Anorexia Nervosa

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Anorexia Nervosa
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What is beauty or attractiveness to you?
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Researchers that relate size and shape of women
to their physical attractiveness use BMI WHR

• BMI Standard measure of weight, calculated by
  dividing weight in kilograms by height in meters
  squared.
• BMIs below 18.5 are considered underweight.
• BMIs from 18.5 to 25 are normal weight
• BMIs from 25 to 30 overweight
• BMIs over 30 are obese

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WHR Waist-to-hip Ratio

• WHR is calculated by dividing waist circumference
  by hip circumference
• Young adult women fall in the .70 to .90 range.
• Adult men fall in the range of .80 to .95

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Differences in waist to hip ratio

• They are usually due to hormonal differences,
  with circulating ESTROGEN causing fat cells
  accumulation of in the hip region and inhibiting
  fat accumulation in the waist region!
• Testosterone causes accumulation of fat cells
  around the waist and inhibits fat deposits in the
  hip region.

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Differences in female and male shape

• AHA!! Its largely due to the difference of
  estrogen and testosterone in our bodies! They
  allow each sex to carry their weight in different
  places.

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Womens Ideals

• In this research the ideal was 20.3, which is at
  the low end of normal.
• In self ratings overweight BMI rated themselves
  as least attractive, while women who were
  underweight rated themselves as most attractive.

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Men are more likely to participate in
binge eating and purging than women. The binge
eating is societally more accepted for men than
women.Mens body concerns are different than
womens. Women often wanting thinness or
leanness. While men want muscularity for their
bodies.
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If being underweight is correlated with being
attractive, no wonder we have a drive to be thin!
Our society believes THIN IS INResults in
increased social pressure to be thin and body
dissatisfaction, which putatively lead to
dieting, negative affect, and consequent
increased risk for eating pathology
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The drive to being thin comes from a
variety of areas in both women and mens lives.
The need to be a societys ideal is so strong,
that people often develop eating disorders.
-Anorexia Nervosa-Bulemia
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Anorexia Nervosa

• Weight 15 below ideal body weight. Refusal to
  maintain a normal weight or above normal weight
  for height and age. Not everyone who is of a low
  weight is anorexic it is important to recognize
  that it is the REFUSAL to maintain a normal
  weight that is the key factor.

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Self evaluation quiz for Anorexia

• Are you constantly thinking about your weight and
  food?
• Are you dieting strictly and/or have you lost a
  lot of weight?
• Are you more than 10 below your healthy weight?
• Are people concerned about your weight?
• Is your energy level down?
• Do you constantly feel cold?

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Types of Anorexia

• Many individuals with anorexia will severely
  restrict their calories sometimes taking in only
  a few hundred calories a day or just water. This
  is called the RESTRICTING TYPE. Our bodies do not
  like to starve. Remember, the individual with
  anorexia has an appetite they just try to control
  it. It is very difficult when you are starving
  not to want to eat. What happens to many as a
  result is that they lose control they eat or eat
  something they feel they should not have eaten.
  For these individuals, this might mean something
  as simple as a cookie, a normal meal or even a
  binge. With the fear of gaining weight, they may
  vomit or exercise. This type of anorexia is
  called the BINGE-EATING/PURGING TYPE one of the
  most dangerous forms of an eating disorder

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Symptoms of Anorexia

• ANOREXIA NERVOSA
• Deliberate self-starvation with weight loss
  Intense, persistent fear of gaining weight
  Refusal to eat or highly restrictive eating
  Continuous dieting Excessive facial/body hair
  because of inadequate protein in the diet
  Compulsive exercise Abnormal weight loss
  Sensitive to cold Absent or irregular
  menstruation Hair loss

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PHYSICAL REPERCUSSIONS FROM ONE OR BOTH
DISEASES Malnutrition  Dehydration
Ruptured stomach Serious heart, kidney, and
liver damage Tooth/gum erosion Tears of the
esophagus 
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  PSYCHOLOGICAL REPERCUSSIONS FROM
BOTH DISEASES Depression Low self-esteem
Shame and guilt Impaired family and social
relationships Mood swings Perfectionism
'All or nothing' thinking

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Are your periods abnormal or have your periods
stopped? Are you overeating and feeling
out of control?Are you vomiting, using laxatives
or water pills, herbal agents, or trying to fast
as a way to control your weight?Are you over
exercising or do others consider your excercise
excessive ?Does your weight drastically
fluctuate?Do any of the above interfere with
your enjoyment of life, relationships, or
everyday functioning?
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Figures on Anorexia

• AGE AT ONSET OF ILLNESS86 report onset of
  illness by the age of 20 10 report onset at
  10 years or younger 33 report onset between
  ages of 11-15 43 report onset between ages of
  16-20DURATION OF ILLNESS/MORTALITY 77
  report duration from one to fifteen years 30
  report duration from one to five years 31
  report duration from six to ten years 16
  report duration from eleven to fifteen years It
  is estimated that six percent of serious cases
  die Only 50 report being cured 

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Death rates of Anorexia

• Young women that have anorexia nervosa are 12
  times more likely to die other women her age
  without anorexia. Anorexia has the highest
  mortality rate of all mental disorders. The
  mortality rate is about 5 for each decade and
  increases up to 20 for patients that have the
  illness for more than 20 yrs.

