ABNORMAL PSYCH CHAPTER 9:
EATING DISORDERS AND OBESITY
Ana Carolina Reston CLINICAL ASPECTS OF EATING
- 21, yrs old, 88 pounds on her DISORDERS
5-foot-8 frame, Brazilian model
- generalized infection on November I. Anorexia Nervosa
15, 2006 plus Anorexia Nervosa - literally means “lack of appetite
- hospitalized for kidney failure. induced by nervousness.”
- A.N. began after she was criticized - is an intense fear of gaining
for being “too fat” during a casting weight or becoming fat, combined
call in China. with behaviors that result in
- Diet consisted only of tomatoes and significantly low body weight.
apples. - Unlike DSM IV, DSM-5 amenorrhea
is no longer required for a person to
> Nicole Richie, Mary-Kate Olsen, be given the diagnosis even in male.
Victoria Beckham, and the late Princess - Disorder received its current name
Diana (Bulimia nervosa), have also (1873) by Charles Lasègue in Paris
struggled with eating disorders. and Sir William Gull in London.
- Typically wear baggy clothes to
> After the death in 2006 of Luisel Ramos, weigh more and drink large amounts
model from Uruguay, the fashion industry of water to increase their weight
tried to address the situation. temporarily.
> In 2010, Victoria Beckham reportedly Richard Morton
deemed 23 models “too skinny” and refused - He published in 1689 the first known
to have them be part of her New York medical account of anorexia
Fashion Week runway show. nervosa.
CRITERIA FOR ANOREXIA NERVOSA
● Body Mass Index - a measure of a A. Restriction of energy intake
person’s weight relative to height relative to requirements, lead-
● Eating Disorders - are ing to a significantly low body weight in the
characterized by a persistent context of age, sex, developmental
disturbance in eating behavior. trajectory, and physical health. Significantly
● Obesity - is not considered to be an low weight is defined as a weight that is less
eating disorder or a psychiatric than minimally normal or, for children and
condition in the DSM; however, its adolescents, less than that minimally
prevalence is rising at an alarming expected.
rate. B. Intense fear of gaining weight or
● Amenorrhea - cessation of of becoming fat, or persistent behavior that
menstruation interferes with weight gain, even though at a
● Binge - involves an out-of-control significantly low weight.
consumption of an amount of food C. Disturbance in the way in which
that is far greater than what most one’s body weight or shape is experienced,
people would eat in the same undue influence of body weight or shape on
amount of time and under the same self-evaluation, or persistent lack of
circumstances. recognition of the seriousness of the current
● Purge - remove from their bodies, low body weight.
the food they have eaten. Methods
of purging commonly include 2 TYPES OF ANOREXIA NERVOSA:
self-induced vomiting or misusing 1. Restricting Type
laxatives, diuretics, and enemas. Or - every effort is made to limit the
, food into very small pieces, or gain by using inappropriate
dispose of food secretly. behaviors such as self-induced
vomiting and excessive exercise.
2. Binge-eating/Purging type - they - The British psychiatrist G. F. M.
either binge, purge, or binge and Russell (1997) proposed the term in
purge. 1979,
- adopted into the DSM in 1987. The
Tim: Obsessed With His Weight - word: bulimia comes from the
- 8 years old Greek bous (which means “ox”),
- Concerned with weight (weighs and limos (“hunger”).
daily) - denote a hunger of such proportions
- Complains he is too fat, cuts back that a person “could eat an ox.”
food if he does not lose. - Binge eating and purging now have
- Lost 10 pounds last year but still to occur on average once a week
feels fat even if he’s clearly (instead of twice a week) over a
underweight. 3-month period.
- His parents removed scales from the
house but Tim decided to keep a CRITERIA FOR BULIMIA NERVOSA
record of the calories he eats daily
- Obsessed with cleanliness and A. Recurrent episodes of binge
neatness eating. An episode of binge eating is
- Has no friends because he doesn't characterized by both of the following:
want their house to become dirty. 1. Eating, in a discrete period
- Becomes upset when someone of time (e.g., within any 2-hour
touches him period), an amount of food that is
- Always checking whether he is doing definitely larger than what most
things the way they “should” be individuals would eat in a similar
done. period of time under similar
- Wake up at least 2 hours before circumstances.
leaving for school to get ready. 2. A sense of lack of control
- woke up at 1:30 a.m. to prepare for over eating during the episode (e.g.,
school. a feeling that one cannot stop eating
or control what or how much one is
Gelsey Kirkland eating).
- Ballet dancers are at very high risk B. Recurrent inappropriate
for developing eating disorders. compensatory behaviors in order to prevent
- According to Gelsey Kirkland, once weight gain, such as self-induced vomiting;
the premier ballerina at the New misuse of laxatives, diuretics, or other
York City Ballet, the value placed on medications; fasting; or excessive exercise.
being thin can create a C. The binge eating and
“concentration camp aesthetic” inappropriate compensatory behaviors both
supported and encouraged by the occur, on average, at least once a week for
dance company. 3 months.
D. Self-evaluation is unduly
Ms. R.: Going to Extremes influenced by body shape and weight.
