Fundamentals of Psychological Disorders - 3rd edition Part IV Mental Disorders - Block 3 Module 10 Feeding and Eating Disorders

Fundamentals Disorders IV Part IV . Mental Disorders Block edition as of July 2023 Part IV . Mental Disorders Block Disorders Covered 10 . Feeding and Eating Disorders 11 . and Addictive Disorders Module 10 Feeding and Eating Disorders edition as of July 2023 Module Overview In Module 10 , we will discuss matters related to feeding and eating disorders to include their clinical presentation , epidemiology , etiology , and treatment options . Our discussion will cover anorexia , bulimia , and binge eating disorder . Be sure you refer Modules for explanations of key terms ( Module ) an overview of the various models to explain psychopathology ( Module ) and descriptions of the therapies ( Module ) Module Outline . Clinical Presentation . Epidemiology . Etiology Module Learning Outcomes Describe how feeding and eating disorders present . Describe the epidemiology of feeding and eating disorders . Describe in relation to feeding and eating disorders . Describe the etiology of feeding and eating disorders . Describe treatment options for feeding and eating disorders . Clinical Presentation Section Learning Objectives Describe how anorexia presents . Describe how bulimia presents . Describe how disorder ( BED ) presents . 203

Fundamentals Disorders Feeding and eating disorders are characterized by a persistent disturbance of eating or related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning ( APA , 2022 , 371 ) They are very serious , yet relatively common mental health disorders , particularly in Western society , where there is a heavy emphasis on thinness and physical appearance . In fact , 13 of adolescents will be diagnosed with at least one eating disorder by their birthday ( 2013 ) Furthermore , a large number of adolescents will engage in significant disordered eating behaviors just below the clinical threshold ( Burt , 2009 ) While there is no exact cause for eating disorders , the combination of biological , psychological , and sociocultural factors has been identified as major contributors in both the development and maintenance of eating disorders . Within the ( APA , 2022 ) six disorders are classified under the Feeding and Eating Disorders chapter pica , rumination disorder , food intake disorder , anorexia , bulimia , and disorder . In this module , we will cover the latter three whose diagnostic criteria are mutually exclusive , meaning that only one of these diagnoses can be assigned at any given time due to substantial differences in their clinical course , outcome , and treatment needs , despite a number of common psychological and behavioral features . For a discussion of the first three disorders , see Module 16 please . For more on eating disorders in general , please visit the National Eating Disorders Association website below . Anorexia Anorexia involves the restriction of energy intake , which leads to significantly low body weight relative to the individual age , sex , and development . This restriction is often secondary to an intense fear of gaining weight or becoming fat , despite the individual low body weight . Altered perception of self and an of one body weight and shape contribute to this disturbance of body size . Typical warning signs and symptoms are divided into two different categories and physical . Some emotional and behavioral symptoms include dramatic weight loss preoccupation with food , weight , calories , etc . frequent comments about feeling fat eating a restricted range of foods making excuses to avoid mealtimes and not eating in public . Physical changes may include dizziness , difficulty concentrating , feeling cold , sleep problems , thinning loss , and muscle weakness , to name a few . When the individual loses weight , they view this as an impressive achievement and a sign of extraordinary discipline , while weight gain is seen as an unacceptable failure of ( APA , 2022 ) The onset of the disorder typically begins with mild dietary restrictions such as eliminating carbs or specific fatty foods . As weight loss is achieved , the dietary restrictions progress to more severe , under 500 . Symptoms present in adolescence or young adulthood and rarely before 204

