Feeling sated can become a cue to eat more

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When hunger pangs strike, we usually interpret them as a cue to reach for a snack; when we start to feel full, we take it as a sign that we should stop eating. However, new research shows that these associations can be learned the other way around, such that satiety becomes a cue to eat more, not less. The findings, published in Psychological Science, a journal of the Association for Psychological Science, suggest that internal, physical states themselves can serve as contexts that cue specific learned behaviors. “We already know that extreme diets are susceptible to fail. One reason might be that the inhibition of eating learned while dieters are hungry doesn’t transfer well to a non-hungry state,” says psychological scientist Mark E. Bouton of the University of Vermont, one of the authors on the study. “If so, dieters might ‘relapse’ to eating, or perhaps overeating, when they feel full again.”

To test this hypothesis, Bouton and co-author Scott T. Schepers conducted a behavioral conditioning study using 32 female Wistar rats as their participants. Every day for 12 days, the rats, who were already satiated, participated in a 30-minute conditioning session. They were placed in a box that contained a lever and learned that they would receive tasty treats if they pressed that lever. Then, over the next 4 days, the rats were placed in the same box while they were hungry, and they discovered that lever presses no longer produced treats.

Through these two phases, the rats were conditioned to associate satiety with receiving tasty food and hunger with receiving no food. However, what would the rats do if they were placed in the box again? The results were clear: When the rats were tested again, they pressed the lever far more often if they were full than if they were hungry. In other words, they relapsed back to seeking treats. “Rats that learned to respond for highly palatable foods while they were full and then inhibited their behavior while hungry, tended to relapse when they were full again,” Bouton explains.

This relapse pattern emerged even when food was removed from the cage before both the learning and unlearning sessions, indicating that the rats’ internal physical states, and not the presence or absence of food, cued their learned behavior. Findings from three different studies supported the researchers’ hypothesis that hunger and satiety could be learned as contextual cues in a classic ABA¹ (sated-hungry-sated) renewal design. However, the researchers found no evidence that an AB design², in which the rats learned and subsequently inhibited the lever-treat association in a hungry state and were tested in a sated state, had any effect on the rats’ lever pressing. Together, these results show that seeking food and not seeking food are behaviors that are specific to the context in which they are learned.

Although our body may drive food seeking behavior according to physiological needs, this research suggests that food-related behaviors can become associated with internal physical cues in ways that are divorced from our physiological needs. “A wide variety of stimuli can come to guide and promote specific behaviors through learning. For example, the sights, sounds, and the smell of your favorite restaurant might signal the availability of your favorite food, causing your mouth to water and ultimately guiding you to eat,” say Schepers and Bouton. “Like sights, sounds, and smells, internal sensations can also come to guide behavior, usually in adaptive and useful ways: We learn to eat when we feel hunger, and learn to drink when we feel thirst. However, internal stimuli such as hunger or satiety may also promote behavior in ways that are not so adaptive.”

¹A-B-A design involves establishing a baseline condition (the “A” phase), introducing a treatment or intervention to effect some sort of change (the “B” phase), and then removing the treatment to see if it returns to the baseline (“A”).

²An AB design is a two part or phase design composed of a baseline (“A” phase) with no changes, and a treatment or intervention (“B”) phase.

Adapted from: Scott T. Schepers, Mark E. Bouton. Hunger as a Context: Food Seeking That Is Inhibited During Hunger Can Renew in the Context of Satiety. Psychological Science, 2017; 095679761771908 DOI: 10.1177/0956797617719084

Nutrtition Tip of the Day

Package your own healthy snacks! Put cut-up veggies and fruits in portion-sized containers for easy, healthy snacking on the go, without the added sugars and sodium.

Daily Inspiration 

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Parent and Teen Weight Relate to Feeding Practices

A new study helps identify which parents of teens are most likely to use feeding practices that have been linked with unhealthy outcomes, researchers say. Parents most often pressure their teen to eat when neither they nor the teen are overweight, while when parents and teens are both overweight, parents most often use food restriction, the researchers found. Previous research has shown that when parents use restriction and pressure-to-eat feeding practices, children and adolescents are at higher risk for being overweight and having eating disorders, said lead author Jerica M. Berge of the University of Minnesota Medical School in Minneapolis, in email to Reuters Health. She and her colleagues analyzed data from two studies involving more than 3,000 parents and more than 2,000 teens. Teens had their height and weight measured by trained professionals at school, and parents filled out a questionnaire at home, self reporting their own heights and weights.

