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Eating Disorders - Anorexia Nervosa

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sarah bhatti

on 15 August 2014

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Transcript of Eating Disorders - Anorexia Nervosa

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Definition:
Anorexia nervosa is an eating disorder that causes people to obsess about their weight and the food they eat. People with anorexia nervosa attempt to maintain a weight that's far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.
DSM-V
The requirement for amenorrhea has been eliminated and presence of behaviour that interferes with weight gain added to criterion B.

Diagnostic criteria for anorexia:
To be diagnosed with anorexia, you generally must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.

DSM diagnostic criteria for anorexia are:
• Refusal to maintain a body weight that is at or above the minimum normal weight for your age and height
• Intense fear of gaining weight or becoming fat, even though you're underweight
• Denying the seriousness of having a low body weight, or having a distorted image of your appearance or shape
• In women who've started having periods, the absence of a period for at least three consecutive menstrual cycles

Symptoms
Physical Symptoms:
• Extreme weight loss
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting

Emotional/Behavior symptoms:
• Refusal to eat
• Denial of hunger
• Afraid of gaining weight
• Lying about how much food has been eaten
• Excessive exercise
• Flat mood (lack of emotion)
• Social withdrawal
• Irritability
Age of Onset
• A young age. Anorexia is more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in people older than 40. Teenagers may be more susceptible because of all of the changes their bodies go through during puberty. They also may face increased peer pressure and may be more sensitive to criticism or even casual comments about weight or body shape.

• Genetics. Changes in certain genes may make people more susceptible to anorexia nervosa.
Family history. Those with a first-degree relative — a parent, sibling or child — who had the disease, have a much higher risk of anorexia nervosa.

Sports, work, and artistic activities:
Athletes, actors and television personalities, dancers, and models are at higher risk of anorexia. For some, such as ballerinas, ultra thinness may even be a professional requirement. Sports associated with anorexia include running, wrestling, figure skating and gymnastics. Professional men and women may believe they'll improve their upward mobility by losing weight, and then take it to an extreme. Coaches and parents may inadvertently raise the risk by suggesting that young athletes lose weight.

RED FLAGS:
• Skipping meals
• Making excuses for not eating
• Eating only a few certain "safe" foods, usually those low in fat and calories
• Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
• Cooking elaborate meals for others but refusing to eat
• Repeated weighing of themselves
• Frequent checking in the mirror for perceived flaws
• Complaining about being fat
• Not wanting to eat in public

What age group does Anorexia target?
Anorexia does not specifically "target" any age group in particular. It can happen at virtually any age. It does, however, tend to occur between the ages of 12 and 25.
Sarah Bhatti, Tanya Sharma, Josh Harding, Rosina Yeboah
Eating Disorders - Anorexia Nervosa

Prevalence/incident rates
In any given year, nearly 1 in 60 teens would qualify for an eating disorder diagnosis such as anorexia, bulimia or binge eating disorder.

In Ontario:
In one study, it was found that by the age of 18 years, 80% of girls of normal height and weight reported that they would like to weigh less.
Significant symptoms of eating disorders were reported by 27% of Ontario schoolgirls aged 12–18 years.
In a recent study, it was found that 29.3% of the Southern Ontario girls examined were currently trying to lose weight.

General:
• Almost 50% of people with eating disorders meet the criteria for depression.
• Only 1 in 10 men and women with eating disorders receive treatment. Only 35% of people that receive treatment for eating disorders get treatment at a specialized facility for eating disorders.
• Up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia and binge eating disorder) in the U.S.
• Eating disorders have the highest mortality rate of any mental illness.
This is relevant in today's society because just looking at the statistics you can see that eating disorders have the highest mortality rate at any mental illness. Also only 1 in 10 men and women with eating disorders receive treatment based on these facts i'd say this is not on the relevant to today's society but also has an impact on children and youth workers considering the age bracket 15 to 24 and the lack of support in treatment for this suffering from an eating disorder; it's clear there needs to be more awareness in education on this topic. Furthermore children youth workers will be the ones who are interacting in working with this age brackets and should be aware/ educated earth signs, symptoms, and treatments.
How relevance to society & impacting us as CYW's?
Interventions
Brief Therapy Interventions
• Effective in reducing symptoms in bulimic patients
• First step in treatment – bulimic patients who were not well informed about bulimia had more problems with intimacy
• higher compulsivity scores benefited from self- help manuals that provided info about the disorder or focused on self-assertion skills
• Group psychoeducation by itself provided therapeutic benefits in 5 sessions

Treatments
• Psychotherapy is a common treatment for anorexia but its efficacy remains in question

• The best outcome results from treatment that involves psychotherapy combined with nutritional management and family interventions

• Cognitive analytic therapy has been shown to benefit anorexic patients

• Behavior therapy is commonly used with rewards made contingent on adherence to the re-feeding protocol

• Individual or family therapy following hospitalization has also shown favourable long-term benefits

o Family therapy may also be employed to help resolve underlying family conflicts

