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Presentation 5 Lecture Notes Eating Disordes

by: AmberNicole

Presentation 5 Lecture Notes Eating Disordes PSYC 2250

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About this Document

These notes cover what will be on the Presentation 5 Eating Disorders quiz.
Eating Disorders
Dr. Greg Neimeyet
Class Notes
eating, Eating Disorders, disorders, Anorexia
25 ?




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This 6 page Class Notes was uploaded by AmberNicole on Saturday September 24, 2016. The Class Notes belongs to PSYC 2250 at East Carolina University taught by Dr. Greg Neimeyet in Fall 2016. Since its upload, it has received 9 views. For similar materials see Eating Disorders in Psychology at East Carolina University.

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Date Created: 09/24/16
The Role of Nutrition in Eating Disorders The Minnesota Experiment 1944  1944: 32 normal-weight men without any history of psycholoigcal disturbance participated  They volunteered to lose 25% of their body weight  As the men began to experience chronic undernutrition, several psychological changes similar to those with eating disorders occurred o Preoccupation with food (obsessed with food)  Thoughts of food and images food control them and their experience of the world around them o Odd rituals around food  Take whatever portion was provided and divide it into quartiles o Lack of pleasure in daily activities  Anhedonia  Hendinst (opposite) enjoys things  Big symptom in depression o Poor judgment, dishonesty  Outbursts of anger or irritability, lie about food, suspesious and hostile atitude  Dishonest about what they ate and how much they ate to prevent other people from interferring with that relationship with their food o Excessive use of nonfood pacifiers (I.e. chewing on pens)  Simply puttign something in mouth and rolling it around on tongue: Oral fixation o Moodiness (irritability, depression) o Difficulty sleeping  Insomnia: inability to get to sleep at night  Early morning awakening: wakes up at a certain point in the night o Disturbed energy levels  They became lazy  Body tries to preserve its energy capcity or storage o Decreased interest in sex  Biology and speciation: if they can't feed themselves, it is more than unlikely to feed offspring  High levels of depression  Loss of levels of testosterone  These were also several physical changes similar to those with eating disorders o Gastrointestinal symptoms  Upset stomach  Digestive ability  Upper and lower GI complications o Loss of muscle mass  All muscles and also in internal organs o Decreased heart size (atrophy of heart muscle)  Body consumed itself o Muscle weakness and cramping o Slowed heart rate, lower blood pressure o Dehydration o Hair loss  Occurs in clumps because of lack of lipids and Calcium o Development of lanugo (a layer of fine hair over the body)  Body is cannibalizing other energy sources so it's trying to preserve its available source to it grows hair to preserve heat o Decreased metabolic rate  Slowly metabolize energy o Decreased brain size Hibernation Metabolism  Hibernation metabolism o When caloric intake falls too low, the body's metabolism slows down (or hibernates) to conserve energy o When this occurs, bodily systems slow down and the body uses fewer calories to maintain its essential funcitons  Yo-yo dieting actually causes weight to be lost more slowly during each diet and causes more rapid weight gain after the end of each diet o Go on a diet until they lose a certain amount of weight then binge eat and gain weight o Body slows down during diet and off of diet the metabolism making it more likely to gain weight o Best way to lose weight is a combination of diet and exercise Do I look Phat in This  Women need 17-25% body fat to maintain menustration. However, many women are striving to have a body fat percentage that is much lower than this o Loss of period is regarded as positive sign of success  Normal thin women actually have 23-28% body fat  Body fat helps to keep the body warm (protects from hypothermia) and cushions organs from trauma associated with ordinary motions (walking, running, lifting) o Positive biological funcitoning in body fat  The Brain is mostly fat, and when starvation occurs, brain size actually shrinks! o Shrinking of cortical mass o Corticals in brain are much larger in anorexic brain which leads to memory loss, mood iritability, etc Nutrition and Bones  Body fat percentage is closely linked to the production of estrogen, that is why most anorexic women cease to menstruate  Also, fasting is related to a decrease in bone marrow production (activity exceeds input calories o 50% reduction of bone marrow even after 4 days of fasting o People in their 20's that are anorexic have bone marrow similar to individuals in their 70s  Estrogen production in women and testosterone production in men is very important in the production of bone marrow  Most anorexics either have low bone density (osteopenia) or full-fledged osteoporosis (porous bones) which makes them very vulnerable to stress fractures o Particularly in sports because the goal is usually to lose weight o Refeeding  However, when anorexics recover from tehir eating disorder, they regain much of tehir lost bone density, but not back to pre-disorder levels  Lumbar=spinal column/back Re-feeding Syndrome  When humans restrict eating/diet, it often leads to intense hunger and later binge-eating  When a person is starving, they are operating on a fat metabolism, which does not require phosphate it just consumes available stores o Body consumes self  However, when they begin normal eating again, they switch to a carbohydrate metabolism, which does require phosphate o Most of us have carbohydrate metabolisms  If an anorexic eats too much too