Parents also reported how often they encouraged their child to eat more at mealtimes and how often they restricted sweets, high-fat foods or their teen’s favorite foods. In about 1,200 cases, parents were overweight or obese but their teen was not. In almost 900 cases, both parent and child were overweight. In almost 700 cases, the parent and child were both not overweight, and in only about 300 cases the parent was not overweight but the teen was. Pressuring kids to eat was more common when both parties were not overweight, compared to pairs who were overweight or had differing statuses. Similarly, food restriction was most common for pairs that were both overweight or obese, compared to those who were both not overweight or who differed between parent and child, the authors reported in Pediatrics.

Clare Collins, professor in nutrition and dietetics at The University of Newcastle in Callaghan, Australia who wasn’t involved in the new study, noted in email to Reuters Health that the surveys were taken only at one time point so it is unclear from the results if parent feeding practices go on to influence future eating and weight status in the adolescents. “The problem with restricting food from a child or pressuring a child to eat more is that prior research has shown that it may have unintended consequences such as, a child becoming overweight or obese, or engaging in disordered eating behaviors such as, binging or purging,” Berge said. “Rather than restricting or pressuring your child to eat, it is more helpful for parents to make sure that there are a variety of healthy food options in the home, or on the table, for children to eat and then allow the child to decide how much they eat,” she said. Having unhealthy food in the fridge and on the table and telling a teen they cannot eat it is not helpful and sets up food fights, Collins said. But keeping unhealthy food out of the house in the first place does work and helps keep harmony in your house, she said.

Reprinted from Reuters (Kathryn Dole)

Tip of the Day

Can’t find something in your kitchen? Add it to the list! Keeping a running list of items you need and bringing it to the store will minimize the number of products you buy and the size of your bill.

Daily Inspiration 

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Teach Your Teen about Food Labels

If decoding the information on a food package is a challenge for adults, think of how hard it is for teens who are just beginning to make choices for themselves. Give your teens some help as they become more aware of what they’re putting in their bodies.

Narrow the Focus

A wealth of information greets a health-conscious label reader in the Nutrition Facts portion of a food package. Janelle McLeod, RD, LDN, who counsels teens in the weight management clinic at the Penn State Milton S. Hershey Medical Center, teaches her patients to zero in on several key pieces. “I like to teach them how to make lower fat food choices that meet the American Heart Association guidelines,” she says. This entails selecting foods that have no more than 3 grams total fat for every 100 calories. “I also like to encourage higher fiber foods for fullness and foods that have some protein for longer satiety.” Foods with added sugar and salt should be limited as much as possible. Candy, soda, baked goods, chips and other popular snack foods have few valuable nutrients.

Portion Distortion

For a teenager-sized appetite, a single portion often doesn’t satisfy. A teen could consume an entire bag of chips or a bottle of soda that actually contains several portions better suited for splitting between friends. “Many serving sizes listed on items are small and wouldn’t fill you up,” says McLeod. In a world of heaping restaurant portions, fast food and all-you-can-eat buffets, she points out that teens may go along with the crowd. “They may just follow the example of food portions that they see eaten by friends and family.” Teens are growing and need both calories and nutrients. Focusing on nutrient-rich foods — fruits, vegetables, legumes, lean meats, low-fat dairy and whole grains — will help your teen fill up without overdoing it on calories, fat, sugar and salt.

Health Claims: Too Good to be True?

Assertions that manufacturers make about their foods often send mixed messages. Who would guess that a sugar-loaded cereal could be a source of whole grains, or that a fruit-flavored beverage could boost immunity? Teach your teen to investigate further when the message on the front of the package is questionable. Studying the Nutrition Facts Panel helps determine whether or not it’s a good choice overall. Eating disorders are more common during the teen years, especially for teen girls. If your teen becomes obsessed with reading Nutrition Facts Panels and overly restrictive about food, discuss what makes a balanced healthy lifestyle and consider calling the National Eating Disorders Association Helpline.

