Michigan Merit CurriculumStrand 1: Nutrition and Physical Activity

1.2 Distinguish between unhealthy and healthy ways to manage weight.

1.3 Identify and locate valid and reliable resources in one’s community and on the internet for nutrition information, nutrition services, and help with weight management or unhealthy eating patterns.

OBJECTIVESWhat is an eating disorder?Why do some people have eating disorders?List the health hazards of anorexia, bulimia, and pica.Describe the characteristics of individuals most at risk of anorexia or bulimia.

AVERAGE WOMAN

BARBIE STORE MANNEQUIN

HEIGHT 5’4” 6’0” 6’0”

WEIGHT 145 lbs 101 lbs Not available

DRESS SIZE 11 - 14 4 6

BUST 36 – 37” 39” 34”

WAIST 29 – 31” 19” 23”

HIPS 40 – 42” 33” 34”

About 60% of Americans, both males and females About 60% of Americans, both males and females are overweight. About one-third (34%) are obese.are overweight. About one-third (34%) are obese.

Anorexia and bulimia also occur in children as Anorexia and bulimia also occur in children as young as six and individuals as old as seventy-sixyoung as six and individuals as old as seventy-six

About 72% of alcoholic women younger than 30 About 72% of alcoholic women younger than 30 also have eating disorders.also have eating disorders.

An eating disorder occurs when a person’s life revolves around weight and food◦Some people eat too little. This is called

restrictive eating.◦ Some people eat too much at one time. This is

called binge eating.◦Some people binge and purge. They vomit or

use laxatives to get rid of the food they eat.◦ Some people exercise to excess (also called

obsessive or compulsive exercise). They feel anxious or angry if they miss a day, even if they’re injured or sick.

What is an eating disorder?• Anorexia, bulimia, and binge

eating are all eating disorders. • They involve serious medical

and emotional issues. A person with an eating disorder needs help.

• Many people have eating, exercise and body image problems that are unhealthy but don’t fit the criteria for an eating disorder.

Disorders eating, female athletic triad and muscle dysmorphia are examples.

Problems with eating and exercise can be treated. The sooner people get help, the more likely they will recover fully.

What is an eating disorder?

Causes of eating disorders:• Dieting may be the

first step in some cases. But many people diet without developing eating disorders.

• Body image is a big factor. Society’s focus on thinness has a big impact. Many people risk their health to look like the models and actors they see in the media.

CausesEmotional issues are behind most eating disorders. Some people use food and exercise to feel in control. Others eat in response to stress. Some people switch between eating too little and eating too much. It is very important to get help w/ the issues behind an eating disorder.

Who’s at risk?Young women are at highest risk for

eating and body image problems. But women of all ages, as well as men, can have problems too.

People most at risk may have:Low self- esteem and/or depressionProblems with family or friendsA desire to be “perfect”Family or friends who focus on weightActivities or careers that require a certain

body type or weight (modeling, dancing, weight lifting, wrestling)

What are the Signs?A person may not be happy with

his/her body…He or she might:

Hate the thought of any body fatExercise often to burn caloriesUse steroids or supplements

What are the signs continuedA person may have odd eating habits

She or he might:Skip meals oftenEat at meal times, but cut back a lot on food at one or all meals

Eat the same thing day after day or meal after meal

Have conflicts with family and/or friends over how much or when to eat

What are the signs continuedA person may have issues with food

She or he might:Think about food all the timeHave secret eating binges and feel unable to stop

Vomit or use laxatives and/or diuretics after eating

*If you or a friend has some of these signs, talk to a counselor or other health professional. They can help

If you think a friend may have a problem, there are things you can do to help. Focus on the positive:

▪ Express concern. Talk about your friend’s health & happiness rather than his/her eating behaviors.

▪ Be patient and be there. Listen & care. Point out strengths & praise talents.

▪ Encourage your friend to seek professional help. Offer to go along to the first visit.

Avoid the negative:▪ Don’t give advice (unless asked for it). Don’t nag or criticize.

▪ Don’t be part of talk that focuses just on food, body size or weight.

▪ Don’t expect your friend to change overnight. Change can take time.

Some or all of these people may team up to help: Internists & family practice physicians

can check health statusTherapists, social workers & counselors

can help people deal with the issues behind the problem

Dietitians can help set new eating patterns & increase the variety of foods eaten

Support groups can’t replace professional treatment. But they can provide contact with people who understand

Hospital care may be needed if there severe medical or mental concerns.

Anorexia: not eating enough to keep a healthy body weight. Can be life threatening.

• Warning signs– Physical/feelings

• Weight loss to below 15% or normal weight

• Extreme fear of gaining weight

• Loss or menstrual cycle• Sensitive to cold. Feels

tired & weak• Depressed, low self-esteem

and/or poor body image.

Anorexia Continued• Warning signs

• Eating & exercise habits

• Eats too little at one time

• Denies hunger and skips meals

• Some must exercise every day

• May binge and purge

Anorexia Continued

• What can happen over time?– Damage to heart, brain and

kidneys– Not able to have children– Brittle, weak bones– Problems w/hair, nails, and

skin– Death from cardiac arrest,

starvation or suicide

Bulimia: What is it?Eating too much at one time (binge eating.

Then purging by vomiting, taking laxatives or exercising a lot to get rid of the food.

Can be life-threatening

Bulimia

• Warning SignsPhysical/feelings: Usually at or near normal

body weight Teeth lose enamel. Cheeks

swell. Hands and fingers get calluses

Loss of menstrual cycle Tired and weak. Fainting spells Depressed, low self-esteem

and/or poor body image

• Warning Signs• Eating and exercise habits• Eats too much at one time.• Eats in secret.• Purges by vomiting, using

diuretics or laxatives, or exercising too much.