• Cognitive-behavioral therapy (CBT)
o useful in helping bulimic individuals challenge self-defeating thoughts & beliefs: unrealistic expectations, perfectionistic expectations regarding dieting & body weight
o Another common dysfunctional thinking pattern in dichotomous (all or nothing) thinking, which predisposes bulimic individuals to purge when they slip even a little from their rigid diets
o CBT challenges tendencies to overemphasis appearance in determining self-words


Resources
Walk-In Counselling
East Metro Youth Services (EMYS)
Community based children's mental health centre, accredited by Children's Mental Health Ontario, which has been serving young people and their families
1200 Markham Road, Suite 200
Scarborough, ON, M1H 3C3
416-438-3697
Ages served: Up to 18 years
Languages served: English, Mandarin, Cantonese, Tamil
Fees: None
Area Served: Local

SICK KIDS
The Eating Disorders Program at SickKids is a unique program where medical and psychiatric care are fully integrated and are provided through a combination of inpatient, day hospital and outpatient services. We provide a complete range of services for children and adolescents struggling with these life-threatening and potentially chronic disorders.
We assess and treat children and adolescents for anorexia nervosa, bulimia nervosa or an unspecified eating disorder. We provide this care in several settings:
• A ten-bed inpatient unit
• A day hospital program
• An outpatient clinic.

Treatment
ONTARIO
Ontario Shores Child & Adolescent Eating Disorders Unit
In the Fall of 2014, a new 12-bed Eating Disorders Unit will open at the Ontario Shores Centre for Mental Health Sciences in Whitby, Ontario. Funded by the Ministry of Health and Long Term Care, the unit will offer the first-of-its-kind program in Ontario.
For more information about this new program, please contact 905.430.4055 ext. 6010.
www.ontarioshores.ca

WaterStone Clinic
WaterStone is a private clinic situated in a quiet residential neighbourhood in north Toronto. The clinic is committed to providing excellence in adult eating disorders treatment across a range of eating disorder diagnoses and complexities, including substance use. As the first of its kind in Canada, the goal is to give clients the skills to build healthy, happy, and meaningful lives.
50 Bond Avenue, Toronto, ON M3B 0A6
416 510-9998
http://www.waterstoneclinic.com
Support
Ontario – GTA
Eating Disorders of York Region
A grassroots, registered non-profit founded to address the urgent and unmet needs of those who suffer from Eating Disorders.
www.edoyr.com

Sheena’s Place
A community-based Eating Disorders support center in Toronto offering support group programs, outreach/education and resources for parents and teens.
www.sheenasplace.org

Mental Health Helpline
The Mental Health Helpline provides information about mental health services in Ontario. Funded by the Government of Ontario, the service is live, 24/7, confidential and free.
http://www.mentalhealthhelpline.ca
Credit Valley Hospital
Visit: www.cvh.on.ca/edp/index.php
Call: 905-813-4505
Write: Credit Valley Hospital
Eating Disorder Program
2200 Eglinton Avenue West
Mental Health Department, 2nd Floor
Mississauga, Ontario L5M 2N1

William Osler Health System
Visit : www.williamoslerhc.on.ca.
Call: 905-494-6621 or 905-453-1160 ext. 0
Write: William Osler Health System
Eating Disorder Program
2100 Bovaird Drive East,
North Building, 3rd Floor
Brampton, Ontario L6R 3J7

Halton Healthcare Services
Visit: http://www.haltonhealthcare.com/programs_otmh_mental.php#eating
Call: 905-815-5140
Write: Halton Healthcare Services
Eating Disorder Program
700 Dorval Drive, 6th Floor
Oakville, Ontario L6K 3V3


References
Jeffrey S. Nevid, Beverly Greene, Paul A. Johnson, Steven Taylor, and Melanie Macnab (2012). Essentials of Abnormal Psychology, Third Canadian Edition with MySearchLab (3rd Edition), Pearson Education Canada.

• ANAD. (n.d.). Eating Disorders Statistics « National Association of Anorexia Nervosa and Associated Disorders. Retrieved July 17, 2014, from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

• Anorexia nervosa. (n.d.). Definition. Retrieved July 18, 2014, from http://www.mayoclinic.org/diseases-conditions/anorexia/basics/definition/con-20033002

• Categories you should follow. (n.d.). WikiAnswers. Retrieved July 20, 2014, from http://wiki.answers.com/Q/What_age_group_does_anorexia_target
References

• Eating Disorders. (n.d.). Eating Disorders. Retrieved July 20, 2014, from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/ 


• (n.d.). National Center for Biotechnology Information. Retrieved July 20, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/16721169

• Statistics. (n.d.). National Eating Disorder Information Centre (NEDIC). Retrieved July 20, 2014, from http://www.nedic.ca/know-facts/statistics

• Stats. (n.d.). Hopewell Stats Comments. Retrieved July 20, 2014, from http://www.hopewell.ca/?page_id=113

Prevalence of Eating Disorders Among Teens - Psych Central News. (n.d.). Psych Central.com. Retrieved July 20, 2014, from http://psychcentral.com/news/2011/03/07/prevalence-of-eating-disorders-among-teens/24188.html
Peel/Halton
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