Eating Disorders: A Personal and Clinical Perspective
Eating Disorders
A personal and clinical perspective
Juliana Hill, B.A.
-My Story--a brief account
•
how it began
•
Evolution
•
Remission
•
Evolution
•
current status: currently in recovery, gained weight, out of
the underweight BMI, daily/sometimes hourly battle; in
therapy; refuse to take stimulant; two steps forward one
step back
•
***note on cross-addiction—up to 50% of women with
eating disorders are also addicted to alcohol, drugs,etc. I
am an alcoholic in full remission and a recovering shopping
addict
AN, BN, EDNOS
•
-Different types of Eating Disorders/clinical
criteria
•
3 types of eating disorders listed in the
Diagnostic and Statistical Manual IV: Anorexia
Nervosa, Bulimia Nervosa and Eating Disorder
Not Otherwise Specified
AN
--Anorexia criteria and information
•
Individuals with AN weigh less than 85% of the weight that is considered normal
for their age and height (criterion A), they intensely fear gaining weight or
becoming fat (criterion B), the experience and significance of body weight and
shape are distorted in these individuals (criterion C) and postmenarcheal women
experience amenorrhea (criterion D)
•
Some facts: (from October 14, 2008 presentation given by Benek Altayli, Psy. D.)
•
1/200 people living in the United states will develop AN
•
90% of sufferers are women
•
Diagnosis occurs most often in puberty or age 18
•
50-75% of sufferers also have major depression
•
25% have OCD
•
5% die from the disorder
•
Less than 40% recover spontaneously
•
70% can be helped with competent treatment
BN
-Bulimia Nervosa
•
Individuals with BN engage in binge eating, defined as consuming an amount of
food in a discreet period of time (approx 2 hours) that is definitely larger than
most individuals would consume under similar circumstances (criterion A1), the
episode of binge eating is accompanied by a sense of lack of control (criterion A2),
the individual engages in a recurrent use of compensatory behaviors to prevent
weight gain, such as induced vomiting or the misuse of laxatives and diuretics
(criterion B), the binge eating and inappropriate compensatory behaviors occur an
average of two times a week for a period of at least three months (criterion C),
individuals suffering BN place an excessive emphasis on body shape and weight in
their self-evaluation and these factors are typically the most important ones in
determining self-esteem (criterion D)
•
Some facts: (Benek Altayli, Psy. D.)
•
BN affects 3%-10% of adolescent and college age women in the US
•
25% are initially anorexic
•
Commonly co-occurs with affective disorders, impulse control disorders, BPD, PTSD
symptoms, and substance abuse
•
Successful outcome of treatment is negatively impacted by familial obesity
EDNOS
-Eating Disorders Not Otherwise Specified
•
This category is for disorders of eating that do
not meet criteria for any specific eating
disorder
-Possible reasons for eating disorders
(Benek Altayli, Psy. D)
•
Genetic
-many researchers believe there is an inherited predisposition to having an eating disorder. Studies have shown that the
co-occurrence among identical twins is greater than fraternal twins
•
Chemical
-the neurotransmitters serotonin and norepinephrine have also been identified as being significantly decreased in
acutely ill patients suffering from Anorexia and Bulimia as well as Depression and PTSD; these neurotransmitters create a sense
of physical and emotional satisfaction as well as signal fullness and food satisfaction.
•
Hormones
-individuals with eating disorders have been shown to have higher levels of the hormones vasopressin and cortisol
than the general population; these hormones are normally released in response to physical and possible emotional stress, and
may contribute to some of the dysfunction seen in eating disordered individuals.
•
Environmental
-we live in a society that reinforces the idea that to be happy and successful we must be thin; we are assaulted
by magazines, newspapers, television and radio with the message that “fat is bad; other societal issues include dysfunctional
families, sexual abuse, physical abuse, domineering coaches and controlling relationships
•
Psychological
-the practice of an eating disorder can be viewed as a survival mechanism, an individual with an eating disorder
can use eating, purging or restricting to deal with feelings and emotions that may otherwise seem overwhelming; thru the use
of an eating disorder an individual may a sense of partial control over their seemingly incontrollable life.
•
Underlying issues
-some of the issues that are associated with an eating disorder are low self-esteem, depression, feelings of
loss of control, feelings of worthlessness, identity concerns, family communication problems and an inability to cope with
intense emotions; the practice of an eating disorder may be an expression of something that the individual has found no other
way of expressing
•
book by Margo Maine,Ph.D, originally published
early 90s, revised 2004
•
“Father hunger is a deep, persistent desire for
emotional connection with the father that is
experienced by all children.” --unfulfilled longing
for the father that for girls and women often
translates into conflicts about food and weight;
when this normal craving is satisfied, children are
likely to grow up feeling confident, secure, strong,
and “good enough.”
