Eating disorders

Chapter 8

Which are DSM-5 Diagnoses?

 Bulimia Nervosa
 Binge Eating Disorder
 Obesity
 Anorexia Nervosa

Bulimia Nervosa
 Recurrent binging
 Eating much more food in a certain period of time than

 Sense of
 Recurrent
 Over-concern with body shape and weight

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 Anorexia Nervosa
 Refusal to
* Restricting Type
* Binge-Eating/Purging Type
 Intense fear of gaining weight or
getting fat
 Or

 Distorted view of

Medical Complications
 Enlarged
 Erosion of dental enamel


 problems
 Dry skin, brittle hair & nails, intolerance to cold (AN)

Binge-Eating Disorder
 Now an official diagnosis, in DSM-5
 Recurrent
 Marked distress about
 Lack of

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 Onset, Prevalence, & Course
 Onset,
 More common in females than males
 Prevalence rates
 Anorexia:
 0.5% to 1% lifetime for females
 ~0.1% for males
 Bulimia:
 ~2% for females
 ~0.2% for males
 Course,

Social Factors
 Society’s messages about
 Differences between
 Differences among
 Peers’ concern with weight and dieting


 Family influences


 Mothers who are dieting and overly concerned with

own and daughters’ weight

Biological Factors
 There seems to be some genetic component
 EDs run in families
 Higher concordance for MZ twins


 Some neurobiological abnormalities are often

present
 Cause or effect?

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 Psychological Factors
 Low sense of
 Low self-confidence and self-esteem
 (when combined with dissatisfaction
with one’s weight)
 Distorted perceptions of their own body


 Intolerance of

Medication to Treat EDs

 AN
 BN
 better than placebo
 Associated
with reduced binging and purging
 Not adequate on their own, effects are

Psychological Treatments for BN

 Cognitive Behavioral Therapy
 Psychoeducation



 Scheduled

 Cognitive

 Coping strategies
 Interpersonal Psychotherapy
 Improving interpersonal relationships and reducing
conflict

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 Psychological Treatments for AN
 CBT (as with BN)
 Increase
 Family-focused therapy re: messages and
communication about eating and weight


Preventing Eating Disorders

 Based on

 Primary prevention programs showed

 Only those who showed pre-treatment

 Targeted prevention programs seem