Eating Disorders

1. Eating Disorders

5. Top Models

8. Recent Deaths of 22 year old Uruguayan model Luisel Ramos, who succumbed to heart failure during a fashion show in August 2006

9. 21 year old Brazilian model Ana Reston passed away in November 2006 from multiple organ failure • Both deaths were attributed to the effects of anorexia • Ana was 5’ 7” and weighed 88 pounds

10. Anorexia nervosa • common eating disorder that usually begins at the age of fourteen or fifteen, with another peak in incidence in eighteen year olds.

11. It is more common in adolescent girls (affecting almost 1% of adolescent females), but it is also found in boys and its incidence has been increasing.

12. Anorexia causes an overwhelming fear of being overweight and a drive to be thin, leading to a restriction of calories that can lead to being underweight.

13. Teens with anorexia may also have bulimia nervosa, with a loss of control and binge eating, followed by purging behaviors.

14. It is not known what causes eating disorders, but it does seem to be associated with certain genetic attributes and it is more common in children who have a first-degree relative with an eating disorder.

15. Other factors that put you at risk for an eating disorders is participating in certain competitive activities (especially ballet, skating, athletics, and fashion modeling,), having a perfectionist or obsessivepersonality, and having a parent with an eating disorder or weight problem (obesity, frequent dieting).

16. Eating disorders are probably also more common in children with a past history of physical or sexual abuse.

17. Early risk factors for eating disorders include having low self esteem and being dissatisfied with their body.

18. Factors that you should look for: • recent weight loss • a fear of gaining weight or of being overweight • purging behaviors (vomiting or using diuretics (water pills) or laxatives to lose weight)

19. having a distorted image of their body's size or shape (for example, believing that she is overweight even though she is at a healthy weight) • a preoccupation with thoughts of food, calories and their weight

20. restrictive eating patterns, which can lead to a failure to gain weight or to being underweight and can include skipping meals, fasting, or eliminating entire food groups • preference for eating alone

21. amenorrhea (absence of menstrual cycles) or delayed onset of puberty and menarche • being underweight, with a body mass index that is below normal. Use the body mass index calculator to see if your child is underweight.

22. exercising compulsively • an extreme denial that she may have an eating disorder • withdrawal from friends and family • wearing bulky clothing to hide weight loss • has had a recent or past event in their life that was very stressful

23. Complications of Anorexia • Fainting from low blood pressure, electrolyte disorders, being intolerant to cold, constipation, decreased energy, changes in mood, anemia, kidney failure, osteoporosis (brittle bones), suicide, heart rhythm abnormalities, heart failure, sleep problems, confusion, irritability, and dizziness and even death.

24. Physical Signs • Patients with bulimia have an enlargement of the parotid glands (causing chubby cheeks), dental erosions (especially on the back surfaces), and having calluses on their knuckles. • Other signs found in teens with eating disorders include having dry and brittle hair, losing hair, and having muscle wasting.

25. Treatment of Disorders • Slow and difficult (and sometimes requires hospitalization) and should be overseen by a mental health professional that is familiar with treating patients with this disorder to begin psychotherapy and behavior modification.

26. Patients with anorexia also require nutritional and medical intervention to make dietary recommendations, ensure a slow and steady weight gain and correct the medical complications.

27. Bulimia nervosa • Most serious problem is that their purging means a loss of potassium, an important nutrient. • Potassium is found in foods such as bananas, tomatoes, beans, and melons. • Too little potassium can lead to dangerous heart problems.

28. People with bulimia also may damage their stomachs and kidneys and have constant stomach pain. • Like girls with anorexia, girls with bulimia may also stop menstruating.

29. Purging of bulimic presents a serious threat to the patient's physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

30. 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

31. DURATION OF ILLNESS/MORTALITY: •77% report duration from one to fifteen years* •30% report duration from one to five years •31% report duration from six to ten years •16% report duration from eleven to fifteen years •It is estimated that six percent of serious cases die •Only 50% report being cured 

32. COST OF TREATMENT: •Treatment for anorexia nervosa and/or bulimia is often extremely expensive and can extend for several years. •Cost of inpatient treatment can be $30,000 or more a month. •The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more

33. 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

34. Bulimia • Preoccupation with food • Binge eating, usually in secret • Vomiting after bingeing • Abuse of laxatives, diuretics, diet pills • Denial of hunger or drugs to induce vomiting • Compulsive exercise • Swollen salivary glands • Broken blood vessels in the eyes

35. Physical Repercussions • Malnutrition  • Dehydration • Ruptured stomach • Serious heart, kidney, and liver damage • Tooth/gum erosion • Tears of the esophagus 

36. Psychological Repercussions • Depression • Low self-esteem • Shame and guilt • Impaired family and social relationships • Mood swings • Perfectionism • 'All or nothing' thinking

37. The onset of eating disorders can occur at any age, however and the age of onset does appear to be getting younger. • Eating disorders can occur at any time and certainly reports of adult onset and individuals at 70 years of age have been reported.

38. Psychological Factors -fear of growing up- inability to separate from the family- need to please or be liked- perfectionism- need to control- need for attention- lack of self esteem- high family expectations- parental dieting- family discord- temperament - often described as the 'perfect child'- teasing about weight and body shape

39. Bulimia Factors -difficult regulating mood- more impulsive - sometimes will be involved with shoplifting, substance abuse, etc.- sexual abuse- family dysfunction

40. Medical Complications • Death Rates: 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.

41. Mental Functioning -Feeling dull -Feeling Listless -Difficulty concentrating or focusing -Difficulty regulating mood-Associated mental disorders: depression, anxiety disorders, obsessive-compulsive disorder, substance abuse

42. Heart Function -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

43. Skeletal -Stunted growth in children -Stress fractures and broken bones more likely-Osteoporosis

44. Mouth • Enamel erosion -Loss of teeth-Gum disease -“Chipmunk cheeks”- swollen salivary glands from vomiting -Sore throat because of induced vomiting

45. Esophagus Function -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

46. Endocrine Functions • -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 war

47. 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.

48. Intestines • Normal movement in intestinal tract often slows down with very restricted eating and severe weight loss-Frequent Constipation-Chronic irregular bowel movements

49. Genes load the gun - Environment pulls the trigger!