Statistics • 1.5% of Canadian women aged 15 – 24 years had an eating disorder. • Lifetime prevalence of anorexia nervosa • 0.9% in women and 0.3% in men • Lifetime prevalence of bulimia nervosa • 1.5% in women and 0.5% in men • Lifetime prevalence of binge eating disorder: • 3.5% in women and 2.0% in men • The average lifetime duration of bulimia nervosa is approximately 8.3 years. • Anorexia nervosa has the highest mortality rate of any psychiatric illness –10% of individuals with anorexia nervosa will die within 10 years of the onset of the disorder. http://www.nedic.ca/knowthefacts/statistics.shtml
In 2002 it was found that 28% of girls in grade nine and 29% in grade ten engaged in weight-loss behaviors. • 37% of girls in grade nine and 40% in grade ten perceived themselves as too fat • In grades 7-12, 30% of girls and 25% of boys reported teasing by peers about their weight. • 29% of girls and 16% of boys reported having been teased by a family member about their weigh • The beauty and diet industries make more than $45 billion every year http://www.nedic.ca/knowthefacts/statistics.shtml
What are eating disorders? • Clinical eating disorders are eating disorders that are recognized as medical conditions. These include: • Anorexia nervosa • Binge eating disorder • Bulimia nervosa • Eating Disorders Not Otherwise Specified (ED-NOS). • There are criteria to define these conditions. These clear definitions help health workers understand how each condition develops and progresses, and how to treat people with similar symptoms. • Although some people may not fit the exact criteria for a clinical eating disorder, they can still seek help. http://www.nedic.ca/knowthefacts/bodyimage.shtml
Causes of Eating Disorders “There is no single cause. An eating disorder generally results from a combination of factors. Psychological factors include low self-esteem, feelings of inadequacy or lack of control, depression, anger or loneliness. Interpersonal factors include troubled family and personal relationships, difficulty expressing emotions and feelings, history of physical or sexual abuse. Media promotion of unrealistic images and goals, along with its tendency to equate a person's value with their physical appearance is another contributor.” http://www.cmha.ca/bins/content_page.asp?cid=3-98
Body Image vs. Self esteem • Body image is the mental picture you have of your body (what it looks like, what you believe about it, and how you feel about your body) • Self-esteem is the "real" opinion you have of yourself. (How you value and respect yourself as a person.) • Self-esteem and body image also have influences on each other - it is hard to feel good about yourself if you hate your body • http://www.youtube.com/watch?v=mXimYVNf5C8 http://www.nedic.ca/knowthefacts/bodyimage.shtml
Anorexia Nervosa • People are obsessed with controlling their eating. The reason for their obsession is the belief that by controlling their bodies they can control their lives. This obsession is usually achieved through starvation. • Commonly begins during puberty. • Common symptoms: • An inability to maintain a weight that is normal for our age and height. • An obsessive desire to be thinner • Being very afraid of gaining weight or becoming "fat". • Abnormal menstrual periods in women. http://www.nedic.ca/knowthefacts/definitions.shtml
Binge Eating Disorder (BED) • Individuals with binge eating disorders eat excessive amounts of food at one time • They do this for two reasons: • They are very hungry because they have been dieting or restricting their eating in some way. The binge is a response to that hunger. • They over-eat to comfort themselves, to avoid uncomfortable situations, or to numb their feelings. The binge is an attempt to soothe themselves emotionally. • They do not try to compensate for their over-eating by vomiting, fasting, over-exercising or abusing laxatives as people with anorexia or bulimia may do. http://www.nedic.ca/knowthefacts/bodyimage.shtml
Bulimia Nervosa • Characterized by cycles of bingeing and purging. • Driven by a desire to regulate feelings, and with worries about body weight and shape. • The cycle: • rapidly eating large amounts of food in a single sitting • eating feels automatic and helpless which may lead to numb uncomfortable feelings, like anger or sadness • physical discomfort and anxiety about weight gain • person tries to rid the body of the food that was consumed by vomiting, using laxatives, enemas or diuretics, by exercising excessively, by skipping meals or by dieting http://www.nedic.ca/knowthefacts/bodyimage.shtml