• Thinks a lot about food and weight.

Bulimia

Erratic heartbeat and heart damage.

Irritation or bleeding of the throat from vomiting.

Cramping, constipation or nausea.

Problems with hair, nails and skin.

Brittle, weak bone.Death from cardiac arrest or

ruptured stomach.

Bulimia: What can happen over time?

Binge eating/compulsive overeating• What is it?

– Eating too much at one time on a regular basis• Warning Signs

– Physical/feelings• Usually overweight or obese• Feels out of control• Frequent weight changes• Depressed, low self-esteem

Binge eating/compulsive overeatingWarning signs:Eating & exercise habits

• Must eat, even when not hungry• Eats too much or too little at one time• Eats late at night• Often doesn’t exercise

• What can happen over time– Frequent weight changes can damage health– Increased risk for type 2 diabetes– Increased risk for heart disease

Disordered eating• What is it?

– Eating too little or too much at one time. Unusual food and exercise habits.

• Warning Signs– Physical/feelings

• Poor body image• Tired and weak• Weight changes

Disordered eating• Warning Signs

– Eating and exercise habits• Skips meals• Eats too little or too much at one time• Thinks a lot about food and weight• Some must exercise every day

• What can happen?– Shows early signs of an eating disorder– Can turn into full-blown eating disorder

Female Athlete Triad• What is it?

– Seen in physically active women. Includes disordered eating, loss or menstrual cycle & weaker bones

• Warning Signs– Physical/feelings

• Low body weight• Tired and weak• Decreased athletic performance• Frequent injuries. Stress fractures• Depression

Female athlete triad• Warning signs

– Eating and exercise habits• Restricts eating• Binge eats and then purges• Thinks a lot about food and weight• Must exercise every day

• What can happen?– Can shorten or ruin athletic career– Has medical problems that go with an eating

disorder– Brittle, weak bones. Unusual fractures.

Muscle Dysmorphia• What is it?

– Distorted body image. Person feels small, in spite of being muscular.

• Warning Signs– Physical/feelings

• Muscular build• Uses anabolic steroids• Feels ashamed of body

Muscle Dysmorphia• Warning signs:

– Eating & exercise habits• Weight lifting & related activities become the focus of

life• Restricts diet. Eats a very high-protein diet• Must exercise every day• Uses herbal & diet supplements

• What can happen?– Steroids can damage the heart, brain & other vital organs– Unknown risks from using supplements not approved by

FDA (food & drug administration)

Steps to Recovery• An eating disorder can be life-threatening.• People who get better usually take these

steps:– These notice they have a problem with

eating & body image– They get professional help from someone

trained to treat eating disorders– They learn about eating. They learn how

to nourish their bodies with a wide variety of foods. They learn how much food their bodies really need.

Steps to Recovery– They learn about feelings.

They learn how they’ve used food to cope. They learn other ways to express & deal with their feelings.

– They learn to accept their bodies. They learn to value themselves for who they are, not for how they look or what they weigh.

To learn more…• Academy for eating disorders

– 718 920 6782– www.acadeatdis.org

• Anorexia nervosa & related eating disorders– 847 831 3438– www.anred.com

• The national eating disorders association– 206 382 3587– www.edap.org

• The national eating disorders screening program– 781 239 0071– www.nmisp.org

Pica• An eating disorder in n eating disorder in

which a person eats which a person eats nonfood substances nonfood substances like starch, clay, or like starch, clay, or soil.soil.

• This disorder usually This disorder usually occurs among occurs among pregnant women.pregnant women.

• The health dangers The health dangers result from eating result from eating harmful bacteria.harmful bacteria.

February 19, 2004: Western France

French doctors were taken aback when they discovered the reason for a patient’s sore, swollen belly. He had swallowed around 350 coins – $650 worth – along with assorted necklaces and needles.

Doctors we awed when they took an Doctors we awed when they took an X-ray. They discovered an X-ray. They discovered an enormous mass in his stomach that enormous mass in his stomach that turned out to weigh 12 pounds – as turned out to weigh 12 pounds – as much as some bowling balls. The much as some bowling balls. The weight forced his stomach down weight forced his stomach down between his hipsbetween his hips!

He died 12 days later. His family tried to keep coins and jewelry away from him. When he was invited and came in some homes, he liked to steal coins and eat them.

The patient’s rare condition is called PICA, a compulsion to eat things not normally consumed as food. Eating dirt, ashes, chalk, hair, soap, toothbrushes, burned matches and many other things.

PICA is best known in children and pregnant women but also linked to psychiatric illness.

Things To Say and Not Say to People With Anorexia

NOT SAYNOT SAY: “You look so thin!” They will : “You look so thin!” They will interpret this as a compliment and victory!interpret this as a compliment and victory!

““You should get help.” Anyone with an You should get help.” Anyone with an eating disorder clings to it like a lifeboat. eating disorder clings to it like a lifeboat. “Help” suggests taking the lifeboat away, “Help” suggests taking the lifeboat away, and they will resist and restrict more.and they will resist and restrict more.

SAY: Feel free to share your PERCEPTIONS SAY: Feel free to share your PERCEPTIONS AND FEELINGS:AND FEELINGS:

““I’m really scared about how you look.”I’m really scared about how you look.”

I’m really frightened about what you are I’m really frightened about what you are doing to yourself.”doing to yourself.”

I really miss the fun friend you used to be.”I really miss the fun friend you used to be.”

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