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  1. Bulimia nervosa & anorexia nervosa. Name some characteristics.
    Disruptions in eating behavior (evenly distributed among peers & across the world).

    Fear of gaining weight.
  2. What is the most common eating disorder in our society? (Not a biological disorder)

    What % of US adults are overweight?

    % obese?

    65% overweight

    30% obese
  3. Bulimia Nervosa. What is it?

    What are the compensatory behaviors?

    Belief that _____ and _____ are determined by _____ and _______.
    Binge eating excess amounts of food, perceived as "out of control".

    • Compensator behaviors:
    • Purging
    • Excessive exercise
    • Fasting

    popularity, self-esteem, weight, body shape.
  4. Bulimia Nervosa-Clinical Desc.

    What are the subtypes of Bulimia Nervosa?

    Are most within 10% of normal weight?
    • Subtypes:
    • 1) Purging (most common but ineffective).
    • 2) Non-purging 6-8%

    Yes, within 10%
  5. What are some medical consequences in Bulimia Nervosa?

    • -Salivary gland enlargement
    • -Erosion of dental enamel
    • -Electrolye imbalance
    • -Kidney failure
    • -Seizures
  6. What are the associated psychological disorders with Bulimia Nervosa?
    • Anxiety 75%
    • -Social phobia & GAD

    Mood disorders (50-70%)

    Substance Abuse (36.8%)
  7. Anorexia Nervosa-Clincal Desc.

    Is their weight loss "overly-successful"?

    What are they fearful of?

    What is Anorexia characterized by?

    What does Anorexia often begin with?
    Yes, successful.

    Gaining weight & losing control of eating.

    Characterized by relentless pursuit of thinness.

    Begins with dieting.
  8. Anorexia Nervosa-Clinical Desc.

    What are the subtypes?
    • Subtypes:
    • 1) Restricting (50%)
    • 2) Binge-eating-purging (50%)

    *Body image disturbance, Pride in diet & control, rarely seek treatment.
  9. What are the medical consequences of Anorexia Nervosa?

    • Amenorrhea (3+ skipped periods)
    • Brittle hair & nailes
    • Lanugo (a coat of downy hairs)
    • Electrolyte imbalance
    • Sensitivity to cold temps.
  10. What are some associated psychological disorders of Anorexia Nervosa?
    • Anxiety
    • -OCD (higher rates)

    Mood disorders (33-60%)

    Substance abuse - suicide
  11. Do Bulimics or Anorexics have a higher rate of OCD?
  12. Binge-Eating Disorder. What is it?
    Food binges: high calorie intake.

    *NO compensatory behaviors
  13. Associated features of Binge-Eating Disorders?

    *Is it equally distributed across the sexes?
    • Many are obese.
    • Older.
    • More psychopathology than non-binging obese.
    • Concerned about shape & weight

    *Yes, equally distributed across the sexes.
  14. Bulimia & Anorexia stats.

    What % is Bulimic and female?


    Lifetime prevalence?

    Chronic if untreated?

    Usually live how many years or less?
    90-95% female (caucasian, middle to upper class)

    Onset: 16-19

    Females: 1.1%; college women: 6-8%

    Yes, chronic if untreated.

    30 years or less.
  15. Bulimia in men.

    What % in males?

    5-10% in males (caucasian, middle to upper class)

    *Gay or bisexual

    Athletes w/ weight regulations

    Onset: older
  16. Bulimia & Anorexia: stats. Anorexia.

    What % female is anorexia?

    90-95% female (caucasian, middle to upper class)

    Onset: 13-15
  17. Cross-cultural considerations.

    Immigrants to western cultures
    North American minority populations.

    • Immigrants to western cultures.
    • 1) Increase in eating disorders
    • 2) Increase in obesity
  18. Drug treatments of eating disorders.

    In Anorexia?

    In Bulimia?
    Anorexia: no demonstrated efficacy.

    • Bulimia: Anti-depressents (effective)
    • 1) May enhance psychological treatment
    • 2) No long-term efficacy
  19. Psychological treatment of Bulimia.

    CBT (3)

    Interpersonal Pychotherapy

    *Which works quicker?
    • CBT
    • 1) treatment of choice
    • 2) target problem eating behaviors
    • 3) target dysfunctional thoughts

    • IP
    • 1) improve interpersonal functioning
    • 2) similarly effective, long-term

    *CBT may work quicker than IP.
  20. Psychological treatment of
    Binge-eating Disorder.

    Medications & efficacy
    Prozac: no benefit

    Meridia: possible benefits

    Weight restoration: may require hospitalization.


    • Target dysfunctional attitudes
    • -body shape
    • -control
    • -thinness = worth
  21. Psychological Treatment of Anorexia (contd).

    How can the family involve themselves?

    Long-term prognosis?
    • Families can communicate about eating food.
    • Attitudes about body shape.

    *Long-term prognosis is poorer than bulimia.
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