Making Good Choices Away from Home

With teens’ increased independence, parents often are no longer in control of what they eat. Instilling general principles of healthy eating will help guide teens when they’re out and about. Smartphone apps and other online tools may motivate a teen to be mindful of eating habits. “Many food journal apps and websites have Nutrition Facts for menu items of chain restaurants,” says McLeod.

There’s no question that your teenagers will make mistakes along the way, but continue to encourage them to take ownership of their health — it will pay off!

Reprinted from the Academy of Nutrition and Dietetics (Andrea Johnson, RD, CSP, LDN)

Tip of the Day

Kick back with a fruity snack! Looking for a fast, healthy snack? Make a smoothie by blending plain yogurt with your favorite fruit. Freeze fruit first or add ice.

Daily Inspiration 

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Getting Serious About Mental Illnesses

For the past few years, National Institute of Mental Health (NIMH) has been increasingly focusing their research on serious mental illness (SMI). What does “SMI” mean? If some illnesses are considered “serious,” does that mean that others are not? If some mental illnesses are not classified as serious, does that mean they aren’t significant? Does everyone with a diagnosis of schizophrenia or bipolar disorder have SMI? What about anorexia nervosa or borderline personality or post traumatic stress disorder (PTSD)? Do these qualify as SMI? Should NIMH focus their efforts on the best science that will reduce the tremendous morbidity and mortality associated with all mental illnesses or should they limit themselves to those causing the most disability? To answer these questions, a little history might help.

Where did the term “SMI” come from? In the 1992 ADAMHA Reorganization Act (P.L. 102-321), Congress directed the Secretary of Health and Human Services to develop a federal definition of SMI to aid in the estimation of SMI incidence and prevalence rates in states that were applying for grant funds to support mental health services. “Adults with a serious mental illness are persons: age 18 and over, who currently or at any time during the past year, have a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R, that has resulted in functional impairment which substantially interferes with or limits one or more major life activities. All of these disorders have episodic, recurrent, or persistent features; however, they vary in terms of severity and disabling effects.” While the federal definition of SMI is specific to adults, there is an analogous definition of “serious emotional disturbance” (SED) for children. Both SMI and SED definitions focus on the DSM diagnosis, plus degree of impairment.

As one can see, the “official” definition of SMI is very inclusive. Recently, SMI has been a subject of conversation in the wake of recent shooting tragedies. Discussions about SMI and violence, directed towards self or others, are usually focused on schizophrenia and bipolar disorder, and sometimes major depressive disorder. Violence is an extreme (and rare) negative outcome of disorders like these, warranting particular emphasis, but it is not the only negative outcome to consider. For example, anorexia nervosa can be fatal, yet eating disorders have understandably been excluded from discussions about SMI.

In fact, all mental illnesses have the potential to be impairing and meet the meaning of “serious” in the sense of the federal definition. NIMH supports an extensive portfolio on all aspects of mental illness, from basic research to clinical investigations,  to common disorders in men and women affecting adults and children in a diversity of populations. To better understand how NIMH research addresses SMI, the next few sentences provide a quick break-down of their overall portfolio. In 2012, nearly 13% of their total budget was mandated for research on HIV/AIDS, and about 5% went to administrative costs: Support for the Institute, funding hospitals and clinics, and general overhead. Research on disorders that can be disabling (including autism) covered 51% of non-AIDS portfolio but if one looks at the broad range of research that could shed light on new diagnostics or new treatments, then one could consider that 81.3% of NIMH non-AIDS portfolio was dedicated to SMI research.

NIMH investment in basic science, usually unrelated to a specific diagnostic category, accounts for the 30% interval between their SMI portfolio defined narrowly (51%) vs. broadly (81.3%). They continually talk about serious mental disorders as brain disorders. What NIMH doesn’t say is that their knowledge of how the brain works remains far behind their understanding of other organ systems. Developing tools for understanding the brain, identifying the major circuits important for behavior, and deciphering the language of the brain are critical investments for NIMH in order to make progress on diagnostics and therapeutics for SMI. Similarly, basic behavioral science can give NIMH the tools to detect the earliest signs of schizophrenia or autism. They do not count these among their SMI portfolio, yet investing in basic science may be NIMH most important investments for people with serious mental illness.