-Father Hunger
-Father Hunger
•
Girls may adopt the “if only I were skinny”
approach to escape pain and reduce all their
negative emotions into simply “feeling fat.”
Problems encountered in eating disordered
patients, chronic dieters, over exercisers, and
weight preoccupied women have little to do with
weight and food—those are merely symptoms for
deeper issues rooted in pain and confusion, as
the individual reaches for self esteem and
identity while dealing with depression, anxiety,
fear, trauma and disappointment.
-Father Hunger
•
Global Girls-Maine coined this phrase to describe the
effects of globalization on today’s young women.
These largely negative effects are due to the
unprecedented access to and influence of the media
via communications and world markets as well as
mobilization. This increased mobility means more
opportunities to explore the external and superficial
while less emphasis is placed on developing an internal
sense of one’s true self, complicating the task of forging
a personal identity in a culture where moral authority,
traditions, and core values are not valued.
-Father Hunger
•
Encouraged to look outside themselves for comfort, values
and direction, global girls fall easy prey to addictive
behaviors and unrealistic images that are promoted in
various advertising media.
•
By imposing impossible standards to keep women of all
ages unsure, uneasy and in their place, the mass media
relentlessly pressure global girls to be someone other than
who they are naturally. By default they develop a false self,
constantly focusing on the outside, expressing their
femininity through their appearance rather than their
actions, accomplishments, feelings and relationships.
-Disordered eating—what does it look
like?
•
restriction
•
calorie counting
•
eliminating food groups
•
rigid adherence to a given eating routine
•
lack of variety
•
ritualistic
-Healthy Lifestyle
•
Exercise (up to 90/min a day)
•
3 meals, 3 snacks
•
water
•
fun/pleasure/treats
•
BALANCE
-Eating Disorder resources for recovery
•
Eating Disorders Support Groups
•
Individual Therapy
•
University Counseling Center-255-3265
-Eating Attitudes Test
•
For anyone who has a concern that they may
be at risk, there is an Eating Attitudes Test that
you can take anonymously on line that will tell
you your risk level
•
***if you ARE concerned, it is highly
recommended you see a professional
This insightful content delves into eating disorders from a personal narrative and clinical standpoint, covering Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder Not Otherwise Specified (EDNOS). It provides criteria for each disorder, facts, and statistics, shedding light on the challenges, impact, and treatment of these conditions.
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Presentation Transcript
Eating Disorders A personal and clinical perspective Juliana Hill, B.A.
-My Story--a brief account how it began Evolution Remission Evolution current status: currently in recovery, gained weight, out of the underweight BMI, daily/sometimes hourly battle; in therapy; refuse to take stimulant; two steps forward one step back ***note on cross-addiction up to 50% of women with eating disorders are also addicted to alcohol, drugs,etc. I am an alcoholic in full remission and a recovering shopping addict
AN, BN, EDNOS -Different types of Eating Disorders/clinical criteria 3 types of eating disorders listed in the Diagnostic and Statistical Manual IV: Anorexia Nervosa, Bulimia Nervosa and Eating Disorder Not Otherwise Specified
AN --Anorexia criteria and information Individuals with AN weigh less than 85% of the weight that is considered normal for their age and height (criterion A), they intensely fear gaining weight or becoming fat (criterion B), the experience and significance of body weight and shape are distorted in these individuals (criterion C) and postmenarcheal women experience amenorrhea (criterion D) Some facts: (from October 14, 2008 presentation given by Benek Altayli, Psy. D.) 1/200 people living in the United states will develop AN 90% of sufferers are women Diagnosis occurs most often in puberty or age 18 50-75% of sufferers also have major depression 25% have OCD 5% die from the disorder Less than 40% recover spontaneously 70% can be helped with competent treatment
BN -Bulimia Nervosa Individuals with BN engage in binge eating, defined as consuming an amount of food in a discreet period of time (approx 2 hours) that is definitely larger than most individuals would consume under similar circumstances (criterion A1), the episode of binge eating is accompanied by a sense of lack of control (criterion A2), the individual engages in a recurrent use of compensatory behaviors to prevent weight gain, such as induced vomiting or the misuse of laxatives and diuretics (criterion B), the binge eating and inappropriate compensatory behaviors occur an average of two times a week for a period of at least three months (criterion C), individuals suffering BN place an excessive emphasis on body shape and weight in their self-evaluation and these factors are typically the most important ones in determining self-esteem (criterion D) Some facts: (Benek Altayli, Psy. D.) BN affects 3%-10% of adolescent and college age women in the US 25% are initially anorexic Commonly co-occurs with affective disorders, impulse control disorders, BPD, PTSD symptoms, and substance abuse Successful outcome of treatment is negatively impacted by familial obesity