Fundamentals Disorders puberty or after age 40 . The onset of the disorder typically is preceded by a stressful life event such as leaving home for college . For more on anorexia , please visit the National Eating Disorders Association website below . Bulimia Unlike anorexia where there is solely restriction of food , bulimia involves a pattern of recurrent binge eating behaviors . Binge eating can be defined as a discrete period of time where the amount of food consumed is significantly more than most people would eat during a similar time period . Individuals with bulimia often report a sense of lack of control during these eating episodes . While not always the case , these episodes are followed by a feeling of disgust with oneself , which leads to a compensatory behavior to rid the body of the excessive calories . These compensatory behaviors include vomiting , use of laxatives , fasting ( or severe restriction ) diuretics or other medications , or excessive exercise . This cycle of binge eating and compensatory behaviors occurs on average , at least once a week for three months ( National Eating Disorder Association website APA , 2022 ) It is important to note that while there are periods of severe calorie restriction like anorexia , the two disorders can not be diagnosed simultaneously . Therefore , it is important to determine the individual weight when distinguishing between anorexia and bulimia . If an individual has a significantly low body weight and engages in behaviors , the diagnosis is anorexia if the individual does not have a significantly low body weight and engages in behaviors , the diagnosis is bulimia . Signs and symptoms of bulimia are similar to anorexia . These symptoms include but are not limited to hiding food wrappers or containers after a bingeing episode , feeling uncomfortable eating in public , developing food rituals , limited diet , disappearing to the bathroom after eating a meal , and drinking excessive amounts of water or beverages . Additional physical changes include weight both up and down , difficulty concentrating , dizziness , sleep disturbance , and possible dental problems due to purging post binge eating episode . Making Sense of the Disorders Though anorexia and bulimia share some common features , they differ as follows Diagnosis anorexia if significantly low body weight with severe calorie restriction Diagnosis bulimia if body weight is within normal range but displays calorie restriction AND episodes Symptoms of bulimia typically present later in development adolescence or early adulthood . Like anorexia , bulimia initially presents with mild restrictive dietary behaviors however , episodes of binge eating interrupt the dietary restriction , causing to rise around 205

Fundamentals Disorders normal levels . In response to weight gain , patients engage in compensatory behaviors or purging episodes to reduce body weight . This cycle of restriction , binge eating , and calorie reduction often occurs for years before seeking help . Additionally , those with bulimia are often ashamed of their eating problems and attempt to hide the symptoms . The binge eating occurs in secrecy or as inconspicuously as possible . Common antecedents of binge eating include negative affect interpersonal stressors dietary restraint boredom and negative feelings linked to body weight , shape , and food . For more on bulimia , please visit the National Eating Disorders Association website below . Disorder ( BED ) disorder is similar to bulimia in that it involves recurrent binge eating episodes along with feelings of lack of control during the episode . The episodes are associated with at least three of the following eating quicker than usual , eating until uncomfortably full , eating large amounts even if not hungry , eating alone , and feeling disgust with oneself or being depressed . Despite the feelings of shame and guilt , individuals with BED will not engage in vomiting , excessive exercise , or other compensatory behaviors . These binge eating episodes occur on average , at least once a week for months . Because these episodes occur without compensatory behaviors , individuals with BED are at risk for obesity and related health disorders . Individuals with BED report feelings of embarrassment at the quantity of food consumed , and thus will often refuse to eat in public . Due to the restriction of eating around others , individuals with BED often engage in secret binge eating episodes in private , followed by discrete disposal of wrappers and containers . Making Sense of the Disorders Though bulimia and BED are similar , they differ as follows Diagnosis BED if binge eating occurs WITHOUT compensatory behaviors Diagnosis bulimia if binge eating occurs AND there are compensatory behaviors to prevent weight gain While much is still being researched about disorder , current research indicates that the onset of BED is adolescence to early adulthood but can begin later in life . Those who seek treatment tend to be older than those with either bulimia or anorexia . Binge eating has been found to be common in adolescent and samples and for all , is associated with social role adjustment issues , impaired quality of life and life satisfaction , and increased medical morbidity and mortality ( APA , 2022 ) 206

Fundamentals Disorders For more on binge eating disorder , please visit the National Eating Disorders Association website below ( Key Takeaways You should have learned the following in this section Anorexia involves the restriction of food , which leads to significantly low body weight relative to the individual age , sex , and development , and an intense fear of gaining weight or becoming fat . Bulimia is characterized by a pattern of recurrent binge eating behaviors followed by compensatory behaviors . disorder is characterized by recurrent binge eating episodes along with a feeling of lack of control but no compensatory behavior to rid the body of the calories . Section Review Questions . What does mutually exclusive mean ?

