Eating Eating Disorders Disorders

PresentationPresentationBecky Brandsberg-Herrera MSW, Becky Brandsberg-Herrera MSW,

LCSWLCSW

University Counseling ServicesUniversity Counseling Services

785-4014785-4014

ucs.truman.eduucs.truman.edu

Goals of this PresentationGoals of this Presentation To discuss and understand the difference To discuss and understand the difference

between disordered eating and eating between disordered eating and eating disorders.disorders.

To understand main types of eating disorders.To understand main types of eating disorders. To learn why people develop eating disorders.To learn why people develop eating disorders. To understand the different approaches to To understand the different approaches to

treatment.treatment. To learn tips to help a student who may be To learn tips to help a student who may be

experiencing an eating disorder.experiencing an eating disorder. To leave with excellent resources for future To leave with excellent resources for future

reference.reference.

Disordered Eating vs. Eating Disordered Eating vs. Eating Disorders Disorders

A reaction to a A reaction to a life situation; a life situation; a habithabit

Absence of Absence of compulsive compulsive thoughts or thoughts or problems in problems in regular regular functioningfunctioning

Education, self-Education, self-help can result in help can result in changechange

An illnessAn illnessFrequent and Frequent and persistent thoughts persistent thoughts and behaviors about and behaviors about body, food and body, food and eating that lead to eating that lead to problems in regular problems in regular functioningfunctioningLife-threateningLife-threateningProfessional Professional intervention intervention

Eating Feelings, Attitudes Eating Feelings, Attitudes & Behaviors Continuum& Behaviors Continuum

Body Image Body Image ConfidenceConfidence

Preoccupation Preoccupation with body with body shape/size & shape/size & eatingeating

Distress Distress about body about body shape/size & shape/size & eatingeating

Eating Eating DisordersDisorders

Mostly positive Mostly positive feelings about body feelings about body shape/sizeshape/sizeNo “good” or “bad” No “good” or “bad” foodsfoodsRegular moderate Regular moderate exerciseexercise

Don’t like the way Don’t like the way parts of body look or parts of body look or consistently feel like consistently feel like losing a few poundslosing a few poundsFrequent thinking Frequent thinking about food, eating about food, eating and bodyand bodySometimes feel Sometimes feel guilty or bad for guilty or bad for what you have what you have eaten and may eaten and may “make up for it” “make up for it”

Thinking about Thinking about food, eating and food, eating and body interferes with body interferes with daily activitiesdaily activitiesRigidity in eating Rigidity in eating patternspatternsWorking hard to Working hard to change body and change body and compensating for compensating for eating (vomiting, eating (vomiting, fasting, extreme fasting, extreme exercising)exercising)No significant No significant weight lossweight loss

Anorexia NervosaAnorexia NervosaBulimia NervosaBulimia NervosaBinge Eating Binge Eating DisorderDisorderEating Disorder Eating Disorder NOSNOS

Types of eating disordersTypes of eating disorders

Anorexia NervosaAnorexia Nervosa Bulimia NervosaBulimia Nervosa Binge Eating DisorderBinge Eating Disorder Not Otherwise Specified (NOS)Not Otherwise Specified (NOS)

Dying to be Thin Written, Produced and Directed by Larkin McPhee; a NOVA production (2000)

Anorexia Nervosa: What is Anorexia Nervosa: What is it?it?

Eating Disorders: Causes, Symptoms and Treatment Produced and Edited by Constance M. Jones (2004)

Anorexia Nervosa: Warning Anorexia Nervosa: Warning SignsSigns

Dramatic weight lossDramatic weight loss Refusal to eat certain foods or food Refusal to eat certain foods or food

categories (e.g. no fats, no carbs)categories (e.g. no fats, no carbs) Consistent excuses to avoid Consistent excuses to avoid

situations involving foodsituations involving food Excessive and rigid exercise routineExcessive and rigid exercise routine Withdrawal from usual Withdrawal from usual

friends/relatives friends/relatives

Source: National Eating Disorders Association WebsiteSource: National Eating Disorders Association Website

Health Risks with AnorexiaHealth Risks with Anorexia

Heart failureHeart failure Kidney failureKidney failure Low protein storesLow protein stores Digestive problemsDigestive problems Electrolyte Electrolyte

imbalanceimbalance

Bulimia Nervosa: What is it?Bulimia Nervosa: What is it?