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Anorexia effects the body in a variety of
ways. . There are problems associated with mental
functioning, the heart, esophagus, stomach,
intestines, mouth, and endocrine system.
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Psychological Problems Associated with Anorexia

• -Feeling dull -Feeling Listless -Difficulty
  concentrating or focusing -Difficulty regulating
  mood-Associated mental disorders depression,
  anxiety disorders, obsessive-compulsive disorder,
  substance abuse

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Medical Issues

• Cardiovascular (Heart)
• -Slow irregular, pulse -Low blood
  pressure-Dizziness or faintness -Shortness of
  breath -Chest pain -Decreased potassium levels
  may result in life threatening cardiac
  arrhythmias or arrest-Electrolyte imbalances may
  lead to life threatening cardiac arrhythmias or
  arrest
• Muscular Skeletal (Bones) -Stunted growth in
  children -Stress fractures and broken bones
  more likely-Osteoporosis

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More Medical Issues

• Mouth
• -Enamel erosion -Loss of teeth-Gum disease
  -Chipmunk cheeks- swollen salivary glands from
  vomiting -Sore throat because of induced
  vomiting
• Esophagus
• -Painful burning in throat or chest -May vomit
  blood from small tear(s) in esophagus -Rupture
  of the esophagus, may lead to circulatory
  collapse and death 
• Endocrine System
• -Thyroid abnormalities-Low energy or fatigue
  -Cold intolerance -Low body temperature -Hair
  becomes thin and may fall out -Development of
  fine body hair as the bodys attempt to keep warm

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Yet Even More Medical Issues

• Stomach
• -Stomach may swell following eating or binging
  (causes discomfort and bloating) -Gastric
  rupture due to severe binge eating (gastric
  rupture has an 80 fatality rate)-Vomiting
  causes severe electrolyte imbalance which can
  lead to sudden cardiac arrest.
• Intestines
• -Normal movement in intestinal tract often slows
  down with very restricted eating and severe
  weight loss-Frequent Constipation-Chronic
  irregular bowel movements

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Study done testing the motor functions in rats
with DR( Dietary Restrictions)

• Rats had a lower level of accuracy while on a
  restricted caloric diet
• During DR animals became frantic and made
  repeated attempts to grasp a single pellet.

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Other Problems

• DR may also disrupt reproductive cycles in both
  male and female rats, often causing delayed onset
  of puberty and decrease in fertility.
• Could this be for humans too? Yes!

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Yet more problems

• Negative effects of DR are sometimes more
  apparent in younger animals.
• Food is scarce or severely restricted,
  reproductive performance, growth, and immune
  responces are sacrificed
• Leaves animals prone to infection, reduced
  growth, hormonal imbalances, or permanent
  neurological deficit.

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Both in humans and rats

• Dietary restrictions often lead to preoccupation
  with food, irritability, and overeating upon
  presentation of food
• In anorexia, there is often a preoccupation of
  thinking about food, and their episodes of
  purging.

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• Food restrictions acts a cellular stressor to
  metabolic substrate deprivation
• Increase in levels of plasma corticosterone
• Increase in adrenal gland weight
• Decrease in glutocotropin receptors
• Increase of responcivity to stress inducing
  procedures

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Why all of this?

• It has been suggested that behavioral alterations
  during DR are due to hypothalmic-pituitary-adrenal
  axis and changes in level of stress hormone.
• Fewer and shorter synapses in sensorimotor
  cortex.

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Therapy

• There are over 400 schools of psychotherapy, each
  claiming a distinct theory and set of treatment
  technique. Psychodynamic and cognitive-behavioral
  therapies probably represent the most widely
  used.
• There is no one definitive form of therapy
  recommended for eating disorders. Often the
  therapist will evaluate where the patient is. For
  some individuals, they may be very knowledgeable
  and have had experience with some intervention.
  For others, it is a totally new experience

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Resources

•  Moradi B, Dirks D, Matteson AV. Roles of sexual
  objectification experiences and internalization
  of standards of beauty in eating disorder
  symptomatology A test and extension of
  objectification theory. Journal of Counseling
  Psychology. 2005 52(3)420-428
•  Ricciardelli LA, McCabe MP, Holt KE, Finemore J.
  A biopsychosocial model for understanding body
  image and body change strategies among children.
  Journal of Applied Developmental Psychology.
  2003 24(4)475-495.

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Continuation of Resources

• Smith LK, Metz GA. Dietary restriction alters
  fine motor function in rats. Physiol Behav. 2005
  85(5)581-592
• Weeden J, Sabini J. Physical attractiveness and
  health in western societies A review. Psychol
  Bull. 2005 131(5)635-653
• http//www.anad.org/site/anadweb/
• National Association of Anorexia Nervosa and
  Other Associated Disorders