Mashie ShirkenMarch 4, 2015

Outline• Eating Disorders:

DefinitionsHealth ConsequencesRisk FactorsPrevalence Prevention

What is an Eating Disorder?

Condition characterized by abnormal eating habits

Cause is unknownBiological, Psychological, and Environmental

influencesSome genes have been identified

Type of behavioral addictionTriggers similar pathways in the brain associated

with substance abuse

Disordered Eating vs. Eating Disorder

Disordered eating is a classification used to describe a wide range of irregular eating behavior that do not warrant a diagnosis of a specific eating disorder

Individuals affected by disordered eating may be diagnosed with an eating disorder not otherwise specified (ENOS)

Anorexia Nervosa

Bulimia Nervosa

Binge Eating Disorder

Eating Disorders

Less Well Known Eating Disorders

Night Eating Syndrome

Nocturnal Sleep Related Eating Disorder

Chewing and Spitting

Pica

Less Well Known Eating Disorders

Purging Disorder

Anorexia Athletica (compulsive exercising)

Body Dysmorphic Disorder (BDD)

Eating Disorders not Otherwise Specified (ENOS)

US Government Office on Women’s Health

US Government Office on Women’s Health

Risk FactorsGender AgeGenetic DispositionUnrealistic ExpectationsMedia Model InternalizationPerfectionismIndividual Athletics

Figure 11.4 Dangerous shortcutsAbnormal Psychology, Eighth Edition DSM-5 UPDATE, Ronald J. Comer.Copyright © 2014 by Worth Publishers

Figure 11.3 When do people seek junk food?Abnormal Psychology, Eighth Edition DSM-5 UPDATE, Ronald J. Comer.Copyright © 2014 by Worth Publishers

Statistical Facts About Eating Disorders in the

USA20 million girls and women and 10 million boys and men

struggle with severe eating disorders such as Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.

35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives. Overweight girls are more likely than normal weight girls to engage in such extreme dieting.

(NEDA, 2013)

Statistical Facts - continued86% of Individuals report onset of illness by

the age of 20, with the highest rate of onset between ages of 16-20 (ANAD, 2000).

91% of women surveyed on a college campus attempted to control weight through dieting.

35% of “normal dieters” progress to pathological dieting.

Of those, 20-25% progress to partial or full syndrome eating disorders.

(NEDA, 2013)

Statistical Facts - continuedOver one-half of teenage girls and nearly

one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.

Eating disorders have the highest mortality rate of any other mental disorder.

Co-occurrence of substance abuse and eating disorders is estimated at close to 50%.

Statistical Facts - continuedThe average BMI of Miss America winners has

decreased from around 22 in the 1920’s to 16.9 in the 2000’s. The World Health Organization classifies a normal BMI as falling between 18.5 and 24.9.

Of American, elementary school girls who read magazines, 69% say that the pictures influence their concept of the ideal body shape. 47% say the pictures make them want to lose weight.

(NEDA, 2013)

Figure 11.1 Undergraduates and body dissatisfactionAbnormal Psychology, Eighth Edition DSM-5 UPDATE, Ronald J. Comer.Copyright © 2014 by Worth Publishers

Think Prevention!Primary Prevention refers to programs or

efforts that are designed to prevent the occurrence of eating disorders before they begin.

Secondary Prevention refers to programs or efforts that are designed to promote the early identification of an eating disorder and treatment before it spirals out of control.

Tertiary Prevention aims to treat full blown eating disorders and prevent further physical damage.

Evidence Based Approaches to Prevention and Treatment

Programs that adopt an ecological approach – involving not only individual change but also changing the environment of teacher and peer behavior – have shown some success (NEDA,2013).

Social Support Seeking strategy and long term outcome (Binford et al., 2005).

Evidence Based Approaches to Prevention and Treatment-

continuedPrograms that emphasize a healthy weight

have led to positive change (NEDA, 2013).Dissonance based eating disorders

prevention program were found to be helpful in prevention(Stice et al., 2006).

Prevention of body dissatisfaction can prevent disordered eating (Neumark-Sztainer et al., 2006).

Evidence Based Approaches to Prevention and Treatment-continued

• Cognitive behavioral therapy.

• Psycho-educational program researched in Canada was determined to be equally effective as cognitive behavioral therapy with the exception of severe conditions of eating disorders (Fairburn, 1995).

Cost of treatment for one person with an eating disorder is $30,000 per month.

The average direct medical cost for treating eating disorders patients in the USA is currently $5 to $6 Billion per year.

The global cost of antipsychotic medication is $7 Billion per year.

(NEDA, 2005)

Despite its prevalence funding for eating disorders research is approximately 94% less than for Alzheimer's.

Illness                                         Prevalence                    NIH Research Funds

Alzheimer’s Disease                  5.1million                      $450,000,000 Autism                                        3.6 million                     $160,000,000 Schizophrenia                            3.4 million                     $276,000,000 Eating disorders                       30 million                      $28,000,000

Research dollars spent on eating disorders averaged $0.93 per effected individual compared to $81 per effected individual with Schizophrenia, or $88 per individual with Alzheimer’s Disease. (NIH, 2011)

Thank You