Eating Disorders: Causes, Symptoms and Treatment Produced and Edited by Constance M. Jones (2004)

Bulimia Nervosa: Warning Bulimia Nervosa: Warning SignsSigns

Wrappers/containers indicating Wrappers/containers indicating consumption of large amounts of foodconsumption of large amounts of food

Frequent trips to bathroom after mealsFrequent trips to bathroom after meals Signs of vomiting Signs of vomiting e.g. staining of teeth, calluses on handse.g. staining of teeth, calluses on hands

Excessive and rigid exercise routineExcessive and rigid exercise routine Withdrawal from usual friends/relativesWithdrawal from usual friends/relatives

Source: National Eating Disorders Association WebsiteSource: National Eating Disorders Association Website

Health Risks with BulimiaHealth Risks with Bulimia

Electrolyte Electrolyte imbalanceimbalance

Laxative Laxative dependencedependence

Dental problemsDental problems Stomach ruptureStomach rupture Menstruation Menstruation

irregularitiesirregularities

Binge Eating Disorder: What is Binge Eating Disorder: What is it?it?

Eating Disorders: Causes, Symptoms and Treatment Produced and Edited by Constance M. Jones (2004)

Binge Eating Disorder: Warning Binge Eating Disorder: Warning SignsSigns

Wrappers/containers indicating Wrappers/containers indicating consumption of large amounts of foodconsumption of large amounts of food

MAY be overweight for age and heightMAY be overweight for age and height MAY have a long history of repeated MAY have a long history of repeated

efforts to diet-feel desperate about efforts to diet-feel desperate about their difficulty to control food intaketheir difficulty to control food intake

MAY eat throughout the day with no MAY eat throughout the day with no planned mealtimesplanned mealtimes

Source: National Eating Disorders Association WebsiteSource: National Eating Disorders Association Website

Health Risks with Health Risks with Binge Eating DisorderBinge Eating Disorder

High blood pressureHigh blood pressure High cholesterolHigh cholesterol Gall bladder diseaseGall bladder disease DiabetesDiabetes Heart diseaseHeart disease Certain types of cancerCertain types of cancer

Eating Disorder Not Otherwise Eating Disorder Not Otherwise Specified (NOS)Specified (NOS)

NOS category is for disorders of eating NOS category is for disorders of eating that do not meet the criteria for any that do not meet the criteria for any specific Eating Disorderspecific Eating Disorder

Examples include:Examples include:– For females, all of the criteria for Anorexia For females, all of the criteria for Anorexia

Nervosa are met except that the Nervosa are met except that the individual has regular menses OR despite individual has regular menses OR despite significant weight loss the individual’s significant weight loss the individual’s current weight is in the normal range. current weight is in the normal range.

Source: Adapted from the Diagnostic and Statistical Manual of Mental Disorders-Source: Adapted from the Diagnostic and Statistical Manual of Mental Disorders-IVIV

Body Dysmorphic DisorderBody Dysmorphic Disorder Excessively concerned about an imagined Excessively concerned about an imagined

defect in appearancedefect in appearance

Muscle DysmorphiaMuscle Dysmorphia Obsess about being small and Obsess about being small and

underdevelopedunderdeveloped

What is the situation at What is the situation at Truman?Truman?

In the Spring of 2006, 552 Truman students In the Spring of 2006, 552 Truman students completed the National College Health completed the National College Health Assessment (NCHA). The following are the Assessment (NCHA). The following are the findings:findings:

1.8% of students reported experiencing 1.8% of students reported experiencing AnorexiaAnorexia

2.9% of students reported experiencing 2.9% of students reported experiencing BulimiaBulimia

2.4% of students reported that their eating 2.4% of students reported that their eating disorder/problem affected their academicsdisorder/problem affected their academics

What is the situation at What is the situation at Truman?Truman?