So when NIMH states its increasing their focus on SMI, what they really mean is that they are investing in the best science that can reduce the most disability and mortality. Some of these investments are focused on biomarkers or new treatments for schizophrenia, bipolar disorder, and major depressive disorder but they also are committed to supporting science that will give a much deeper understanding of brain and behavior. That, in the long run, is the most direct path to “paving the way for prevention, recovery, and cure.”

Biology, Not Just Society, May Increase Risk of Binge Eating During Puberty

Biological changes associated with puberty may influence the development of binge eating and related eating disorders, according to a study on female rats conducted by the National Institute of Mental Health (NIMH)-funded researchers. After puberty, the rats showed binge eating patterns that resemble those in humans, supporting the role of biological factors, since rats do not experience pressures to be thin or other psychosocial risk factors commonly associated with human eating disorders.

Background

Among girls, symptoms of binge eating or bulimia nervosa often arise around puberty. Past research has largely focused on psychosocial roots for this association, but biological changes that occur during and after puberty are likely to have an effect as well. Kelly Klump, Ph.D., of Michigan State University, and colleagues tested this theory in an animal model since animals do not experience psychological risk factors during puberty. They used a rat model that can distinguish between rats that are resistant to binge eating (BER) from those prone to binge eating (BEP), based on their individual eating habits. For this study, the researchers studied binge eating risk from pre-puberty to adulthood in 66 female rats. In addition to their standard food, the rats were provided intermittent access to cake frosting, a highly enjoyable but nutritionally empty and high fat food.

Results

Over the course of development, all rats ate more frosting as they matured. However, a difference in frosting intake between BER and BEP rats emerged during puberty; no differences in frosting intake were observed in pre-puberty, but large differences were observed in puberty and adulthood. The researchers noted that rats in the BER and BEP groups ate similar amounts of the standard food and were similar in body weight. This suggests that the BEP rats were not overeaters generally, but were instead, prone to binge eat on high-fat foods only.

Significance

The findings reveal dramatic increases in binge eating proneness during puberty, suggesting that increases in binge eating and similar eating disorders during and after puberty in girls may be partially due to biological factors. Similar to binge eating in humans, BEP rats ate much more of the high-fat food but did not increase their consumption of the standard food. Also, all rats preferred the high-fat food, regardless of developmental stage, which is similar to behaviors seen in girls; for example, girls tend to prefer candy over healthier treats at all ages. In both rats and humans, this behavior begins to diverge during puberty, with some consuming much more of the high-fat food than others. Unlike humans, however, the percentage of binge eating rats (30 percent) was much higher than estimates in humans (3.5–19 percent). According to the researchers, this difference may indicate that binge eating in rats is a “pure” form of binge eating that is unmodified by psychosocial factors, such as social disapproval or guilt that tends to decrease binge eating rates in humans.

More research is needed to develop and validate animal models of the cognitive and behavioral symptoms of eating disorders. Studies exploring the mechanisms underlying developmental changes that occur during puberty, for example the action of ovarian hormones, may also inform research on eating disorders.

About Eating Disorders

What is an eating disorder?

Eating Disorders are serious and complex emotional and physical addictions. Without treatment, eating disorders lead to mood swings, physical problems, and potential death. Eating Disorders include a range of conditions that involve an obsession with food, weight and appearance to the degree that a person’s heath, relationships and daily activities are adversely affected. While commonly affecting young women, eating disorders are widespread and can impact people of all ages and sexes. It is estimated that 10 million women and 1 million men in the United States suffer from an eating disorder, and the statistics are growing. The number of men with an eating disorder has more than doubled in the last ten years.

Whether a person restricts food intake, binge eats, binges and purges, abuses laxatives, compulsively overeats, or excessively exercises, these behaviors often are symptoms and not the problem. They often develop as a way of coping with emotional pain, conflicts related to separation, low self-esteem, depression, stress or trauma. Eating disorders are characterized by severe disturbances in eating behavior. The practice of an eating disorder can be viewed as a survival mechanism. Just as an alcoholic uses alcohol to cope, a person with an eating disorder can use eating, purging or restricting to deal with their problems. Some of the underlying issues that are associated with an eating disorder include low self-esteem, depression, feelings of loss of control, feelings of worthlessness, identity concerns, family communication problems and an inability to cope with emotions. The practice of an eating disorder may be an expression of something that the eating disordered individual has found no other way of expressing.