- very thin, 19-year-old, single ballet E. The disturbance does not occur
student who comes in at the exclusively during episodes of anorexia
insistence of her parents for a nervosa.
consultation concerning her eating
behavior. > Difference between Bulimia Nervosa and
- Ms. R. has had difficulties with binge-eating/purging type Anorexia nervosa
eating since age 15 when, for is weight. The person with Anorexia
reasons she is unable to explain, nervosa is severely underweight. This is
EATING DISORDERS AND OBESITY
Ana Carolina Reston CLINICAL ASPECTS OF EATING
- 21, yrs old, 88 pounds on her DISORDERS
5-foot-8 frame, Brazilian model
- generalized infection on November I. Anorexia Nervosa
15, 2006 plus Anorexia Nervosa - literally means “lack of appetite
- hospitalized for kidney failure. induced by nervousness.”
- A.N. began after she was criticized - is an intense fear of gaining
for being “too fat” during a casting weight or becoming fat, combined
call in China. with behaviors that result in
- Diet consisted only of tomatoes and significantly low body weight.
apples. - Unlike DSM IV, DSM-5 amenorrhea
is no longer required for a person to
> Nicole Richie, Mary-Kate Olsen, be given the diagnosis even in male.
Victoria Beckham, and the late Princess - Disorder received its current name
Diana (Bulimia nervosa), have also (1873) by Charles Lasègue in Paris
struggled with eating disorders. and Sir William Gull in London.
- Typically wear baggy clothes to
> After the death in 2006 of Luisel Ramos, weigh more and drink large amounts
model from Uruguay, the fashion industry of water to increase their weight
tried to address the situation. temporarily.
> In 2010, Victoria Beckham reportedly Richard Morton
deemed 23 models “too skinny” and refused - He published in 1689 the first known
to have them be part of her New York medical account of anorexia
Fashion Week runway show. nervosa.
CRITERIA FOR ANOREXIA NERVOSA
● Body Mass Index - a measure of a A. Restriction of energy intake
person’s weight relative to height relative to requirements, lead-
● Eating Disorders - are ing to a significantly low body weight in the
characterized by a persistent context of age, sex, developmental
disturbance in eating behavior. trajectory, and physical health. Significantly
● Obesity - is not considered to be an low weight is defined as a weight that is less
eating disorder or a psychiatric than minimally normal or, for children and
condition in the DSM; however, its adolescents, less than that minimally
prevalence is rising at an alarming expected.
rate. B. Intense fear of gaining weight or
● Amenorrhea - cessation of of becoming fat, or persistent behavior that
menstruation interferes with weight gain, even though at a
● Binge - involves an out-of-control significantly low weight.
consumption of an amount of food C. Disturbance in the way in which
that is far greater than what most one’s body weight or shape is experienced,
people would eat in the same undue influence of body weight or shape on
amount of time and under the same self-evaluation, or persistent lack of
circumstances. recognition of the seriousness of the current
● Purge - remove from their bodies, low body weight.
the food they have eaten. Methods
of purging commonly include 2 TYPES OF ANOREXIA NERVOSA:
self-induced vomiting or misusing 1. Restricting Type
laxatives, diuretics, and enemas. Or - every effort is made to limit the
, food into very small pieces, or gain by using inappropriate
dispose of food secretly. behaviors such as self-induced
vomiting and excessive exercise.
2. Binge-eating/Purging type - they - The British psychiatrist G. F. M.
either binge, purge, or binge and Russell (1997) proposed the term in
purge. 1979,
- adopted into the DSM in 1987. The
Tim: Obsessed With His Weight - word: bulimia comes from the
- 8 years old Greek bous (which means “ox”),
- Concerned with weight (weighs and limos (“hunger”).
daily) - denote a hunger of such proportions
- Complains he is too fat, cuts back that a person “could eat an ox.”
food if he does not lose. - Binge eating and purging now have
- Lost 10 pounds last year but still to occur on average once a week
feels fat even if he’s clearly (instead of twice a week) over a
underweight. 3-month period.
- His parents removed scales from the
house but Tim decided to keep a CRITERIA FOR BULIMIA NERVOSA
record of the calories he eats daily
- Obsessed with cleanliness and A. Recurrent episodes of binge
neatness eating. An episode of binge eating is
- Has no friends because he doesn't characterized by both of the following:
want their house to become dirty. 1. Eating, in a discrete period
- Becomes upset when someone of time (e.g., within any 2-hour
touches him period), an amount of food that is
- Always checking whether he is doing definitely larger than what most
things the way they “should” be individuals would eat in a similar
done. period of time under similar
- Wake up at least 2 hours before circumstances.
leaving for school to get ready. 2. A sense of lack of control
- woke up at 1:30 a.m. to prepare for over eating during the episode (e.g.,
school. a feeling that one cannot stop eating
or control what or how much one is
Gelsey Kirkland eating).
- Ballet dancers are at very high risk B. Recurrent inappropriate
for developing eating disorders. compensatory behaviors in order to prevent
- According to Gelsey Kirkland, once weight gain, such as self-induced vomiting;
the premier ballerina at the New misuse of laxatives, diuretics, or other
York City Ballet, the value placed on medications; fasting; or excessive exercise.
being thin can create a C. The binge eating and
“concentration camp aesthetic” inappropriate compensatory behaviors both
supported and encouraged by the occur, on average, at least once a week for
dance company. 3 months.
D. Self-evaluation is unduly
Ms. R.: Going to Extremes influenced by body shape and weight.
- very thin, 19-year-old, single ballet E. The disturbance does not occur
student who comes in at the exclusively during episodes of anorexia
insistence of her parents for a nervosa.
consultation concerning her eating
behavior. > Difference between Bulimia Nervosa and
- Ms. R. has had difficulties with binge-eating/purging type Anorexia nervosa
eating since age 15 when, for is weight. The person with Anorexia
reasons she is unable to explain, nervosa is severely underweight. This is