Within the last 30 days, Truman students reported:Within the last 30 days, Truman students reported:

MaleMale FemalFemalee

Exercising to lose weightExercising to lose weight 38.238.2 64.464.4

Dieting to lose weightDieting to lose weight 24.324.3 41.441.4

Vomiting or taking laxatives Vomiting or taking laxatives to lose weightto lose weight

0.00.0 3.63.6

Taking diet pills to lose weightTaking diet pills to lose weight 0.00.0 3.93.9

Doing none of the aboveDoing none of the above 57.457.4 30.830.8

Why do people develop eating Why do people develop eating disorders? disorders?

Behaviors are unhealthy coping Behaviors are unhealthy coping mechanisms mechanisms

Factors to considerFactors to considerPsychological Psychological InterpersonalInterpersonalSocial/CulturalSocial/CulturalBiologicalBiological

Psychological factorsPsychological factors

Low self-esteemLow self-esteem Feelings of inadequacy or failureFeelings of inadequacy or failure Feeling out of controlFeeling out of control Response to change (puberty) Response to change (puberty) Response to stress (sports, dance)Response to stress (sports, dance) Personal illnessPersonal illness

More psychological factors:More psychological factors:

Vulnerable Personality Vulnerable Personality CharacteristicsCharacteristics

Identity difficultiesIdentity difficulties Need for approvalNeed for approval PerfectionistPerfectionist Obsessive Obsessive

tendenciestendencies Irrational thinkingIrrational thinking Difficulty copingDifficulty coping Inability to accept Inability to accept

selfself

Interpersonal FactorsInterpersonal Factors

Troubled family and personal Troubled family and personal relationshipsrelationships

Difficulty expressing emotions and Difficulty expressing emotions and feelingsfeelings

History of being teased or ridiculed History of being teased or ridiculed based on size or weightbased on size or weight

History of physical or sexual abuseHistory of physical or sexual abuse

Social and Cultural FactorsSocial and Cultural Factors

Cultural pressures that glorify Cultural pressures that glorify thinness and place value on obtaining thinness and place value on obtaining the perfect bodythe perfect body

Narrow definitions of beauty that Narrow definitions of beauty that include only women and men of include only women and men of specific body weights and shapesspecific body weights and shapes

Cultural norms that value people on Cultural norms that value people on the basis of physical appearance and the basis of physical appearance and not inner qualities and strengthsnot inner qualities and strengths

Barbie and BodiesBarbie and Bodies

Seven feet tallSeven feet tall 38 inch chest38 inch chest 21 inch waist21 inch waist 36 inch hips36 inch hips Virtually Virtually

unattainable for unattainable for an adult womanan adult woman

G. I. JoeG. I. Joe

1970-GI Joe was 5 ft. 10 1970-GI Joe was 5 ft. 10 inches, 32 inch waist and inches, 32 inch waist and 12 inch upper arms12 inch upper arms

2000-29 inch waist and 16 2000-29 inch waist and 16 ½ inch arms½ inch arms

Biological FactorsBiological Factors Eating disorders often run in families Eating disorders often run in families

(learn coping skills and attitudes in family)(learn coping skills and attitudes in family) Genetic component—research about brain Genetic component—research about brain

and eating in taking place (certain and eating in taking place (certain chemicals in the brain control hunger, chemicals in the brain control hunger, appetite and digestion have been found appetite and digestion have been found unbalanced).unbalanced).

