“GLAMOUR QUEENS IN SIZE 2 JEANS”

Steven G. Liga, MSW, LSW, LCADC, CPS CEO/Executive Director

Course Outline

            Introduction What do you think of when I say “Eating Disorder?” Definitions What are we talking about?

Consequences What’s the big deal?

Causes How does this happen to someone?

Prevention and Treatment What can be done, and where do we turn?

Conclusion What does this have to do with NCADD?

INTRODUCTION

Eating Disorders

 Let’s Brainstorm!

 What do you think of when I say “Eating Disorder?”

Facts and Figures

    The average American woman is five feet, four inches and weighs 140 pounds. The average American woman wears a size 14 dress.

One-third of all American women wear a size 16 or larger.

The diet industry (diet foods, programs, drugs, etc.) takes in over $40 billion each year and it is still growing.

Facts and Figures (cont.)

    50% of American women are on a diet at any one time.

75% of American Women do not like or are dissatisfied with their appearance.

90% of high school junior and senior women diet regularly, although only 10-15% are over the weight recommended by doctors.

50% of nine year olds and 80% of 10 year olds have dieted.

Facts and Figures (cont.)

  1% of teenaged girls and 5% of college aged women become anorexic or bulimic.

Anorexia has the highest mortality rate of any psychiatric diagnosis   20%!

Suicide as a result of depression is only 15%

Glamour Queens in Size 2 Jeans

Original poem by Nathalie Gottlieb www.feminist.com/resources/artspeech/body/voices.htm

DEFINITIONS

Which of these people has an eating disorder?

 Shelia eats so many French fries that she wants to throw up. And she actually does.

 Marsha skips breakfast and lunch and eats just a small salad with vinegar dressing for dinner.

 Susan indulges in a hot fudge sundae (four scoops of ice cream, fudge, whipped cream, and cherry) every night for a week.

Profile of an Anorexic

      Female (90%) Perfectionist Feels fat even though underweight Denies appetite (won’t eat even when hungry) Preoccupied with food and weight Sleep disturbances

Profile of an Anorexic (cont.)

      Inability to concentrate Mood swings (irritable and depressed) Ritualistic food practices Strict food rules Excessive and rigid exercise routines Shops and cooks for others while not eating themselves

What does she see in the mirror?

Myths

    Bulimics and Anorexics are underweight and compulsive overeaters are overweight.

People who have eating disorders are weak willed.

Eating disorders are a vain, attention-getting disease.

People with eating disorders don’t want anything to do with food.

Eating vs. Eating Disorders

 Eating     Appetite Food availability Family & cultural practices Voluntary control

Eating vs. Eating Disorders (cont.)  Eating Disorders   Obsession with:  Food   Weight Appearance So much that health, relationships, and activities are affected.

Behaviors

      Restrict food intake Binge eating Binge and purge Abuse laxatives Compulsively overeat Exercise excessively

Coping Mechanisms

      Pain Separation Low self-esteem Depression Stress Trauma

DSM 307.1 Anorexia Nervosa

    Refusal to maintain body weight at or above a minimally normal weight for age and height.

Intense fear of gaining weight or becoming fat, even though underweight. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. In postmenarchal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.

DSM 307.1 Anorexia Nervosa (cont.) Specify type:  Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)  Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

DSM 307.51 Bulimia Nervosa

 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:   eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances a sense of lack of control over eating during the episode  Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.

DSM 307.51 Bulimia Nervosa (cont.)  The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.  Self-evaluation is unduly influenced by body shape and weight.  The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

DSM 307.51 Bulimia Nervosa (cont.) Specify type:  Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self induced vomiting or the misuse of laxatives, diuretics, or enemas  Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

DSM 307.50 Eating Disorder NOS  For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.

 All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range.  All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.

DSM 307.50 Eating Disorder NOS (cont.)  The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).  Repeatedly chewing and spitting out, but not swallowing, large amounts of food.  Binge-eating disorder (BED): recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.

CONSEQUENCES

What’s the Big Deal?

