Special cases

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Special cases
2010-09-03 14:57:58
orthorexia drunkorexia

Lecture #8
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  1. Orthorexia
    • unhealthy obsession with eating healthy food
    • fixation on healthy foods can lead to death
    • OCD and anorexia traits
  2. Drunkorexia
    • BN - binge on food and alcohol and then purge
    • AN - drink to calm down before eating or to ease the anxiety of having indulged in a meal
  3. Pregnancy
    • ED symptoms tend to decrease or remit completely during pregnancy
    • In most cases, symptoms of the ED return within 12 months after childbirth
    • Minority of women manage to remain symptom free
  4. Possible remission factors
    • Psychological
    • feeling of responsibility
    • changed body perception
    • differentiation of pregnancy from eating disorder
    • Social
    • network of family and friends
    • suport from the father of the baby
    • involvement of health care providers
    • Endocrinological
    • Changes in levels or activities of neurosteroids
    • involvement of sex hormones
  5. Consequences of ED while pregnant
    • miscarriages
    • low birth weight
    • premature delivery
    • obstetric complications
    • birth defects
    • perinatal mortality
  6. Binge eating in children
    • early eating patterns that are set as young as 2 years old
    • compounded by emotional and psychological changes
    • loss of control
    • dieting may not be associated with BE in children
  7. Signs and symptoms of BED in children
    • preoccupation with food and the next meal
    • eating more than usual, while saying he/she still hungry
    • eating rapidly/constantly
    • sneaking or hoarding food
    • feeling ashamed when confronted
    • excessive concern with weight and body shape
    • feeling lonely, depressed, worried
    • spending a great deal of time alone
  8. Body image in the elderly
    • assumption that body image issue diminish among elders -> NOT true
    • evidence suggests that concerns about aging and its effect on body weight and physical appearance are common in later life, particularly among older women
  9. Research on the elderly
    • body weight concerns ranked SECOND behind memory loss as a central issue
    • weight related issues are a major source of dissatisfaction among older women
    • increased difficulty of weight loss is highly frustrating
  10. Gender themes
    • body as one entity, as a whole
    • body as many distinct parts
    • important of looking good
    • importance of being able to do
    • aging has a negative impact
    • aging is associated with decreased emphasis on appearance
  11. Body As One Entity, As a Whole
    • men tended to evaluate and discuss the body as a singular and complete object
    • women tend to take apart their body and pay attention to certain aspects
  12. body as many distinct parts
    • evident in all women's account regardless of whether the overall evaluation was negative or positive
    • focused on distinct parts of the body
  13. importance of looking good
    • importance of the body as an object of display
    • emerges in both men and women
    • more prevalent in women
  14. importance of being able to do
    • body is important b/c of what it allows the person to do
    • found exclusively in mens accounts
    • men look at their body as a function
  15. Aging has a negative impact on appearance
    dominantly mentioned by women
  16. aging is associated with decreased emphasis on appearance
    • found exclusively among women
    • women said that as they got older there was less pressure on them to look good
  17. ED in elderly
    • presents similarly in the elderly and the young
    • difference -> elderly tend to use laxatives instead of vomiting
  18. Unique challenges of elderly
    • medical problems that affect their ability to consume food
    • lost of smell or taste, swallowing problems, or medication that reduce apetite
    • memory problems -> forget if they ate
    • social problems
  19. Contributing factors of elderly
    • loss of independence, coupled with death of spouses
    • undiagnosed depression
    • anger -> men
  20. Diabetes and ED
    • Type I -> insulin dependent (no production of insulin)
    • Type II -> non-insulin dependent (insulin receptors desensitized
  21. Diabulimia
    • Type I: omit necessary daily insulin to lose weight or compensate for a binge (do not absorb glucose)
    • glycosuria - when body has too much glucose and excretes it out through urine
    • insulin omission in the service of weight control has been found to avg 11-15% in type I women
    • BE commonly linked to insulin omission
    • women with clinical ED and Type I, ranged from 53-85%
  22. Digestion of sugars
    stomach changes food to glucose -> glucose enters blood stream -> pancreas makes little or no insulin -> no insulin enters bloodstream -> glucose builds up
  23. Comorbid psychiatric disorders
    • affective disorders
    • anxiety
    • personality
    • impulse control
    • substance abuse
  24. affective disorders
  25. anxiety disorders
    • generalized anxiety disorder - constant anxiety
    • social phobia - afraid to be around other people
    • panic disorder - panic attacks
    • OCD
    • obsessions - recurring and persistent thoughts which cause distress
    • compulsions - feeling the need to repeat physical behaviors in response to obsessions
  26. Personality disorder
    • Cluster A - paranoid, schizoid -> not associated with ED
    • Cluster B - dramatic, emotional, erratic
    • borderline, antisocial, histrionic
    • BN, AN-BP type
    • Cluster C - anxious, fearful
    • avoidant, dependent, obsessive compulsive
    • AN-restrctive
  27. Impulse control disorders
    • impulses = impelling forces or sudden spontaneous inclinations or urges
    • substance abuse
    • self-injury
    • habitual and repetitive
    • episodic and gratifying
  28. substance abuse
    • prevalence of drug and alcohol abuse occurs in 50% of those with an ED compared to 9% in general population
    • 35% of those with substance abuse report having an ED, while 1-3% in general population