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Transcript of Bulimia
Bulimia Nervosa is an illness: individual binges on food or has regular episodes of overeating
feels a loss of control
individual uses different methods such as:
to prevent weight gain. Vomiting or abusing laxatives
Affirmative: feelings of inadequacy, guilt, shame Somatic: swollen salivary glands, erosion of tooth enamel, stomach or intestinal problems Cognitive: negative self-image, poor body image Behavioral: recurring episodes of binge eating followed by self induced vomiting, intense exercise, or laxatives Symptoms:
A physical exam may show:
• Broken blood vessels in eyes (strain from vomiting)
• Dry mouth, decaying teeth
• Pouch-like look of the cheeks
• Rashes and pimples
• Small cuts and calluses across the top of finger joints (from forced vomiting)
• Constipation Etiology:
(root causes of Bulimia) Diagnosis Biological Cognitive Sociocultural Low serotonin levels = bulimia, serotonin controls intake of food (according to Galla 1995). Biological causes Aim: bulimia within families- genetic or environmental
Method: 1000 pairs of female twins interviewed about whether or not they had bulimia
Results: 123 cases of bulimia, and there was a concordance rate for bulimia of-
MZ = 26%
DZ = 9%
Conclusion: most likely a biological cause for bulimia, Kendler proposed proposed half the cause (55%) for bulimia is due to genetic factors (biological) and half is due to environmental factors. 1st Study: Kendler et al (1991) Cognitive causes People with eating disorders suffer from perceptual distortion and maladaptive cognitive patterns.
Body-image distortion hypothesis Patients convinced they are fat, overestimate weight.
The degree of distortion varies with contextual factors (e.g.instructions given to estimate their size)
represent the participant's emotional appraisal rather than perceptual experience.
Brodie and Slade (1994): reformation of body-image distortion hypothesis
Bulimics unsure of their size and shape, overestimate when forced to make a judgement. Fallon and Rozin (1985): gender difference perception of body images.
US undergraduates were shown figures of gender, identify ideal
Women chose thinner body shapes for the ideal compared to the body shape they chose as current figure,
Men chose similar body figures for each case. 2nd study: Polivy and Herman (1985)
Cognitive disinhibition due to dichotomous thinking, ("all-or-nothing").
Bulimics follow strict dieting rules when they think about eating (cognitions), however will ignore these rules and binge eat (disinhibition).
Method: Dieters and non-dieters, given chocolate milk shakes and ice cream, eat as much as they wanted.
Results: dieters ate significantly more than non-dieters
Conclusion: dieters tend to display distorted eating behaviour
Evaluation: The cognitive explanation is more descriptive than explanatory. difficult to establish cause and effect
show this "ideal" body:
male = superheroes, action figures
female = Barbie, Bratz Dolls
Sanders and Bazaglette: transformed barbies measurements to a woman of average height and found that is was physically impossible
this exposure of the modern ideal body, by media and culture = children as young as 10 to feel dissatisfaction with their body --> (dieting). culture:
modern ideal of perfect female body = thin
But only 5% of the female population achieve thin figure
- those unable feel discouraged, this leads to body dissatisfaction, possibly Bulimia.
ideal male body: very muscular, toned
V- shaped figure.
In 1993 a MORI survey of UK adult males showed that 30% of them had been on a diet, and 60% believed a change in shape would make them more attractive. dissatisfaction could lead to bulimia. Socio-cultural causes: Jaeger et al (2002)
Aim: to investigate body dissatisfaction (linked to bulimia) dependence on cultural factors
Method: 1751 medical/nursing students, 12 nations (western and non-western) self reported information on body dissatisfaction, self esteem, and dieting.
series of 10 body silhouettes shown to assess body dissatisfaction.
Results: most body dissatisfaction = Mediterranean countries/northern European countries.
countries in the process of westernization = intermediate amount.
Non-weastern countries = lowest levels
Conclusion: there is a cultural impact on bulimia, where bulimia can be caused by body dissatisfaction due to the idealized body portrayed in mass media. weastern higest = media idealized body very thin and practically unachievable, 3rd study: Therapeutic approaches Biomedical therapy Group therapy Individual therapy Bio-Medical: Prozac (approved by US Food, McGilley and Pryor (1998)
382 patients: reduction of vomiting in 29% (5% with placebo)
Higher dosage: reduction of binge eating in 67% and vomiting in 56%
Replication by Goldstein et al (1995): reduction of binge eating in 51% (17% with placebo)
revolves around individuals perceptions on society/their effect on themselves.
like alcoholics anonymous
McKisack et al (1997): very successful if-
group members have similar characteristics
A united opinion = developed understanding of their illness pro: Group dynamics can help them support each other out of bulimia. cost-effective
con: not enough personal attention. Group therapy Low levels of cholecystokinin (CCK) = bulimia, because CCK causes one to feel full and stop eating, Individual therapy CBT:
doctors address the cognitive and behavioral components
The aim = to reinstate control over eating while avoiding any type of dieting (trigger binging)
The patients receive extensive feedback during therapy, and they are taught to identify and deal with symptom triggers. Patients learn to:
increase their expressions of feelings
avoid negative thoughts Support for CBT:
Wilson (1996) found CBT extremely successful
medication + CBT success rate doubles.
However, Wilson found only 50 % fully recover media:
creates widespread exposure for the "idea" figure, bombarding people with images of how they "should" look
setting unachievable/unhealthy standards of beauty: airbrushed/photoshopped "Oh my gosh, I'm SOO fat!" "Wow, I'm really ugly.." "Why don't people like me?"