramsCommunity Programs

Get Help!

There are MANY treatment facilities in Alabama

The Medical Center in Auburn University

RecoveryRecovery

With treatment 60% fully recover40% still struggle

Without treatment, up to 20% of people with serious eating disorders die. That number falls to 2-3% with treatment!!!

ExtrasExtras

HBO: ThinPro-Eating Disorder Websites

http://community.livejournal.com/proanorexia

SourcesSources

ANRED. Anorexia Nervosa and Related Eating Disorders, Inc. 2005.http://www.anred.com. 3 April 2007.

Something Fishy Website on Eating Disorders. 2006. http://www.somethingfishy.org. 3 April 2007.