 Pick a letter   Except F, J, N, Q, R, U, V, X, Y, Z www.edreferral.com/consequences_of_ed.htm

Dying to be Perfect: The Ellen Hart Pena Story

CAUSES

Bio-psycho-social Model

 Bio = heredity  Psycho = pain, separation, low self esteem, depression, stress, trauma  Social = media & culture (web sites)

PREVENTION & TREATMENT

Prevention

 Do not promote the belief that thinness/weight loss is great and being large/weight gain is horrible.

 Avoid categorizing food as “good” and “bad”.

 Learn and discuss the genetic basis of different body types.

Prevention (cont.)

 Link respect for diversity in weight and shape with diversity in race, gender, ethnicity, and intelligence.

 Help children understand the ways that the media distorts the true diversity of human body types and implies that a slender body means beauty, power, excitement, and sexuality.

 Learn and discuss the dangers of trying to alter your body shape through dieting.

 Take women seriously for what they say, feel, and do not in regard to their shape or looks.

Basic Principles

   Eating disorders are serious and complex problems Warnings are not enough. We must address:  Our cultural obsession with slenderness   Roles of men and women in society Development of self-esteem that transcends appearance Programs must include opportunities for participants to speak with trained professionals

Warning Signs

           Weighing self 2-3 times per day Choosing exercise over friends and family Exercising after meals to burn calories Exercising even when injured Weakness/dizziness Mood swings Peculiar eating rituals Difficulty eating in public Preoccupied with desire to be thin Obsessed with fat grams and calories Fear of gaining weight

Warning Signs (cont.)

         Running water for a long time while in the bathroom Eating when lonely, stressed, tense Eating a lot without gaining weight Wearing clothes to hide thinness Hair loss, brittle nails, lanugo Gray teeth from erosion of enamel Hand sores, calluses Irregular or non-existent periods Irregular body temperature

High Risk Sports

          Gymnastics Swimming Ballet Wrestling Body building Jockeying Rowing Diving Figure skating Long distance running

Treatment Resources

 Eating disorders ALWAYS require professional help!



The Renfrew Center of Northern New Jersey

174 Union Street Ridgewood, NJ 07450 Tel: 1-800-RENFREW Website: http://www.renfrewcenter.com



University Medical Center at Princeton

Eating Disorders Program 253 Witherspoon Street Princeton, NJ 08540 Tel: (609) 497-4490 Toll-Free: (877) 932-8935 Website: www.princetonhcs.org

Treatment Resources (cont.)



Somerset Medical Center

Eating Disorders Program 110 Rehill Avenue Somerville, NJ 08876 Tel: (800) 914-9444 Website: www.somersetmedicalcenter.com



Overlook Hospital

Eating Disorders Program at Atlantic Health 99 Beauvoir Avenue, Box 243 Summit, NJ 07901 908-522-5757 Website: www.goryebchildrenshospital.org

CONCLUSION

Eating Disorders & Addiction

         Feelings of guilt and distress Phases/Stages Bio-psycho-social causes 12 steps Myths about weakness Important to recognize as a disease CAN Recover Can be deadly if not treated Medical and social complications

Eating Disorders & Addiction (cont.)          Media plays a HUGE role PREVENTION WORKS!

DSM-IV Effects all cultures, genders, socioeconomic classes Co-dependence Secret Relapse is common Lying Excuses

What To Learn More?

 National Eating Disorders Association http://www.nationaleatingdisorders.org

 Eating Disorder Association of New Jersey http://www.edanj.org

 Something Fishy Website on Eating Disorders http://www.something-fishy.org

What To Learn More? (cont.)

 Academy for Eating Disorders www.aedweb.org

 National Association of Anorexia Nervosa & Associated Disorders www.anad.org

 United States National Library of Medicine www.nlm.nih.gov/medlineplus/eatingdisorders.html

What To Learn More? (cont.)

 Eating Disorder Referral and Information Center www.edreferral.com

 National Institute of Mental Health www.nimh.nih.gov

 Anorexia Nervosa and Related Eating Disorders, Inc.

www.anred.com

Contact Information

152 Tices Lane East Brunswick, NJ 08816 732-254-3344 ext. 11 [email protected]

For more information or additional resources, call NJPN at (732)367-0611 or visit www.njpn.org

for the contact information of your local affiliate.