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A lesson on eating disorders for an IB high school class

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Tuuli Pöllänen

on 3 December 2013

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Transcript of A lesson on eating disorders for an IB high school class

What is an eating disorder?
Mental illnesses,
serious disturbances in diet habits
Severely
reducing or increasing
intake, grossly distorted eating habits
From bening to an out-of-control loop
Negative, distorted body image
Comorbidity
Severe impairment of
life quality, high mortality
!
Young women
, 14 - 18

Types:
o Anorexia nervosa
o Bulimia nervosa
o Binge-eating disorder
o Eating disorders not otherwise specified (EDNOS)

What do you think?
Are anorexia and bulimia really two different things,
or could they be two manifestations of the same problem?

More similarities than differences.
Additionally...
- Patients
"flip-flop" diagnoses
- Same
population
- Same
comorbidity
- Poor
response to therapy

Anorexia: overcoming the urge to eat
Positive incentives theory
- Voluntary starvation enabled by a decline in the
positively motivating value
of food
"But anorexic patients are
obsessed
with food! "
interacting
with food vs.
consuming
food

Starvation typically triggers a radical increase in the positive value of eating!

Why does this not occur in anorexia?


Aversive psychological effect of meals
- Whe begin a meal in a
homeostatic state
Influx of calories breaks the homeostasis!
- Longer starvation -> greater aversive effects
- WW 2: death by refeeding

Recipe: Anorexia
Servings: One
Note: The recipe you are about to make is an acquired taste.

Ingredients:
1 cup low self-esteem
2 cup self-control
3/4 cup determination
1 1/2 strength
2/3 cup solitude
2 Tbsp routine
3 Tbsp secrecy and lies
2 tsp jealousy
3 tsp guilt
a dash of anger
and 1/2 cup tears (optional)

Directions:
Combine all ingredients and mix in a fragile soul.

Beat until all feeling is gone.
Place in a shallow bowl and serve with a tall glass of Diet coke.
Dish is ready to enjoy - guaranteed to disappear right before your eyes!!

Anorexia and Bulimia nervosa
What
provides such strong incentive that its value eventually surpasses that of survival?
.. .I remember at one time I actually cried because I was so hungry. Eventually, my hunger went away.
I didn't have a "taste" for food anymore.

I got used to not eating. By the time Christmas was over I was a size 5.
“I think my problem began when eating started to lose its positive-incentive value for me – In my mind,
I kind of associated eating with being fat and all the boyfriend problems I was having.

This made it easy to diet, but every once in a while I would get hungry and binge, or my parents would force me to eat a big meal. I would eat so much that I would feel ill. So I would put my finger down my throat and make myself throw up. This kept me from gaining weight, but I think it also taught my body to
associate my favourite foods with illness – kind of a conditioned taste aversion.”
Causes?
Gene - environment interaction

The impact of socio-cultural factors
Evidence of Anorexia nervosa since 12th century
Named and identified in 1870's
Recognized with the current population distribution in 1970's.
Where are we now with eating disordes?
Media pressure
Individualism
Success as a personal responsibility
Ambition, perfectionism
Lack of compartmentalization when it comes to competence
Young and attractive -> successful

The loop:
Controlling
an inherent
biological motive
(feeding) with rigid,
goal-oriented behavior
(dieting) to gain
acceptance
of others by aspiring towards beauty ideals.
feeling of
competency
,
self-efficacy
,
control
reinforce
the behavior
Rules are internalized and start to control life
negative response from environment
, secrecy, guilt, self-loathing
Inability to exit the loop:

social isolation

Go to recovery
Refuse recovery
Change means losing yourself for a while
Poor response to treatment
50% relapse
Facing the original problem
Rebuilding social contacts
Stigma
Retain sense of self-integrity, values, goals
Problem:
social isolation
remains
Solution: build a new social network from likeminded individuals

Where would
you

find such a network?
If you're interested in reading more:

ANOREXIA - it's not a new disease
(New York Times) - on history of anorexia nervosa:
http://www.nytimes.com/1985/12/08/style/anorexia-it-s-not-a-new-disease.html

The fine line between Fitspo and pro-ana
(Psychology today):
http://www.psychologytoday.com/blog/food-junkie/201310/the-fine-line-between-fitspo-and-pro-ana

National eating disorder association
(USA): http://www.nationaleatingdisorders.org/

Slovenski stran motenj hranjenja
: http://www.motnje-hranjenja.si/novice.html

Page with detailed articles about basic info on all classified eating disorders
: http://www.helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm

A miraculous web-page where you can find nearly any information about anything
: google.com
The "pro-ana movement" and social networking
online
Arguing for anorexia as a
"choice"
or
lifestyle
Adverse effect for both healthy participants and participants with ED
from browsing the sites!
- induce ED-like behaviors and experiences even in healthy viewers
- increased
negative affect
- decrease in
self-esteem
, less
satisfaction with appearance


Anorexia nervosa
Bulimia nervosa
weight
eating habits
body image
physical
symptoms
emotional
symptoms
relationships
significantly underweight
normal or overweight
Extreme limitations, rituals
binges purges
Distorted, obsessive
Distorted, obsessive
Starvation, low blood pressure, heart and kidney problems, hair loss, fatigue, lack of period...
Weight fluctuation, ulcers, sores in mouth and throat, dental problems, fatigue, irregular period...
Depression, anxiety, obsessive-compulsive behaviors, intense fear of weight gain, self-destructive behavior
Depression, anxiety, obsessive-compulsive behaviors, intense fear of weight gain, self-destructive behavior
Withdrawn, secretive, may refuse to eat in presence of others
Withdrawn, secretive
CHOOSE A TOPIC FOR DISCUSSION:
Knowing how individuals with eating disorders use web services, how would you design a pro-recovery site that would have a better chance at reaching its purpose?

What factors might improve recovery rate for anorexia and bulimia nervosa?
How could we use this in practice?
Things

learned after first visit
on a pro-ana site:
1. thinspiration
2. hiding ED behaviors
3. fasting
4. using diuretics and laxatives
5. vomiting
6. using alcohol and drugs to inhibit appetite
7. self-harm
SOCIAL SUPPORT OR AGGRAVATION OF ILLNESS?

- ED patients also misuse pro-recovery sites!
- pro-ana sites help compensate for
low social support

greater support
from online communities
! Encouragement
to
continue
ED behaviors
Reasons for
joining
:
1. sense of belonging
2. social support
3. support for the choice (of no recovery)
Reasons for
continuing
use:
1. support for stress
2. meeting others with ED
3. finding triggers for ED behaviors
Full transcript