What does it mean with respect to eating disorders ?

What are the key differences in diagnostic criteria for anorexia , bulimia , and binge eating disorder ?

Define compensatory behavior . What disorder is this found in ?

Epidemiology Section Learning Objectives Describe the epidemiology of anorexia . Describe the epidemiology of bulimia . Describe the epidemiology of binge eating disorder . Anorexia 207 Fundamentals Disorders According to the National Eating Disorder Alliance ( website , at any point in time more women ( than men ( will be diagnosed with anorexia . Anorexia is most prevalent in , countries such as the United States , Australia , New Zealand , Japan , and many European countries . In the , prevalence is lower among and Black Americans than Whites ( APA , 2022 ) Bulimia According to the website , at any point in time , of women and of men will meet the diagnostic criteria for bulimia . A study by and ( 2012 ) found that between and of females and to of males will develop bulimia and that bulimia occurs in to of adolescent females . The reports that the prevalence ranges from to with higher rates in females and countries . Rates are similar across groups across the ( APA , 2022 ) Binge Eating Disorder Hudson et al . 2007 ) reports that BED is three times more common than anorexia and bulimia and is more common than breast cancer , HIV , and schizophrenia . It has also been found that between and of females and and of males will develop binge eating disorder with binge eating disorder occurring in of adolescent females ( 2012 ) The reports a prevalence of to with rates times higher in women , similar rates across groups in the United States and between most industrialized countries ( APA , 2022 ) For more on statistics and research related to feeding and eating disorders , please visit the National Eating Disorders Association website below Key Takeaways You should have learned the following in this section BED is three times more common than anorexia and bulimia . All feeding and eating disorders are more common in women and , industrialized countries . Only anorexia shows differences across groups in the United States . 208

Fundamentals Disorders Section Review Questions . Which feeding and eating disorder is most common ?

What gender differences occur with regards to the eating disorders ?

Are there any other noteworthy similarities or differences in the prevalence rates of the three disorders ?

Section Learning Objectives Describe the of anorexia . Describe the of bulimia . Describe the of BED . Anorexia Anorexia is rarely a single diagnosis . High rates of bipolar , depressive , and anxiety disorders are common among individuals with anorexia . disorder is more often seen in those with the restricting type of anorexia , whereas alcohol use disorder and other substance use disorders are more commonly seen in those with anorexia who engage in behaviors . Unfortunately , there is also a high rate of , with rates reported to be 18 times greater than in an and comparison group . It is also estimated that between and 25 of individuals with anorexia have attempted suicide ( APA , 2022 ) Bulimia The majority of individuals diagnosed with bulimia also present with at least one other mental disorder . Similar to anorexia , there is a high frequency of depressive symptoms ( low esteem ) as well as bipolar and depressive disorders . While some experience mood fluctuations because of their eating pattern ( occurring at the same time or following the development of bulimia ) some individuals will identify mood symptoms prior to the onset of bulimia ( APA , 2022 ) Anxiety , particularly social anxiety , is often present in those with bulimia . However , most mood and anxiety symptoms resolve once an effective treatment of bulimia is established . Substance use disorder , and in particular alcohol use disorder , is also prevalent in those with bulimia , with about a 30 prevalence among those with bulimia . The substance abuse begins as a compensatory behavior ( stimulant use is used to control appetite and weight ) and over time , as the eating disorder 209