Types:
Anorexia Nervosa: Anorexia nervosa is self-imposed starvation. Anorexia nervosa is a serious, life-threatening disorder, which usually stems from underlying emotional causes. Although people with anorexia nervosa are obsessed with food, they continually deny their hunger. People with anorexia nervosa often also limit or restrict other parts of their lives besides food, including relationships, social activities, or pleasure. Anorexia nervosa can cause severe medical problems and even lead to death. The disorder involves extreme weight loss–at least 15% below the individual’s “ideal” weight–and a refusal to maintain body weight that is even minimally normal for their age and height and body frame.

Bulimia Nervosa: Bulimia nervosa is a serious eating disorder that can be fatal if left untreated. People who have bulimia nervosa routinely “binge,” consuming large amounts of food in a very short period of time, and immediately “purge,” ridding their bodies of the just-eaten food by self-inducing vomiting, taking enemas, or abusing laxatives or other medications. If left untreated, bulimia nervosa can lead to serious and even life-threatening problems, such as depression, anxiety disorders, heart damage, kidney damage, injury to all parts of the digestive system, and severe dental damage. Those with bulimia nervosa are at risk for dangerous impulsive, self-destructive behaviors, such as kleptomania, self-mutilation, alcohol and/or drug abuse, and sexual promiscuity.

Compulsive eating disorder: Compulsive overeating can affect women or men, though it appears twice as often among women. People with compulsive overeating disorder suffer from episodes of uncontrolled eating or bingeing followed by periods of guilt and depression. Compulsive overeating is marked by the consumption of large amounts of food, sometimes accompanied by a pressured, “frenzied” feeling. Compulsive overeating disorder may cause a person to continue to eat even after they become uncomfortably full.

Binge eating disorder: The essential features of binge-eating disorder are recurrent, out-of-control episodes of consuming abnormally large amounts of food. One who suffers from this disorder, eats whether they are hungry or not and consume food well past being uncomfortably full. Binge-eaters are usually extremely distressed by their eating behavior and experience feelings of disgust and guilt both during and after bingeing. Most feel ashamed and try to hide their problem. Many are so good at concealing their binge-eating habits from others that even close family members or friends are unaware they suffer from an eating disorder. Binge-Eating Disorder:

  • Binge-eating episodes not accompanied by purging at least 2 times per week.
  • Occurs in approximately 30%-50% of subjects in weight control programs (40% are males).

Obesity (25% or more over ideal body weight): Obesity is one of our nation’s most critical health problems. Each year hundreds of thousands of people are affected by serious and sometimes life-threatening mental and physical complications as a direct consequence of their obesity. Appropriate treatment not only improves individuals’ quality of life, it can save lives. The consequences of obesity can be severe. If left untreated, an obese person is at pronounced risk of developing serious mental disorders, such as depression, personality disorders, or anxiety disorders as a direct consequence of their obesity. For many, obesity leads to chronic and often life-threatening eating disorders such as bulimia nervosa or anorexia nervosa. Feelings of shame and a profound sense of isolation often accompany obesity.

Facts:

  • 80% of women who answered a People magazine survey responded that images of women on television and in the movies make them feel insecure.
  • Two out of five women and one out five men would trade three to five years of their life to achieve their weight goals.
  • In one study, three out of four women stated that they were overweight although only one out of four actually were.
  • In 1970 the average age a girl started dieting was 14; by 1990 the average dropped to 8.
  • One study asked children to assign attractiveness values to pictures of children with various disabilities. The participants rated the obese child less attractive than a child in a wheelchair, a child with a facial deformity and, a child with a missing limb.
  • The dieting industry is the only business in the world that has a 98% failure rate.
  • One half of 4th grade girls are on a diet.
  • The average U.S. woman is 5’4” and weighs 140 pounds. In contrast, the average US model is 5’11” and weighs 117 pounds.
  • 51% of nine and ten-year-old girls stated they felt better about themselves when they were adhering to a diet.
  • One out of three women and one out of four men are on a “diet” at any given time.
  • Four out of five U.S. women are dissatisfied with their appearance.
  • 81% of ten-year-old girls are afraid of being fat.
  • One study found that adolescent girls were more fearful of gaining weight than getting cancer, nuclear war or losing their parents.
  • Some of the pictures of the models in magazines do not really exist. The pictures are computer-modified compilations of different body parts.
  • One study found that 25% of Playboy centerfolds met the weight criteria for anorexia.
  • Eating disorders have the highest mortality rate of all mental illnesses. The mortality (death) rate for eating disorders is approximately 18% in 20-year studies, and 20% in 30-year follow-up studies.
  • 52% of girls begin dieting before age 14 according to the Journal of Adolescence and Youth.
  • Eating disorders cross racial, economic, and educational boundaries.
  • Bulimia can cause damage to the reproductive system, kidney failure, cardiac arrest, and ulcers of the intestinal tract.
  • Many people with eating disorders are addicted to exercise.
  • Victims of eating disorders generally have very low self-esteem.

