BULIMIA ANOREXIA NERVOSA ASSOCIATION

NEW MEMEBER ORIENTATION

Presented by:Mia TannousAmanda Raffoul

HISTORY OF BANA

• Dr Moriarty founded BANA in 1983, as a self help group for parents of kids with eating disorders;

• Funded through United Way and private donations;

• First wave of funding from Ministry of Health & Long Term Care in 1989 for clinical treatment for adults;

• Second wave of funding in 1996 for clinical treatment for adolescents;

History of BANA Cont’d

• First wave of prevention funding in 2002 for three years from Ontario Trillium Foundation (OTF), to focus on health promotion

• Third wave of funding from MOH&LTC in 2006 to stabilize the programme

• Second wave of prevention funding from OTF for Body Based Harassment

• First wave of funding from Ministry of Health Promotion 2010 for Healthy Community Fund Grant

TYPES OF EATING DISORDERS (BASED ON DSM IV CRITERIA)

Anorexia Nervosa – 2 subtypes:• Restrictive (ANR), • Binge/purge (ANBP)

Bulimia Nervosa – 2 subtypes:• Purge (BNP), • Non purge (BNNP), subtypes

Eating Disorder Not Otherwise Specified (EDNOS): • EDNOS – ANR/ANBP, EDNOS –

BNP/BNNP;• Binge Eating Disorder (BED)

SIGNS AND SYMPTOMS OF EATING DISORDERS

Anorexia Nervosa:• Loss or failure to maintain at least 15% of

normal body weight;• Intense body dissatisfaction;• Weight loss not due to other medical

condition;• May alternate restrictive eating with binge

purge episodes (ANR or ANBP).

Bulimia Nervosa (BN)• Binge episodes, eating large quantities of

food in a short period of time, at least twice per week over a three month period;

• Body dissatisfaction;• Purge episodes (BNP) or other

compensatory behaviours following the binges (BNNP).

Signs Cont’d

Eating Disorder Not Otherwise Specified (EDNOS)

• Disordered Eating, • Doesn’t meet the weight criteria for AN,

(EDNOS AN)• Doesn’t meet the binge/purge frequency

criteria for BN (EDNOS BN)

Signs Cont’d

Binge Eating Disorder (BED):• Recurrent episodes of binge eating at

least twice weekly over a six month period

• Body dissatisfaction• Feeling powerless to control the binging • No other compensatory behaviours

Signs Cont’d

SOCIO-CULTURAL:• Presentation of negative stereotypes of

the feminine ideal in the media• Pressure to be thin/oppression of fat• Historical perspective of ED• Economy of Weight Loss Industry

Causes

Families don’t cause eating disorders, but:

• Perfectionism in families may discourage feelings for fear of criticism, and the tendency to be overly concerned with what others think may overshadow individual experiences

• Chaos in families such as addictions, sexual, physical, emotional abuse contribute to feelings of lack of control

Causes Cont’d

• Being over-protective can interfere with the adolescent developmental stages of autonomy and identity and parental role

Causes Cont’d

Causes Cont’d

• Individual is perfectionist• Genetic Predisposition • Low self esteem• Lacks awareness of emotions• Confusion of fullness and satiety

BANA’s Clinical Treatment Continuum

• Specialized Diagnostic Assessment• Psycho-education• Cognitive Behavioural Therapy• Nutrition Education• After care/support

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Map of Clinical Service Recipient Process

MAP LEGEND

= Adult Service Recipients = Adolescent/Child Service Recipients = Clinical Rounds & Specialized Diag. Assessment = Cost of Service = Decision Made = Path of Service

ENTRY POINTFROM

COMMUNITY

CHILD/ADOLESCENT

Referral Out OCOPED

Local Community

Psycho-educationTherapy

10 week group4 per year

8-10 registered

Family Therapy and Support

Hospital Visits

Follow-up@ 3 months@ 6 months@ 12months

.SpecializedDiagnostic

AssessmentStructured

interview + 8 Psychometric tests

Clinical Rounds20 Diagnoses and treatment plans;

local referral intensive

programme

IntakeVia Informal

Other Service Track

Via FormalClinical Track

ADULTIntakeVia Informal

Other Service Track

Via FormalClinical Track

Family Therapy and Support

Hospital Visits

Specialized Protocols

Weekly check in for Anorexia; Pregnancy

Referral OutOCOPED

Local Community

Psycho-educationTherapy

10 week group4 per year

8-10 registered

Nutrition Education

10 week group4 per year

Cognitive Behaviour

Therapy20 week group

2 per year

Follow-up@ 3 months@ 6 months@ 12months

.SpecializedDiagnostic

AssessmentStructured

interview + 8 Psychometric tests

Clinical Rounds150 Diagnoses and

treatment plans; local referral

intensive programme

May 31, 2010

• Specialized Health Promotion Assessment• Self esteem workshops• Media savvy workshops• Individualized program

BANA’s Health Promotion Continuum

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Map of Health Promotion and Education Service Recipient Process

MAP LEGEND

= Service Recipients = Primary Task/Activity =Specialized Community Request Assessment = Cost of Service = Decision Made = Path of Service

May 31, 2010

ENTRY POINTFROM

COMMUNITY

Specialized Community Assessment(English/French)

IntakeAgency or Institution Request

Health Fairs

Specially Offered

Programmes

Self EsteemPresentations

Sizing up the Media

Presentations

Nutrition Education

Presentations

General Information

BODY IMAGE WORKSHOP

• Every BODY Is A Somebody” by The Body Image Coalition of Peel:• Delivered to students in grades 5-8;

BODY IMAGE CONT’D

• Workshops include an interactive power point presentation followed by two activities;

• What is Self- Esteem?• Why is Self-Esteem so important?• How is Self-Esteem Developed?• Gender Socialization and Stereotypes;• Societal Influence;• Building Positive Self-Esteem.

Sizing Up The Media: Decoding the Messages

• Statistics on ED:• 1 in 5 women will suffer from an eating

disorder;• 70% of women and 35% of men are

dieting at any given time;• 98% of all diets fail and not for lack of

will-power

Sizing Up The Media: Decoding the Messages

• Canadian children in grades 3 & 4 say they’d rather lose a parent, get cancer or live through a nuclear war than be fat;

• In one study of 500 schoolgirls, 81% of 10 year olds reported they had dieted at least once;

Impact Of The Media

• Average person sees 400-600 ads per day, that’s 50 million ads by the age of 60 years. 1 out of 11 commercials has a direct message about beauty

• Thinness not only represents attractiveness but also symbolizes success, self-control, and higher SES

• The weight-loss industry grosses $32 billion annually

• Women earn more than men on average in only two job categories: modeling & prostitution

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PORTION DISTORTION IN OUR SOCIETY

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Media Cont’d

Use of scenes of violence against women as an acceptable practice to sell products.

Media Cont’d

Composite of many features to make one image.

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Media Cont’d

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THANK YOU!

• Questions/Comments