EDNOS -Eating Disorders Not Otherwise Specified This category is for disorders of eating that do not meet criteria for any specific eating disorder
-Possible reasons for eating disorders (Benek Altayli, Psy. D) Genetic-many researchers believe there is an inherited predisposition to having an eating disorder. Studies have shown that the co-occurrence among identical twins is greater than fraternal twins Chemical-the neurotransmitters serotonin and norepinephrine have also been identified as being significantly decreased in acutely ill patients suffering from Anorexia and Bulimia as well as Depression and PTSD; these neurotransmitters create a sense of physical and emotional satisfaction as well as signal fullness and food satisfaction. Hormones-individuals with eating disorders have been shown to have higher levels of the hormones vasopressin and cortisol than the general population; these hormones are normally released in response to physical and possible emotional stress, and may contribute to some of the dysfunction seen in eating disordered individuals. Environmental-we live in a society that reinforces the idea that to be happy and successful we must be thin; we are assaulted by magazines, newspapers, television and radio with the message that fat is bad; other societal issues include dysfunctional families, sexual abuse, physical abuse, domineering coaches and controlling relationships Psychological-the practice of an eating disorder can be viewed as a survival mechanism, an individual with an eating disorder can use eating, purging or restricting to deal with feelings and emotions that may otherwise seem overwhelming; thru the use of an eating disorder an individual may a sense of partial control over their seemingly incontrollable life. Underlying issues-some of the issues that are associated with an eating disorder are low self-esteem, depression, feelings of loss of control, feelings of worthlessness, identity concerns, family communication problems and an inability to cope with intense emotions; the practice of an eating disorder may be an expression of something that the individual has found no other way of expressing
-Father Hunger book by Margo Maine,Ph.D, originally published early 90s, revised 2004 Father hunger is a deep, persistent desire for emotional connection with the father that is experienced by all children. --unfulfilled longing for the father that for girls and women often translates into conflicts about food and weight; when this normal craving is satisfied, children are likely to grow up feeling confident, secure, strong, and good enough.
-Father Hunger Girls may adopt the if only I were skinny approach to escape pain and reduce all their negative emotions into simply feeling fat. Problems encountered in eating disordered patients, chronic dieters, over exercisers, and weight preoccupied women have little to do with weight and food those are merely symptoms for deeper issues rooted in pain and confusion, as the individual reaches for self esteem and identity while dealing with depression, anxiety, fear, trauma and disappointment.
-Father Hunger Global Girls-Maine coined this phrase to describe the effects of globalization on today s young women. These largely negative effects are due to the unprecedented access to and influence of the media via communications and world markets as well as mobilization. This increased mobility means more opportunities to explore the external and superficial while less emphasis is placed on developing an internal sense of one s true self, complicating the task of forging a personal identity in a culture where moral authority, traditions, and core values are not valued.
-Father Hunger Encouraged to look outside themselves for comfort, values and direction, global girls fall easy prey to addictive behaviors and unrealistic images that are promoted in various advertising media. By imposing impossible standards to keep women of all ages unsure, uneasy and in their place, the mass media relentlessly pressure global girls to be someone other than who they are naturally. By default they develop a false self, constantly focusing on the outside, expressing their femininity through their appearance rather than their actions, accomplishments, feelings and relationships.
-Disordered eatingwhat does it look like? restriction calorie counting eliminating food groups rigid adherence to a given eating routine lack of variety ritualistic
-Healthy Lifestyle Exercise (up to 90/min a day) 3 meals, 3 snacks water fun/pleasure/treats BALANCE
-Eating Disorder resources for recovery Eating Disorders Support Groups Individual Therapy University Counseling Center-255-3265
-Eating Attitudes Test For anyone who has a concern that they may be at risk, there is an Eating Attitudes Test that you can take anonymously on line that will tell you your risk level ***if you ARE concerned, it is highly recommended you see a professional
