| Eating Disorders |
| Obesity - Obesity o A condition in which there is excess body fat, although “excess” can be difficult to pinpoint. o Male should be considered obese at a percentage of body fat of 25 or higher o Women at 32 % or higher o Very difficult to treat because obesity and the ability to deposit fat are related not only eating habits but also, possibly, to a low daily energy expenditure; there also appears to be a strong genetic component. o Obesity is associated with a number of degenerative diseases, including cardiovascular disease, diabetes, and certain types of cancer. o People with more fat in the upper body and abdominal area appear to be at greater risk for cardiovascular disease and diabetes than those with greater fat deposition in the lower body. o Obesity can also be associated with reduced performance o Obese individuals usually fatigue faster than lean individuals, often have more difficulty with thermoregulation, and may be at greater risk for heat exhaustion and heat stroke. - Body mass index o The number of kilograms of body weight per unit of surface area o Classification of Obesity Category %over ideal weight Body mass index (kg/m²) Prevalence (% of total obese population in U.S.) Mild 20-40 25-30 90.5 Moderate 41-100 30-35 9.0 Severe >100 >35 0.5 Treatment - Admission of the problem - Diet, including reduced caloric and fat intake - Increasing caloric expenditure through regular exercise and other physical activity - Behavior modification, including self-monitoring of food intake so as to be aware of how much food is being eaten; learning to recognize and control events that lead to overeating; and developing a support group and a system of noncaloric rewards for helping to achieve weight reduction goals |
| Bulimia Nervosa - Bulimia nervosa and anorexia nervosa are listed as mental disorders in Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-IIIR), published by the American Psychiatric Association. - Bulimia nervosa o An abnormal and constant craving for food o Approximately 1 – 2% of American women and 0.1-0.2% of American men are bulimic. o The DSM-IIIR diagnostic criteria for bulimia are listed follows; § Recurrent episodes of binge eating (rapid consumption of a large amount of food in short periods of time, often less than 2 hr) § Three or more of the following; · Consumption of high-caloric food · Inconspicuous binging (often at night) · Termination of binges by abdominal pain, sleep, social interruption, or self-induced vomiting · Repeated attempts at losing weight by severely restrictive diets, self-induced vomiting, or use of cathartics or diuretics · Frequent weight fluctuations due to alternate binges and semi-starvation § Awareness of abnormal eating patterns but a fear of not being able to stop the binges voluntarily § Depression and self-deprecating thoughts after binges - The psychological manidestations of bulimia nervosa include o Pre-occupation with food o Pursuit of thinness o Difficulty in expressing emotions o Low tolerance for frustrations o High need for approval - Binge eating can create a number of medical problems, including o Stomach dilation and rupture o Infection of the lungs from aspirating vomitus o Infection and rupture of the esophagus o Enlargement of the salivary glands o Gum problems o Tooth erosion and decay o Loss of electrolytes Treatment - discussion of the eating disorder with the affected person - psychological counseling aimed at behavior modification and nutritional and dietary guidance, the latter in conjunction with a registered dietician |
| Anorexia Nervosa - Anorexia nervosa o Essentially self-starvation o The DSM-IIIR diagnostic criteria for anorexia nervosa are listed follows § An intense fear of becoming obese, even as weight is lost and underweight is achieved § Disturbance of body image; claims of being or feeling fat even when emaciated § Loss of 25% or more of original body mass; in children , expected growth reduced by 15% § Amenorrhea (absence of three consecutive menstrual cycles) in women - The psychological characteristics of anorexia nervosa including o Pre-occupation with food o Irrational fear of being or becoming fat o A distorted body image o Marked dissatisfaction with one’s body o Low self-esteem o Depression o Irritability and anxiety Treatment - long-term professional counseling, both psychological and nutritional, is necessary - Drug therapy may also be necessary to treat the psychological problems, and nutritional support is needed to reverse the effects of starvation |
| Approaching an Athlete Who Has an Eating Disorder - Identification of eating disorders can be difficult |