Source: www.NationalEatingDisorders.orgSource: www.NationalEatingDisorders.org

More on biologyMore on biology

Dying to be Thin Written, Produced and Directed by Larkin McPhee; a NOVA production (2000)

Consequences of eating Consequences of eating disordersdisorders

-Tearing up the mind and body-Tearing up the mind and body -Mind- distorted and obsessive thoughts -Mind- distorted and obsessive thoughts

regarding food, exercise, body image, regarding food, exercise, body image, -Takes over your life—loss of life in other areas: -Takes over your life—loss of life in other areas:

social, financial, spiritual, professional, social, financial, spiritual, professional, academic academic

-Anything that pulls you out of balance can -Anything that pulls you out of balance can destroy your life—or at least make it miserabledestroy your life—or at least make it miserable

-Physical-amenorrhea, dehydration, electrolyte -Physical-amenorrhea, dehydration, electrolyte imbalances, dry skin, long lasting disruptions of imbalances, dry skin, long lasting disruptions of normal bowel functioning normal bowel functioning

Source: Academy For Eating Disorders http://www.aedweb.org)Source: Academy For Eating Disorders http://www.aedweb.org)

Treatment optionsTreatment optionsHelp comes in different forms includingHelp comes in different forms including::

PsychotherapyPsychotherapy Support or self-Support or self-

help groupshelp groups Medical treatmentMedical treatment Nutritional Nutritional

treatmenttreatment MedicationMedication HospitalizationHospitalization

Help is available. Get help if you need it. Help is available. Get help if you need it. EncourageEncourage a loved one to get help if they need it.a loved one to get help if they need it.

A little more personal now…A little more personal now…

Deciding If You Abuse FoodDeciding If You Abuse Food

I often deal with difficult feelings with foodI often deal with difficult feelings with food I think constantly about my weight and I think constantly about my weight and

appearanceappearance I give too much time and thought to foodI give too much time and thought to food I have lied or been secretive about my I have lied or been secretive about my

eating behavioreating behavior I have gone on eating binges that I felt I I have gone on eating binges that I felt I

might not be able to stopmight not be able to stop I have used vomiting, laxatives, water I have used vomiting, laxatives, water

pills, and/or diet pills to control my weightpills, and/or diet pills to control my weight

How to HelpHow to Help Family and Friends Family and Friends

““Tips for Talking to a Friend Who May Be Struggling with an eating Disorder” Tips for Talking to a Friend Who May Be Struggling with an eating Disorder”

*Set a time to talk*Set a time to talk*Communicate your concerns*Communicate your concerns*Ask your friend to explore these concerns*Ask your friend to explore these concerns*Avoid conflicts or a ballet of the wills*Avoid conflicts or a ballet of the wills*Avoid placing shame, blame, or guilt*Avoid placing shame, blame, or guilt*Avoid giving simple solutions*Avoid giving simple solutions*Express your continued support*Express your continued support

KnowledgeKnowledge AwarenessAwareness SupportSupport BoundariesBoundaries

By National Eating Disorders AssociationBy National Eating Disorders Associationwww.NationalEatingDisorders.org

Body ImageBody Image Not the entire solution, but if we Not the entire solution, but if we

have a healthy, realistic body image have a healthy, realistic body image we are less prone to use food as a we are less prone to use food as a way to cope with our emotions, way to cope with our emotions, stress and problems. stress and problems.

Web ResourcesWeb Resources

Anorexia Nervosa and Related Eating Anorexia Nervosa and Related Eating DisordersDisorders– www.anred.com

National Eating Disorders AssociationNational Eating Disorders Association– www.NationalEatingDisorders.org

American Dietetic AssociationAmerican Dietetic Association– www.eatright.org

Something Fishy Web Site on Eating Something Fishy Web Site on Eating DisordersDisorders– www.something-fishy.org

Truman State University Truman State University ResourcesResources

University Counseling Services University Counseling Services – 785-4014785-4014– ucs.truman.eduucs.truman.edu

Student Health ServicesStudent Health Services– 785-4182785-4182– studenthealth.truman.edustudenthealth.truman.edu

Thank You!!Thank You!!

Becky Brandsberg-Herrera, MSW. LCSWBecky Brandsberg-Herrera, MSW. LCSW

University Counseling ServicesUniversity Counseling Services

brandsberg@ truman.edubrandsberg@ truman.edu

785-4014785-4014

http://ucs.truman.edu

http://ucs.truman.edu/howwasit