Fundamentals Disorders progresses , so does the substance abuse . There is also a percentage of individuals with bulimia who display personality features that meet the criteria for at least one personality disorder , most often borderline personality disorder . Finally , about to of individuals with bulimia have had suicidal ideation and a comparable amount have attempted suicide . BED Research shows that BED shares similar with anorexia and bulimia . Common include major depressive disorder and alcohol use disorder . About 25 of those with BED have shown suicidal ideation ( APA , 2022 ) Key Takeaways You should have learned the following in this section Anorexia has a high with bipolar , depressive , and anxiety disorders . OCD and alcohol use disorder are also but depend on the type of anorexia ( restricting or ) Bulimia has a high with bipolar disorder , depressive symptoms and disorders , social anxiety , and substance use disorder . BED is highly with and alcohol use disorder . There is a high rate of suicidal ideation with all three disorders . Section Review Questions . Discuss the rates among the three main eating disorders . Etiology Section Learning Objectives Describe the biological causes of feeding and eating disorders . Describe the cognitive causes of feeding and eating disorders . Describe the sociocultural causes of feeding and eating disorders . Describe how personality traits are the cause of feeding and eating disorders . 210

Fundamentals Disorders What causes eating disorders ?

While researchers have yet to identify a specific cause of eating disorders , the most compelling argument to date is that eating disorders are multidimensional disorders . This means many contributing factors lead to the development of an eating disorder . While there is likely a genetic predisposition , there are also environmental , or external factors , such as family dynamics and cultural that impact their presentation . Research supporting these is well documented for anorexia and bulimia however , seeing as BED has only just recently been established as a formal diagnosis , research on the evolvement of BED is ongoing . Biological There is some evidence of a genetic predisposition for eating disorders , with relatives of those diagnosed with an eating disorder being up to six times more likely than other individuals to be diagnosed also . Twin concordance studies also support the gene theory . If an identical twin is diagnosed with anorexia , there is a 70 percent chance the other twin will develop anorexia in their lifetime . The concordance rate for fraternal twins ( who share less genes ) is 20 . While not as strong for bulimia , identical twins still display a 23 concordance rate , compared to the rate for fraternal twins . In addition to hereditary causes , disruption in the system is common in those with eating disorders ( Racine , 2015 ) Unfortunately , it difficult for researchers to determine if these disruptions caused the disorder or have been caused by the disorder , as manipulation of eating patterns is known to trigger changes in hormone production . With that said , researchers have explored the hypothalamus as a potential contributing factor . The hypothalamus is responsible for regulating body functions , particularly hunger and thirst ( 2010 ) Within the hypothalamus , the lateral hypothalamus is responsible for initiating hunger cues that cause the organism to eat , whereas the ventromedial hypothalamus is responsible for sending signals of satiation , telling the organism to stop eating . Clearly , a disruption in either of these structures could explain why an individual may not take in enough calories or experience periods of overeating . Cognitive Some argue that eating disorders are , in fact , a variant of disorder ( OCD ) The obsession with body shape and hallmark of an eating likely a driving factor in anorexia . Distorted thought patterns and an of body size likely contribute to this obsession and one desire for thinness . Research has identified high levels of impulsivity , particularly in those with binge eating episodes , suggesting a temporary lack of control is responsible for these episodes . Post episode , many individuals report feelings of disgust or even thoughts of failure . These strong cognitive factors are indicative as to why therapy is the preferred treatment for eating disorders . Sociocultural Eating disorders are overwhelmingly found in Western countries where there is a heavy emphasis on core feature of eating disorders . It is also found in countries where food is in abundance , as 211

Fundamentals Disorders in places of deprivation , round figures are viewed as more desirable ( Herman , 2002 ) While eating disorders were once thought of as disorders of higher SES , recent research suggests that as our country becomes more homogenized , the more universal eating disorders become . Media . One commonly discussed contributor to eating disorders is the media . The idealization of thin models and actresses sends the message to young women ( and adolescents ) that to be popular and attractive , you must be thin . These images are not isolated to magazines , but are also seen in television shows , movies , commercials , and large advertisements on billboards and hanging in store windows . With the emergence of social media ( Facebook , Snapchat , Instagram ) exposure to media images and celebrities is even easier . Couple this with the ability to alter images to make individuals even thinner , it is no wonder many young people become dissatisfied with their body ( Herman , 2004 ) Ethnicity . While eating disorders are not solely a white woman disorder , there are significant discrepancies when it comes to race , especially for anorexia . Why is this ?

