anorexia nervosa

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What is beauty or attractiveness to you?. Researchers that relate size and shape of women to their physical attractiveness use BMI

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anorexia nervosa

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1. Anorexia Nervosa

3. Researchers that relate size and shape of women to their physical attractiveness use BMI & WHR BMI: Standard measure of weight, calculated by dividing weight in kilograms by height in meters squared. BMI’s below 18.5 are considered underweight. BMI’s from 18.5 to 25 are normal weight BMI’s from 25 to 30 overweight BMI’s over 30 are obese

4. WHR: Waist-to-hip Ratio WHR is calculated by dividing waist circumference by hip circumference Young adult women fall in the .70 to .90 range. Adult men fall in the range of .80 to .95

5. Differences in waist to hip ratio They are usually due to hormonal differences, with circulating ESTROGEN causing fat cells accumulation of in the hip region and inhibiting fat accumulation in the waist region! Testosterone causes accumulation of fat cells around the waist and inhibits fat deposits in the hip region.

6. Differences in female and male shape AHA!! It’s largely due to the difference of estrogen and testosterone in our bodies! They allow each sex to carry their weight in different places.

7. Women’s Ideals In this research the ideal was 20.3, which is at the low end of normal. In self ratings overweight BMI rated themselves as least attractive, while women who were underweight rated themselves as most attractive.

11. Anorexia Nervosa Weight: 15 % below ideal body weight. Refusal to maintain a normal weight or above normal weight for height and age. Not everyone who is of a low weight is anorexic; it is important to recognize that it is the REFUSAL to maintain a normal weight that is the key factor.

12. Self –evaluation quiz for Anorexia Are you constantly thinking about your weight and food? Are you dieting strictly and/or have you lost a lot of weight? Are you more than 10% below your healthy weight? Are people concerned about your weight? Is your energy level down? Do you constantly feel cold?

13. Types of Anorexia Many individuals with anorexia will severely restrict their calories sometimes taking in only a few hundred calories a day or just water. This is called the RESTRICTING TYPE. Our bodies do not like to starve. Remember, the individual with anorexia has an appetite they just try to control it. It is very difficult when you are starving not to want to eat. What happens to many as a result is that they lose control they eat or eat something they feel they should not have eaten. For these individuals, this might mean something as simple as a cookie, a normal meal or even a binge. With the fear of gaining weight, they may vomit or exercise. This type of anorexia is called the BINGE-EATING/PURGING TYPE one of the most dangerous forms of an eating disorder

14. Symptoms of Anorexia ANOREXIA NERVOSA • Deliberate self-starvation with weight loss • Intense, persistent fear of gaining weight • Refusal to eat or highly restrictive eating • Continuous dieting • Excessive facial/body hair because of inadequate protein in the diet • Compulsive exercise • Abnormal weight loss • Sensitive to cold • Absent or irregular menstruation • Hair loss

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17. Are your periods abnormal or have your periods stopped? 

18. Figures on Anorexia AGE AT ONSET OF ILLNESS:•86% report onset of illness by the age of 20* •10% report onset at 10 years or younger •33% report onset between ages of 11-15 •43% report onset between ages of 16-20

20. Death rates of Anorexia Young women that have anorexia nervosa are 12 times more likely to die other women her age without anorexia. Anorexia has the highest mortality rate of all mental disorders. The mortality rate is about 5% for each decade and increases up to 20% for patients that have the illness for more than 20 yrs.

22. Psychological Problems Associated with Anorexia -Feeling dull -Feeling Listless -Difficulty concentrating or focusing -Difficulty regulating mood-Associated mental disorders: depression, anxiety disorders, obsessive-compulsive disorder, substance abuse

23. Medical Issues Cardiovascular (Heart): -Slow irregular, pulse -Low blood pressure-Dizziness or faintness -Shortness of breath -Chest pain -Decreased potassium levels may result in life threatening cardiac arrhythmias or arrest-Electrolyte imbalances may lead to life threatening cardiac arrhythmias or arrest Muscular Skeletal (Bones):

24. More Medical Issues Mouth: -Enamel erosion -Loss of teeth-Gum disease -“Chipmunk cheeks”- swollen salivary glands from vomiting -Sore throat because of induced vomiting Esophagus: -Painful burning in throat or chest -May vomit blood from small tear(s) in esophagus -Rupture of the esophagus, may lead to circulatory collapse and death  Endocrine System: -Thyroid abnormalities-Low energy or fatigue -Cold intolerance -Low body temperature -Hair becomes thin and may fall out -Development of fine body hair as the body’s attempt to keep warm

25. Yet Even More Medical Issues Stomach: -Stomach may swell following eating or binging (causes discomfort and bloating) -Gastric rupture due to severe binge eating (gastric rupture has an 80% fatality rate)-Vomiting causes severe electrolyte imbalance which can lead to sudden cardiac arrest. Intestines: -Normal movement in intestinal tract often slows down with very restricted eating and severe weight loss-Frequent Constipation-Chronic irregular bowel movements

26. Study done testing the motor functions in rats with DR( Dietary Restrictions) Rats had a lower level of accuracy while on a restricted caloric diet During DR animals became frantic and made repeated attempts to grasp a single pellet.

27. Other Problems DR may also disrupt reproductive cycles in both male and female rats, often causing delayed onset of puberty and decrease in fertility. Could this be for humans too? Yes!

28. Yet more problems Negative effects of DR are sometimes more apparent in younger animals. Food is scarce or severely restricted, reproductive performance, growth, and immune responces are sacrificed Leaves animals prone to infection, reduced growth, hormonal imbalances, or permanent neurological deficit.

29. Both in humans and rats Dietary restrictions often lead to preoccupation with food, irritability, and overeating upon presentation of food In anorexia, there is often a preoccupation of thinking about food, and their episodes of purging.

30. Food restrictions acts a cellular stressor to metabolic substrate deprivation Increase in levels of plasma corticosterone Increase in adrenal gland weight Decrease in glutocotropin receptors Increase of responcivity to stress inducing procedures

31. Why all of this? It has been suggested that behavioral alterations during DR are due to hypothalmic-pituitary-adrenal axis and changes in level of stress hormone. Fewer and shorter synapses in sensorimotor cortex. Sensorimotor cortex is associated with skilled movement performance and voluntary motor control Sensorimotor cortex is associated with skilled movement performance and voluntary motor control

32. Therapy There are over 400 schools of psychotherapy, each claiming a distinct theory and set of treatment technique. Psychodynamic and cognitive-behavioral therapies probably represent the most widely used. There is no one definitive form of therapy recommended for eating disorders. Often the therapist will evaluate where the patient is. For some individuals, they may be very knowledgeable and have had experience with some intervention. For others, it is a totally new experience

33. Resources  Moradi B, Dirks D, Matteson AV. Roles of sexual objectification experiences and internalization of standards of beauty in eating disorder symptomatology: A test and extension of objectification theory. Journal of Counseling Psychology. 2005; 52(3):420-428  Ricciardelli LA, McCabe MP, Holt KE, Finemore J. A biopsychosocial model for understanding body image and body change strategies among children. Journal of Applied Developmental Psychology. 2003; 24(4):475-495.

34. Continuation of Resources Smith LK, Metz GA. Dietary restriction alters fine motor function in rats. Physiol Behav. 2005; 85(5):581-592 Weeden J, Sabini J. Physical attractiveness and health in western societies: A review. Psychol Bull. 2005; 131(5):635-653 http://www.anad.org/site/anadweb/ National Association of Anorexia Nervosa and Other Associated Disorders

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