Eating DisordersEating Disorders

Anorexia NervosaAnorexia Nervosa

Restricting or Binge-Eating/Purging TypeRestricting or Binge-Eating/Purging Type Body weight less than 85% of expectedBody weight less than 85% of expected Intense fear of gaining weightIntense fear of gaining weight Disturbance of body imageDisturbance of body image Three months without period (for females)Three months without period (for females)

Look for hair falling out, wearing large size Look for hair falling out, wearing large size clothingclothing

Control and body distortionControl and body distortion

Tx of AnorexiaTx of Anorexia Specialized Field due to medical Specialized Field due to medical

complicationscomplications Often you will find separation/individuation Often you will find separation/individuation

issues and controlling/ emotionally punishing issues and controlling/ emotionally punishing family systemfamily system

Help move away from all or nothing thinkingHelp move away from all or nothing thinking Help increase awareness of feelings and Help increase awareness of feelings and

drivesdrives Antidepressants Antidepressants Louise Ousley (Psychologist) and Marjory Louise Ousley (Psychologist) and Marjory

Guise (psychiatrist)Guise (psychiatrist) Work with physician and nutritionist. Cl must Work with physician and nutritionist. Cl must

be under physicians carebe under physicians care

Bulimia NervosaBulimia Nervosa

Purging and Nonpurging TypePurging and Nonpurging TypeTypically in the normal weight, but Typically in the normal weight, but

may be over or under weightmay be over or under weightBinge and Compensation at least Binge and Compensation at least

twice a week for 3 monthstwice a week for 3 monthsLook at fingers and teethLook at fingers and teethHave cl obtain physical for internal Have cl obtain physical for internal

organ damage and check potassium organ damage and check potassium levels (cardiac problems can occur)levels (cardiac problems can occur)

Cycles of Binge/PurgeCycles of Binge/Purge

Usually you will be able to identify Usually you will be able to identify triggers as the cycles occur. Often triggers as the cycles occur. Often related to family or other relationships.related to family or other relationships.

Anxiety increases and client seeks to Anxiety increases and client seeks to reduce pain with bingereduce pain with binge

Binge reduces anxiety (like a drug), Binge reduces anxiety (like a drug), but is quickly followed by guilt and but is quickly followed by guilt and shame and anxiety. However, these shame and anxiety. However, these emotions are more tolerable than the emotions are more tolerable than the initial anxiety.initial anxiety.

Tx of BulimiaTx of Bulimia

Helping Cl to recognize triggers and gain Helping Cl to recognize triggers and gain awareness of anxietyawareness of anxiety

Help to “delay” bingesHelp to “delay” binges Identify other ways to reduce this anxietyIdentify other ways to reduce this anxiety Reduce self-criticism Reduce self-criticism Work on Separation/Individuation issues Work on Separation/Individuation issues

with familywith family Work on self-image aside from body sizeWork on self-image aside from body size Help find supports and “breaking of secret”Help find supports and “breaking of secret”

Tx BulimiaTx Bulimia

Work with Nutritionist, physician, and Work with Nutritionist, physician, and at times psychiatristat times psychiatrist

AntidepressantsAntidepressants

Eating Disorder NOSEating Disorder NOS

AnorexiaAnorexia Normal weightNormal weight Females still have periodFemales still have period

BulimiaBulimia

-- Purge or compensatory less than -- Purge or compensatory less than frequency requiredfrequency required

-- Regular chewing and spitting out of food-- Regular chewing and spitting out of food

-- Regular binges w/out compensatory -- Regular binges w/out compensatory BehaviorBehavior