Research indicates that black men prefer heavier women than do white men ( 1996 ) Given this preference , it should not be surprising that black women and children have larger ideal than their white peers ( Herman , 2000 ) Since black women are less driven to thinness , black women would appear to be less likely to develop anorexia however , findings suggest this is not the case . Caldwell and colleagues ( 1997 ) found that black women were equally as dissatisfied as white women with their physique , suggesting body image issues may be more closely related to SES than that of race . The race discrepancies are also less significant in BED , where the prominent feature of the eating disorder is not thinness ( Herman , 2002 ) Gender . Males account for only a small percentage of eating disorders . While it is unclear as to why there is such a discrepancy , it is likely somewhat related to cultural desires of women being thin and men being muscular or Of men diagnosed with an eating disorder , the overwhelming percentage of them identified a job or sport as the primary reason for their eating behaviors ( Stanford , 2012 ) Jockeys , distance runners , wrestlers , and bodybuilders are some of the professions identified as most restrictive regarding body weight . There is some speculation that males are not diagnosed as frequently as women due to the stigma attached to eating disorders . Eating disorders have routinely been characterized as a white , adolescent female problem . Due to this bias , young men may not seek help for their eating disorder in efforts to prevent labeling ( 2014 ) Family . Family are one of the strongest external contributors to maintaining eating disorders . Often family members are praised for their slenderness . Think about the last time you saw a family member or close how often have you said , You look great ! or commented on their appearance in some way ?

The odds are likely high . While the intent of the family member is not to maintain eating behaviors by praising the physical appearance of someone struggling with an eating disorder , they are indirectly perpetuating the disorder . While family involvement can help maintain the disorder , it can also contribute to the development of an eating disorder . Families that emphasize thinness or place a large emphasis on physical appearance are more likely to have a child diagnosed with an eating disorder ( 2008 ) In fact , mothers with eating disorders are more likely to have children who develop a disorder than mothers without 212

Fundamentals Disorders eating disorders ( Cooper , 2000 ) Additional family characteristics that are common among patients receiving treatment for eating disorders are enmeshed , intrusive , critical , hostile , or overly concerned with parenting ( Herman , 2002 ) While there has been some correlation between these family dynamics and eating disorders , they are not evident in all families of people with eating disorders . Personality There are many personality characteristics that are common in individuals with eating disorders . While it is unknown if these characteristics are inherent in the individual personality or a product of personal experiences , the thought is eating disorders develop due to the combination of the two . Perfectionism . It should come as no surprise that perfectionism , or the belief that one must be perfect , is a contributing factor to disorders related to eating , weight , and body shape ( particularly anorexia ) While an exact mechanism is unknown , it is believed that perfectionism magnifies normal body imperfections , leading an individual to go to extreme ( restrictive ) behaviors to remedy the ( Hewitt , 1995 ) or one belief in their worth or ability , has routinely been identified as a moderator of many psychological disorders , and eating disorders are no exception . Low not only contributes to the development of an eating disorder but is also likely involved in the maintenance of the disorder . One theory , the model of eating disorders , suggests that overall low increases the risk for of body , which in turn , leads to negative eating behaviors that could lead to an eating disorder ( Cooper , 2003 ) Key Takeaways You should have learned the following in this section Biological causes of eating disorders include a genetic predisposition and disruption in the system . Cognitive causes of eating disorders include distorted thought patterns and an of body size . Sociocultural causes of eating disorders include the idealization of thin models and actresses by the media , SES , gender , and family involvement . The personality trait of perfectionism and low are contributing factors to disorders related to eating , weight , and body shape . Section Review Questions . Define multidimensional disorders ?