Signs and Symptoms

Anorexia:

  • Is thin and keeps getting thinner, losing 15% or more of ideal body weight.
  • Continues to diet or restrict foods even though not overweight.
  • Has a distorted body image—feels fat even when is thin.
  • Is preoccupied with food, calories, nutrition, or cooking.
  • Denies hunger.
  • Exercises obsessively.
  • Weighs self frequently.
  • Complains about feeling bloated or nauseated even when eats normal—or less than normal—amounts of food.
  • Loses hair or begins to experience thinning hair.
  • Feels cold even though the temperature is normal or only slightly cool.
  • Stops menstruating.

Bulimia:

  • Engages in binge eating and cannot voluntarily stop.
  • Uses the bathroom frequently after meals.
  • Reacts to emotional stress by overeating.
  • Has menstrual irregularities.
  • Has swollen facial glands, giving her chipmunk cheeks.
  • Experiences frequent fluctuations in weight.
  • Cannot voluntarily stop eating.
  • Is obsessively concerned about weight.
  • Attempts to adhere to diets, but generally fails.
  • Feels guilty or ashamed about eating.
  • Feels out of control.
  • Has depressive moods.

Compulsive Overeating: People with compulsive eating disorder feel unable to stop eating, eat very fast, eat when they’re not hungry, eat only when alone, or eat nearly non-stop throughout the day. Compulsive eaters often over-indulge in sugary foods and use them in an attempt to elevate their mood. When they don’t eat the foods they crave, they often experience severe withdrawal symptoms.

Binge eating disorder: Here are some of the common warning signs that suggest a person may be suffering from binge eating disorder. The person:

  • Eats large amounts of food when not physically hungry.
  • Eats much more rapidly than normal.
  • Eats until the point of feeling uncomfortably full.
  • Often eats alone because of shame or embarrassment.
  • Has feelings of depression, disgust, or guilt after eating.
  • Has a history of marked weight fluctuations.

Obesity:

  • More than 20% over ideal body weight. Ideal weight is based on gender, age, and typical activity level (e.g., sedentary or active).
  • Body-fat percentage greater than 30% for women and 25% for men.

Health Consequences:

Eating disorders can kill! Be aware of medical complications. Get professional help.
Families and friends of eating disordered patients often do not realize the extent to which eating disorders can create serious physical problems. Some of the more common medical consequences of eating disorders are easily recognizable and with early detection can be managed to prevent serious medical complications requiring hospitalization.

  • Hypomagnesemia – a magnesium deficiency
  • Hypocalcemia – a calcium deficiency
  • Dehydration
  • Malnutrition
  • Metabolic Alkalosis – high levels of bases (negative ions) in the body
  • Metabolic Acidosis – high levels of acids in the body
  • Low Blood Pressure
  • Low Heart Rate
  • Heart Failure
  • Esophageal Damage (leading to possible rupture) – this usually happens quickly and is very dangerous
  • Impacted bowels
  • Osteoporosis
  • Heart Arrhythmia
  • Dental Problems

Body Image:

  • How you see yourself when you look in the mirror or when you picture yourself in your mind.
  • What you believe about your own appearance (including your memories, assumptions, and generalizations).
  • How you feel about your body, including your height, shape, and weight.
  • How you sense and control your body as you move. How you feel in your body, not just about your body.

Negative body image:

  • A distorted perception of your shape–you perceive parts of your body unlike they really are.
  • You are convinced that only other people are attractive and that your body size or shape is a sign of personal failure.
  • You feel ashamed, self-conscious, and anxious about your body.
  • You feel uncomfortable and awkward in your body.

