Over one-half of teenage girls and one-third of teenaged boys use unhealthy weight control behaviors such as skipping meals, smoking, fasting, vomiting, or taking laxatives
42% of 1st-3rd grade girls want to be thinner
81% of 10 year olds are afraid of being fat
The average woman is 5’4’’ and weighs 140 pounds. The average supermodel is 5’11’’ and weighs 117 pounds.
Americans spend over $40 billion on dieting and diet related products each year
Characterized by excessive weight loss
Preoccupation with foods, progressing restrictions against whole categories of food
Anxiety about gaining weight or being “fat”
Denial of hunger
Consistent excuses to avoid mealtimes
Excessive, rigid exercise regimen to “burn off” calories
Withdrawal from usual friends
Resistance to maintaining body weight at or above a minimally normal weight for age and height
Intense fear of weight gain or being “fat” even though underweight
Disturbance in the experience of body weight or shape on self-evaluation
Loss of menstrual periods in girls and women post-puberty
What do counselors look for?
Rapid loss of weight
Change in eating habits
Withdrawal from friends or social gatherings
Hair loss or dry skin
Extreme concern about appearance or dieting
Most cases are in women ranging in age from early teens to mid-twenties
Recently there have been more cases of women and men in 30’s and 40’s suffering from an eating disorder
40% of newly identified cases are in girls 15-19
Significant increase in women aged 15-24
Prevalence in Population
0.5%-1% of women from late adolescence to early adulthood meet the full criteria for anorexia
Even more are diagnosed under a subthreshold
Limited data on number of males with anorexia
10 million people have been diagnosed with having an eating disorder of some type
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
-eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
-a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Eating large amounts of food uncontrollably (binging)
Vomiting, using laxatives, or using other methods to eliminate food (purging)
Excessive concern about body weight
Depression or changes in mood
Irregular menstrual periods
Unusual dental problems, swollen cheeks or glands, heartburn, or bloating (swelling of the stomach)
Warning Signs That Counselors Look For
Evidence of binge eating
Evidence of purging behaviors
Excessive, rigid exercise regimen
Unusual swelling of the cheeks and jaw area
Calluses on the back of the hands and knuckles from self-induced vomiting
Discoloration or staining of teeth
Warning Signs That Counselors Look For
Creation of lifestyle schedules and rituals to make time for binge-and-purge sessions
Withdrawal from friends and activities
In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns
The average onset of Bulimia begins in late adolescence or early adult life
Usually between the ages of 16 and 21
However, more and more women in their 30s are reporting that they suffer from Bulimia
The prevalence of Bulimia Nervosa among adolescent and young adult females is approximately 1%-3%.
The rate of occurrence in males is approximately one-tenth of that in females.
Bulimia Nervosa *onset and course
usually begins in late adolescence or early adult life and affects 1-2% of young women
90% of individuals are female
frequently begins during or after an episode of dieting
course may be chronic or intermittent
for a high percentage the disorder persists for at least several years
periods of remission often alternate with recurrences of binge eating
purging becomes an addiction
Bulimia Nervosa *onset and course cont..
occurs with similar frequencies in most industrialized countries
most individuals presenting with the disorder in the U.S. are Caucasian.
only 6% of people with bulimia receive mental health care
the incidence of bulimia in 10-39 year old women TRIPLED between 1988 and 1993
Health Consequences of Bulimia Nervosa:
Causes electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
Inflammation and possible rupture of the esophagus from frequent vomiting.
Tooth decay and staining from stomach acids released during frequent vomiting.
Chronic irregular bowel movements and constipation as a result of laxative abuse.
Gastric rupture is an uncommon but possible side effect of binge eating.
Anorexia Nervosa *onset and course
mean age at onset is 17 years
affects about 1% of all females in late adolescence and early adulthood
Media messages help to create the context within which people learn to place value on the size and shape of their body.
Advertising and celebrity spot lights scream “thin is in,” defining what is beautiful and good.
Media has high power over the development of self-esteem.
Some Basic Facts About the Media’s Influence in Our Lives:
According to a recent survey of adolescent girls, the media is their main source of information about women’s health issues
Researchers estimate that 60% of Caucasian middle school girls read at least one fashion magazine regularly
Another study of mass media magazines discovered that women’s magazines had 10.5 times more advertisements and articles promoting weight loss than men’s magazines did
A study of one teen adolescent magazine over the course of 20 years found that in articles about fitness or exercise plans, 74% cited “to become more attractive” as a reason to start exercising and 51% noted the need to lose weight or burn calories
The average young adolescent watches 3-4 hours of TV per day
A study of 4,294 network television commercials revealed that 1 out of every 3.8 commercials send some sort of “attractiveness message,” telling viewers what is or is not attractive (as cited in Myers et al., 1992). These researchers estimate that the average adolescent sees over 5,260 “attractiveness messages” per year.
Chemical imbalances in the neuroendocrine system
these imbalances control hunger, appetite, digestion, sexual function, sleep, heart and kidney function, memory, emotions, and thinking
Serotonin and norepinephrine are decreased in acutely ill anorexia and bulimia patients
representing a link between depression and eating disorders
Excessive levels of cortisol in both anorexia and depression
caused by a problem that occurs in or near the hypothalamus
Assessment of Eating Disorders
By Becky Sosby
Assessing Eating Disorders
No specific tests to diagnose
No routine screening for eating disorders
Medical history, physical exam, and specific screening questions, along with other assessment tests help to identify eating disorders
What should an assessment include?
A full physical exam
Laboratory and other diagnostic tests
A general diagnostic interview
Specific interview that goes into more detail about symptoms