What evidence is there to suggest eating disorders are biologically driven ?

213 Fundamentals Disorders . According to the cognitive theory , eating disorders may be a variant of what other disorder ?

Discuss the four sociocultural that explains development of eating disorders . What are the two personality traits most commonly used to describe behaviors associated with eating disorders ?

Treatment Section Learning Objectives Describe treatment options for anorexia . Describe treatment options for bulimia . Describe treatment options for binge eating disorder . Discuss the outcome of treatment for feeding and eating disorders . Anorexia The immediate goal for the treatment of anorexia is weight gain and recovery from malnourishment . This is often established via an intensive outpatient program , or if needed , through an inpatient hospitalization program where caloric intake can be managed and controlled . Both the inpatient and outpatient programs use a combination of therapies and support to help restore proper eating habits . Of the most common ( and successful ) treatments are Therapy ( and Therapy ( Because anorexia requires changes to both eating behaviors as well as thought patterns , strategies have been very effective in producing lasting changes to those suffering from anorexia . Some of the behavioral strategies include recording eating pains , quality and quantity of emotional related to the food . In addition to these behavioral strategies , it is also important to address the thought patterns associated with their negative body image and desire to control their physical characteristics . Changing the fear related to gaining weight is essential in recovery . Family based therapy ( is also an effective treatment approach , often used as a component of individual , especially for children and adolescents with the disorder . has been shown to elicit of weight restoration in one year , as well as weight maintenance years treatment ( Campbell , 2014 , Lock , Darcy , et al , 2014 ) Additionally , has been shown to improve rapid weight gain , produce fewer hospitalizations , and is more than other types of therapies with family involvement ( Lock , Brandt , Dodge , et , 2014 ) 214

Fundamentals Disorders typically involves sessions which are divided into phases ( Parents take charge of weight restoration , client gradual control of overeating , and ( addressing developmental issues including fostering autonomy from parents ( Chen , et , 2016 ) While has shown to be effective in treating adolescents with anorexia , the application for older eating patients ( students and above ) is still undetermined . As with adolescents , the goal for a treatment program should center around helping the patient separate their feelings and needs from that of their family . Bulimia just as anorexia treatment initially focuses on weight gain , the first goal of bulimia treatment is to eliminate binge eating episodes and compensatory behaviors . The aim is to replace both negative behaviors with positive eating habits . One of the most effective ways to establish this is through Cognitive Behavioral Therapy ( Similar to anorexia , individuals with bulimia are expected to keep a journal of their eating habits however , with bulimia , it is also important that the journal include changes in sensations of hunger and fullness , as well as other feelings surrounding their eating patterns in efforts to identify triggers to their binging episodes ( 2017 ) Once these triggers are identified , psychologists will utilize specific behavioral or cognitive techniques to prevent the individual from engaging in binge episodes or compensatory behaviors . One method for modifying behaviors is through Exposure and Response Prevention . As previously discussed in the OCD chapter , this treatment is very effective in helping individuals stop performing their compulsive behaviors by literally preventing them from engaging in the action , while simultaneously using relaxation strategies to reduce anxiety associated with not engaging in the negative behavior . Therefore , to prevent an individual from purging episodes , the individual would be encouraged to partake in an activity that directly competes with their ability to purge , write their thoughts and feelings in a journal at the kitchen table . Research has indicated that this treatment is particularly helpful for individuals suffering from anxiety disorders ( particularly OCD , 2017 ) In addition to changing behaviors , it is also important to change the thoughts toward food , eating , weight , and shape . Negative thoughts such as I am fat and I ca stop eating when I start can be modified into more appropriate thoughts such as My body is healthy or I can control my eating By replacing these negative thoughts with more appropriate , positive thought patterns , individuals begin to control their feelings , which in return , can help them manage their behaviors . Interpersonal Psychotherapy ( has also been established as an effective treatment for those with bulimia , particularly if an individual has not been successful with treatment . The goal of is to improve interpersonal functioning in those with eating disorders . Originally a treatment for depression , was adapted to address the social isolation and problems that contribute to the maintenance of negative eating behaviors . has phases typically covered in weekly sessions over months . Phase One consists of engaging the patient in treatment and providing about their disease and the treatment program . This phase also includes identifying interpersonal problems that are maintaining the disease . 215

