Week 10

EATING
DISORDER
Minh Ngoc, Ha Giang,
Bao Tram, Thao Chi
Never have I ever - Season 2 - Episode 5
 1. OVERVIEW

2. CLIENT INFORMATION

3.
CONCEPTUALIZATION
AND TREATMENT

TABLE OF
4. DISCUSSION

CONTENT
5. TREAMENT

6. QUESTIONS
1. OVERVIEW
FEEDING PROBLEMS / EATING DISORDER
Mostly in children Mostly in adolescents
and adults
Picky eating
Disturbed body image
Eating inappropriate: and physical health
eating non-food
substances, Common ED: Anorexia
regurgitating and re- nervosa, Bulimia
chewing nervosa, Binge eating
Client
information
Tracy
 CLIENT INFO
Problems:
- Stress Tracy - 22 y/o - a college junior
- Depressed mood, self-isolation, little pleasure in
doing activities
- Few friends
- Physical pains
Actions:
- Take diet pills & laxatives
- Eat and throw up
- Meal skipping
- Substances-used problems
- Self-destructive problems
SOCIAL HISTORY
Dad: shows little care & affection, busy with work
Mom: substance-used problems, leaving the family to live with boyfriend
Persistent body-shaming Tracy

Boyfriend: cold & unsupportive

Friends: unsupportive & substances-used problems

CONCEPTUALIZATION
CONCEPTUALIZATION
AND TREAMENT
Tracy was referred to a group of 4 women
who also suffered from bulimia

Follow Cognitive Behavioral Therapist

Met the psychologist once/ week for 10 weeks

and talking a bout prearrangement topic
 10 weeks of treatment
Week 1 - 4 Week 5 Week 6 Week 7 - 10

Tracy: Ate the Participants

birthday cake after were asked to Participants follow
Tracy: avoid the fasting all day list things that healthy exercises
meeting and not their bodies did
accepted to be -> feeling guilty for them & Tracy: continues to
change -> realize Approach with
-> Planning in eating follow her plan & her
habits physiology mood is much
knowledge. improved.

Tu rning
point
Goals of 10 Learn to Reflect
Record eating patterns of binge

weeks treament and purging behavior

Aware of the all-or-nothing
thinking
Aware of the contradicting
thougths & behavior

Learn to be Assertive
Acknowledge those disturbing
patterns and the causes
Aware of the body's strength
Approach with physiology
knowledge
DISCUSSION
 TRACY'S DISORDER: BULIMIA NERVOSA - BINGE EATING AND PURGING

Criteria (DSM-IV-TR) Tracy

case

2 binges/week in at least 3 months

Binges stem from stress and out of control

Follow by purge

Intensely aware of weight and fear of becoming fat

Secretly happens

Etiological consideration

Overweight parents, peer teasing, and parental weight-related criticism

Distorted body image perception, extreme weight concerns and dieting practices

For Tracy, binge eating may have served multiple functions: coping with stress and filling a life devoid of other pleasurable activities
TREATMENT
FACTS ABOUT BULIMIA
Many patients avoid treatment due to
disbelief, shame, or hopelessness

Co-occurs with depression

Unpleasant drug side effects -> 1/3

bulimic patients to quit therapy
 Beauty Standard: The Western
Ideal of thiness
SOCIOCULTURAL
PERSPECTIVES Gender& Media: increases body
dissatisfaction

Self-objectification: present
women as sexual objects to be
judged based on their looks
 Challenge societal beauty

COGNITIVE- standards & teach normal

BEHAVIORAL
eating patterns
Identify binge triggers & develop
TREATMENT(CBT) alternative coping strategies
primary psychological Best when going with both CBT
intervention for bulimia
and medication
Violation in practicing treatments
can affect the progress
DISCUSSION QUESTION
 How would you distinction between Tracy’s behavior during an

QUESTION 1 episode of bingeing and purging and the behavior of a person

who is suffering from OCD?

OCD Eating disorder

“Abstract” fear
Fear of things/ events that have never
happened
Have no evidence to support the fear
Obsessive thoughts -> anxiety
Compulsive behavior: reduce anxiety
Rumination
Calm, lengthy, intent consideration
Intense dissatisfaction with body
shape or body weight
Obsessive thoughts -> depression
Purging behavior: raise anxiety
QUESTION 1 Could Tracy's purging behavior be
considered a compulsion? Why not?

No

Compulsion behaviors performed in response

to obsession ( no real-life effect)

Purging does have effect on remaining weight

-- BUT also has negative effect on physical health

Compulsion behavior -> reduce anxiety

Purging behavior -> raise axiety
 Question 2:
Discuss the differences between bulimia and anorexia,
especially with regard to issues related to impulse control
Anorexia Nervosa Buliamia Nervosa
Intense fear of gaining Binge eating
weight
Restricted food intake Compensatory behavior
(purging )
Significantly low body Fear of gaining weight
weight
Impulse control: avoid eating
and weight gain Impulse control: can’t control
->Strong desire to adhere to binge-eating
self-imposed restrictions.
 Why was Tracy’s emotional experience with the little girl’s birthday
QUESTION 3 cake an important turning point in her treatment?

Expose to guilt & shame & crisis: sobbed

uncontrollably, threw up, admit to group

Before: deny about the severity of eating disorder

After: recognized that it’s harming her well-being and
around people

Doesn’t want to go through these frustrated

feelings of harming people again

Suopportsystem
QUESTION 3 What was the most important factor in changing her motivation for
treatment?

New self-awareness:

Severity of the problem

Personal responsibility in changing her own feelings

and behavior.

Desire to be better
QUESTION 4
What are the connections among cognitive
factors, emotion regulation, and binge eating?

How are these issues related to dieting and

restricted intake of food?
 Cognition
“I cannot
Cognition th

Thought
W
ow

ha ou

or l
ha ro
em gh
fe ts h

ho t w

be ont
ot ts
be fat”
w
we e th

vi
an fec

ion of

c
el

tin un
fe ink
ink af

or ext

ea by
el
d

a
th act

an ffe st re

g
ge ed
d a ct re me
we we

bin llow
ct s ss
t

fo
ha
W

CBT cycle Tracy’s

Emotion bulimia case
Behavior Feelings
Behavior
Feeling bad
Behavior Emotion
Restrict
What we feel affects how food intake feelings of tired /
of her body
we act and think
overloaded
 Trigger

Trigger Stress

Jud Brewer’s Tracy’s

Binge Restrict
habit loop eating habit
Reward/
eating food intake
loop
Distract Action
ion
Reward Action
 QUESTION 4
What are the connections among cognitive factors, emotion regulation, and
binge eating?

INTERELATIONSHIP
Someone experiencing intense emotions or stress may
feel exhausted and overwhelmed,
leading to uncontrollable binge-eating as a way to
alleviate this stress.
CLASS Menti.com

DISCUSSION Code: 8914 8859