Body Image and Disordered Eating

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Body Image and Disordered Eating

• Developed by
• Counseling Wellness Services for the Department
  of Housing
• Residential Education

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Session Outline

• Body Image
• Eating Disorders
• Warning signs and tips
• Resources

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What is body image?

• An inner view of your outer self
• Not based on reality
• Four components
• Visual
• Mental
• Emotional
• Kinesthetic

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Positive Body Image

• Doesnt measure worth by weight / size
• Doesnt buy into ideal or perfect body
• Realistic ? Proud ? Expressive ? Comfy

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Fostering Positive Body Image

• Promote body acceptance in
• Ones self
• Ones community
• The media
• Replace criticism with forgiveness
• Health comes in EVERY size
• Use positive self-talk
• Body criticisms sabotage a healthy lifestyle

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Negative Body Image

• Visual ? distorted, unrealistic view
• Mental ? feel ugly compared to ideal
• Emotional ? ashamed, self-conscious
• Kinesthetic ? uncomfortable, not expressive

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Fostering Negative Body Image

• Social ? internalization of ideal body
• Psychological ? low self-esteem, depression
• Interpersonal ? abuse, troubled family life

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And the Consequences?
Depression
Emotional distress
Substance abuse
Disordered eating patterns
Low self-esteem
Eating Disorders
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Some statistics
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Eating Disorders

• Severe disturbances in eating behavior
• Extreme concern about body size, shape
• Risk Factors
• Biological
• Psychological 50-75 with history of depression
• Developmental
• Social

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And the Consequences?
Infertility
Stunted growth
Damage to heart and brain
Vitamin and mineral deficiencies
Cardiac arrest
Emotional problems
Depression
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Anorexia Nervosa (AN)

• APA Diagnostic Criteria
• Refusal to maintain normal BMI (18.5 24.9)
• Intense fear of gaining weight
• Negative body image and denial
• For women amenorrhea (loss of period) (about to
  change)
• Restricting Type vs. Binge-Eating/Purging Type

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Anorexia Nervosa (AN)

• Whats the big deal?
• The highest mortality rate of any psychiatric
  condition
• 5 10 of people with AN die within 10 years
• 18 20 will be dead after 20 years
• Only 30 40 ever fully recover

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Anorexia Nervosa (AN)

• Warning signs
• Clinical (what a doctor or RD sees)
• Abnormal weight loss or underweight BMI
• Low blood pressure/pulse
• Muscle wasting
• Bone loss
• Dehydration or excessive hydration
• Fainting/dizziness
• Hair loss or abnormal hair growth (lanugo)
• Loss of period

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Anorexia Nervosa (AN)

• Warning signs
• Behavioral (What a friend/family member sees)
• Dieting or restricting when not overweight
• Negative body image, feels fat
• Preoccupied with food, calories, nutrition
• Denies hunger cues (doesnt eat when hungry)
• Exercises excessively
• Frequent weighing
• Feels bloating/nausea after normal amounts of food

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Bulimia Nervosa (BN)

• APA Diagnostic Criteria
• Recurrent binge eating
• Recurrent compensation for binges
• Negative body image
• Normal, overweight or obese BMI (gt24.9)
• Purging Type vs. Non-Purging Type

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Bulimia Nervosa (BN)

• Prevalence 1 - 4.2 in US females
• For men prevalence ratio 16 - 110

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Bulimia Nervosa (BN)

• Warning Signs
• Clinical
• Electrolytes, throat/teeth, kidneys, fatigue,
  period, hair
• Behavioral
• Eating without weight gain, bathroom, emotions,
  weight, mood

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Binge Eating Disorder (BED)

• Not defined by APA Diagnostic Criteria (EDNOS)
• Recurrent binge eating
• Eating rapidly until uncomfortable, often when
  not hungry. Eating alone and feeling disgusted or
  shameful
• Distress about binge eating
• Two days a week for 6 months? (about to change)
• No compensatory behavior

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Binge Eating Disorder (BED)

• Whats the big deal?
• Prevalence Estimated at 2
• Most common eating disorder
• In morbidly-obese treatment-seeking populations
  prevalence of 25

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Binge Eating Disorder (BED)

• Warning signs
• Clinical
• Weight gain, blood pressure, cholesterol,
  diabetes
• Behavioral
• Depressed, late-night, secretive eating, low
  self-esteem, avoids social/sexual contact, copes
  with food

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Spectrum of Disordered Eating
Hates his body
Bigorexia
Fasts for one week a month
Throws up once a month
Orthorexia
Pregorexia
Exercises three times a day
Binges on chocolate cake and pie every Friday
night
Obsesses about food
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Treating Eating Disorders

• How do you think eating disorders should be
  treated?

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Treating Eating Disorders

• Individualized therapy
• Team Approach
• MD
• Psychotherapist/Psychiatrist
• Registered Dietitian

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OK so, how do I talk about this?

• Educate yourself!
• Be caring and nonjudgmental
• Expect anger
• Continue to offer support
• Do not accept disordered eating behaviors
• Inform RA or parents if she or he is in trouble
• Offer resources CWS, CHS,
  something-fishy.com

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Resources

• Counseling Wellness Services
• http//campushealth.unc.edu/cws
• Campus Health Services
• http//campushealth.unc.edu
• PACE (Pathway to Awareness in College Eating)
• http//www.pace.unc.edu/
• Something Fishy
• http//www.something-fishy.org

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Events at UNC-Chapel Hill

• Love Your Body Day October
• National Eating Disorders Awareness Week
  February
• Carolina Womens Center Various events
• SHAPE (Students Helping to Achieve Positive
  Esteem)

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For questions contact

• Antonia Hartley, MPH, RD, LDN
• Clinical Nutrition Specialist
• UNC Campus Health Services
• Appointments 919.966.2281
• Email antonia_at_email.unc.edu
• Follow her on Twitter! _at_UNCNutrition