Fundamentals Disorders Phase Two is the main treatment component . In this phase , the primary focus is on interpersonal issues . The most common types of interpersonal issues are lack of intimacy and interpersonal deficits , interpersonal role disputes , role transitions , grief , and life goals . Once the main interpersonal problem is identified , the clinician supports the patient in their pursuit to identify ways to change . A key component of is the supportive role of the clinician , as opposed to the teaching role in other treatments . The idea is that by having the patient make changes , they can better understand their problems , and as a result , make more profound changes ( Murphy , Cooper , 2012 ) Phase Three is the final stage . The goals of this phase are to ensure that the changes made in Phase two are maintained . To achieve this , treatment sessions are spaced out , allowing patients more time to engage in their changed behavior . Additionally , relapse prevention ( ways not to relapse ) is also discussed to ensure long term results . In doing this , the patient reviews the progress they have made throughout treatment , as well as identifying potential interpersonal issues that may arise , and how their treatment can be adapted to address those issues . Support for is limited however , two extensive studies suggest that is effective in treating bulimia , and possibly BED . While treatment is initially slower than , it is equally effective in and maintenance of disorder ( Marcus , Wilson , 1993 ) Binge Eating Disorder Given the similar presentations of BED and bulimia , it should not be surprising that the most effective treatments for BED are similar to that of bulimia . along with antidepressant medications , are among the most effective in treating BED . Interpersonal therapy , as well as dialectical behavioral therapy , have also been effective in reducing episodes however , they have not been effective in weight loss ( Mori , 2017 ) Goals of treatment are , of course , to eliminate binge eating episodes , as well as reduce body weight as most individuals with BED are overweight . Seeing as BED has only recently been established as a separate eating disorder , treatment research specific to this disorder is expected to grow . Antidepressant medications . Given the high between eating disorders and depressive symptoms , antidepressants have been a primary method of treatment for years . While they have been shown to improve depressive symptoms , which may help individuals make gains in their eating disorder treatment , research has not supported antidepressants as an effective treatment strategy for treating the eating disorder itself . Outcome of Treatment Now that we have discussed treatments for eating disorders , how effective are they ?

Research has indicated favorable prognostic features for anorexia are early age of onset and a short history of the disorder . Conversely , unfavorable features are a long history of symptoms prior to treatment , severe weight loss , and binge eating and vomiting . The mortality rate over the first 10 years from presentation is about 10 . Most of these deaths are from medical complications due to the disorder or suicide . 216

Fundamentals Disorders Unfortunately , research has not identified any consistent of positive outcomes for bulimia . However , there is some speculation that individuals with childhood obesity , low , and those with a personality disorder have worse treatment outcomes . While treatment outcome for BED is still in its infancy , initial findings suggest that remission rates of BED are much higher than that for anorexia and bulimia . Key Takeaways You should have learned the following in this section Treatment options for anorexia include and . Treatment options for bulimia include , exposure and response prevention , and the three phases of interpersonal psychotherapy . Treatment options for BED include the taking of antidepressants to manage depressive symptoms , and interpersonal therapy . Section Review Questions . What is the initial ( main ) goal of treatment for anorexia ?

What are the three phases of treatment ?

What is the goal for interpersonal psychotherapy ?

Discuss the three phases of . What is the overall treatment effectiveness of eating disorders ?

Module Recap Module 10 covered eating disorders in terms of their clinical presentation , epidemiology , etiology , and treatment options . In Module 11 , we will discuss and addictive disorders , which will conclude this part . edition 217