Bulimia Nervosa • Common symptoms: • Repeated episodes of bingeing and purging. • Feeling out of control while eating. • Vomiting, using laxatives, diet pills or diuretics, exercising excessively, and skipping meals to rid the body of food. • Frequent dieting. • Using body weight and shape as the main measure of one's self-worth. http://www.nedic.ca/knowthefacts/bodyimage.shtml
Eating Disorder Not Otherwise Specified (ED-NOS) • A mix of anorexia and/or bulimia and/or binge-eating symptoms but do not fit exactly into one of the above mentioned categories. • For example: • a woman may meet all of the criteria for anorexia but continue to have a menstrual cycle . • Someone may have all the symptoms for bulimia or binge eating but they remain within their normal weight range. http://www.nedic.ca/knowthefacts/bodyimage.shtml
Anorexia Athletica • Does not qualify as a “clinical eating disorder” • Compulsive Exercising • People over-exercise because they believe this will control their bodies and give them a sense of power, control and self-respect. • Common Symptoms: • Exercising more than is good for our health. • Being fanatical about our weight and diet. • Taking time off work, school and relationships to exercise. • Believing that our self-worth depends on our physical performance. http://www.nedic.ca/knowthefacts/definitions.shtml
“What Have I Done to Myself”?Effects of Eating Disorders • Vitamin and mineral deficiencies • Electrolyte disturbances • Dehydration and fainting episodes • Loss of muscle mass occur often. • Decreased thyroid and insulin. • Dry scaly skin • Fine, soft hair • Brittle hair and nails, and yellow discoloration. • Slow heart rate (bradycardia) • Decreased blood pressure.
Effects of Eating Disorders • Lower body temperature • Slowing of the gastrointestinal tract may cause abdominal pain, bloating and chronic constipation • Calluses may form over the backs of the hands from repeatedly inducing vomiting. • Dental enamel erosions caused by stomach acid occur on the upper teeth. • Gastrointestinal problems may become life threatening. The stomach may become so distended that it perforates (tears) from excessive binging. • Retching can cause tears in the esophagus, gastrointestinal bleeding, and ulcers
Treatment • The first step: deciding you want treatment! • To be most effective, it is important to have a multi-disciplinary team which includes: a thorough medical assessment, nutritional guidance, support, medical follow-up, individual, group and even family therapy. • There are therapists that specialize in treating eating disorders • Resources in Fredericton: • Hungry For Hope Professional Counseling 420 York St, Fredericton, NB E3B 3P7 (506) 455-1444 http://www.cmha.ca/bins/content_page.asp?cid=3-98
Moving Forward From Self-Harming Behaviors: • List how your self-harming behaviour limits you. • Identify factors that make you vulnerable to self-harming. • Identify triggering events, feelings and beliefs. • Make the links between vulnerabilities and triggers. • Identify alternative ways of thinking and behaving. • Practice these alternatives when you are able to do so. • Build on the changes that work to replace self-harming. Celebrate your new, healthier coping strategies! Courbasson, C. (2001)
The Public Health Nurses’ Role • Initial contact person • Support • Provides resources • Mediates with family members • Follow up • Education
Eating Disorder Awareness • http://www.youtube.com/watch?v=NX3bF8cLoMQ&feature=related • Do you think enough is being done to promote eating disorder awarness? • Did you know anyone in high school who had an eating disorder?
Did you know that there is a national eating disorder awareness week?
Pro-anorexia websites • http://www.youtube.com/watch?v=n9eDpqPLz_A&feature=related • What do you think of these types of websites?
References Aime, A., Craig, W.M., Pepler, D., Jaing, D., Connoly, J.(2008). Developmental pathways of eating problems in adolescents. International Journal of eating Disorders. 41(8): 686-96 Canadan Mental Health Association. (2011). Eating disorders. Retrieved from http://www.cmha.ca/bins/content_page.asp?cid=3-98 Courbasson, C. (2001). Moving from self-harm to self-care. National Eating Disorder Information Centre. Retrieved from http://www.nedic.ca/knowthefacts/documents/MovingfromSelf-HarmtoSelf-Care.pdf De Groot, J.M. (1992). Women, eating disorders and self-esteem. National Eating Disorder Information Centre. Retrieved from http://www.nedic.ca/knowthefacts/documents/Womenbodyimageselfesteem.pdf National Eating disorder Information Centre. (2008). Retrieved from http://www.nedic.ca/ Newell, C. (2010). Early recognition of eating disorders. Practice Nurse, 39(12): 20-5 Zaitsoff, S.L & Taylor, A.(2009). Factors related to motivation for change in adolescents with eating disorders. European eating disorder review. 17(3): 227-33