fast, she can deplete her body's phosphate levels rapidly, leading to "re-feeding syndrome"  If re-feeding syndrome occurs, electrolyte and mineral levels can fall to dangerously low levels leading to o Muscle weakness o Cardiac arrhythmias and heart attacks o Death  Karen Carpenter died of re-feeding syndrome, not anorexic because of heart failure Minimum Caloric Need  On a daily basis, the average human body needs: o 1200 calories/day for breathing, blood circulation, etc... o 150-300 calories/day for renewal of cells o 150 calories/day for digestion and absorpiton of food o 150 calories/day for maintaining body temp., hydration, and chemical concentration in cells Minimum Bodily Needs  This means that a person who does not exercise needs at least 1650-1800 calories/day just to maintain bodily functions! (with no activity) o Body weight x 10 x activity level (1,1.5,2)  With moderate physical activiyt, the person needs to add 300-500 calories/day more. Athletes need to add significantly more, depending on level of activity  The minimum medical recommended fat intake/day is 25 grams o FDA says at least 1/3 of meals need fat criteria o Fat helps with skin and hair  Without meeting these minimum criteria, metabolism slows and bodily functions and organs can be compromised Weight  Never believe that ideal weight is represented by one single number. In general, for women, ideal weight is 100 lbs for 5 feet and 5 pounds for every inch. However, this does not take body frame, muscle to fat ratio (muscle weighs more than fat), age, or ethnicity into account  Normal weight falls within a weight range  Most physicians and psychologists use the Body Mass Index (BMI) to calculate weight and a healthy weight range  BMI is calculated by the formula Kg/(m)^2 or weight/height  1 inch = 2.54 cm  1 lb= 0.45359237 Kg  100 cm = 1 meter Nutritional Counseling  Nutritional counseling is designed to educate and motivate people to follow a healthy, balanced diet and set reasonable weight goals  The first step is to take a thorough nutritional history and gather family info o Up to 70% of weight is determined genetically  Clients should agree to the final goal of eating when they are hungry and stopping when they are comfortably full  Also important is the client accepting and liking themselves at a healthy body weight  For anorexics, cessation of weight loss must be the first goal  Goals are broken down into small, manageable steps  Clients are educated about minimum daily body needs and basic nutrition  The client and nutritionist design a healthy meal plan together that is balanced, varied, contains the 4 good groups, and consists of a minimum of 1200-1500 calories per day  The meal plan usually involves 3 meals/day, with or without snacks (depending on client preference) o 5 small meals  Keeping a diet record may be helpful for the client o Develops mindfulness and baseline to see everything you are eating and can therefore make changes o Not recommended for anorexics because they are already dietary conscious  It's important for clients to learn that hunger is the body's signal that food consumed earlier has been used up for bodily functions o Hunger is a signal o Hunger is the trigger event  Anorexics often consider their state of hunger normal. (always hungry) They must learn to acknowledge their hunger and begin to eat in response to it  Clients should be warned that an initial water weight gain of 2-7 lbs may occur immediately after beginning re-feeding, but that it is temporary  An ideal 10-lb (+ or - ) weight range is selected by the nutritionist based on client's nutritional history/initial assessment  A lower weight may be chosen as an initial goal for an anorexic who may be terrified of becoming fat, with an agreement to re-evaluate when the initial goal is reached  Often the bulk of meals are initially kept small because of the client's heightened sense of bloating/fullness  The client's distorted body image must be addressed frequently and throughout the course of treatment o Caused by emotional issues that need to be kept up with  For anorexics, a weight gains of ½ to 2 lbs a week is expected, otherwise caloric intke is increased by 200-500 calories/week  When clients reach their set-point weight, their intense hinger will decrease and then they can eat a normal amount of food: objective in nutritional counseling  Bulimics often believe many myths about food (such as they must always avoid certain food groups) and many times don't know how to eat normally  Initially, a predetermined and specific maintenance meal plan that minimizes bulimics' decision- making is helpful (helps as a guide)  Again, bulimics must be warned of the possibility of initial water weight gain and that it will pass  Clients should learn to identify emotional and cognitive triggers/cues for eating  They must also learn to separate thoughts and emotions from eating (such as responding to fear and anger by eating)  Talking about their experiences both in nutritional counseling and individual/group therapy can be helpful in this regard  Clients need to address their unrealistic beliefs that thinness will bring them happiness, success, love, etc...  After clients reach their set-point weight and are eating 1800-2500 calories/day, they need to practice the new way eating for at least a month  After maintaining their weight for 1 month with the new way of eating, bulimics may be allowed to lose some weight, but still must not eat less than 1200-1500 calories/day in order to maintain bodily systems o Healthy and unhealthy eating is a habit o Consciously and unconsciously incompetent o Consciously incompetent --> consciously competent o Unconsciously competent – second nature, mindless, natural o Bulimics may be allowed to lose some weight, not anorexics


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