People with negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss.

Positive body image:

  • A clear, true perception of your shape–you see the various parts of your body as they really are.
  • You celebrate and appreciate your natural body shape and you understand that a person’s physical appearance says very little about their character and value as a person.
  • You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight, and calories.
  • You feel comfortable and confident in your body.

Causes:

Eating Disorders are about feelings, not food. Eating Disorders are not just about food and weight. They are an attempt to use food intake and weight control to manage emotional conflicts that actually have little or nothing to do with food or weight. Eating disorders do not occur in an otherwise satisfied, productive, and emotionally healthy person. People with eating disorders are struggling with a number of emotional problems. This may be a hard concept to accept. Many people with eating disorders appear to be functioning at a high level, such as enjoying success with school or work. Often, the only problem appears to be with eating. However, healthier eating habits or stronger willpower are not the missing ingredients that will make the problem disappear. AN EATING DISORDER IS AN EXTERNAL SOLUTION TO INNER TURMOIL.

Psychological Factors that can contribute to Eating Disorders:

  • Low self-esteem
  • Feelings of inadequacy or lack of control in life
  • Depression, anxiety, anger, or loneliness
  • Troubled family and personal relationships
  • Difficulty expressing emotions and feelings
  • History of being teased or ridiculed based on size or weight
  • History of physical or sexual abuse

Social Factors that Can Contribute to Eating Disorders:

  • Cultural pressures that glorify “thinness” and place value on obtaining the “perfect body”
  • Narrow definitions of beauty that include only women and men of specific body weights and shapes
  • Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be imbalanced. The exact meaning and implications of these imbalances remains under investigation. Eating disorders are complex conditions that can arise from a variety of potential causes. Once started, however, they can create a self-perpetuating cycle of physical and emotional destruction.

All eating disorders require professional help!

Coping:

The ideas below present some alternatives to patterns of eating disordered behavior. Remember, changes make a difference, no matter how small you believe those changes are.

  • If you feel the urge to binge, try taking a few moments (it may be seconds at first) to identify feelings. You can still binge later – remember you are simply trying to change the usual patterns of behavior.
  • Get a journal where you can write your feelings throughout the day. You may want to focus on meal times or even one meal at first.
  • If you are afraid of eating, make a list of “safe” foods for you. Supply your home with these foods so that you are prepared to let yourself eat.
  • Grow your support system. The point is to find safe people to help you feel supported.
  • Start calling safe people. As you become more accustomed to making calls, you will find yourself turning to others more easily.
  • If you live with someone, plan a discussion about your needs. There may be changes the other person can make to help you.
  • Make a list of safe people with phone numbers. Carry the list with you.
  • Get a list of feelings if you have difficulty identifying your experience. Refer to the list throughout the day, especially meal times.
  • Notice meal times and content. If you record your level of satiety, urges to binge/restrict/purge, you may learn if there are foods that trigger you or length of time between meals that triggers you.
  • Notice the way you speak to yourself about your food, body, or behaviors. Begin to add positive statements, gradually letting go of the negative. No eating disorder was ever cured through self-blame.
  • Consider your spiritual life. Spirituality means different things to different people. Find out what it means for you and start to draw upon this part of you.
  • Do you let yourself have needs and limits in your work or personal life? Holding back anger and resentment and stifling your needs leads to self-punishment through more eating disordered behavior.
  • Find your voice. Practice with safe people. Start by telling them you’d like to practice saying “NO” to them about something that doesn’t matter. Let yourself start in a comfortable way.

All eating disorders require professional help!

Prevention:

Every family, group, and community is different in terms of what might contribute to effective primary prevention. Eating disorders are serious and complex problems. Their expression, causes, and treatment typically have physical, personal, and social dimensions. Consequently, one should avoid thinking of them in simplistic terms like “anorexia is just a plea for attention” or “bulimia is just an addiction to food.” Prevention programs are not “just a women’s problem” or “something for the girls.” Males who are preoccupied with shape and weight can also develop disordered eating patterns as well as dangerous shape control practices such as steroid use. Moreover, objectification and other forms of mistreatment of women by men contribute directly to two underlying features of an eating disorder: obsession with appearance and shame about one’s body.

Prevention efforts will fail, or worse, inadvertently encourage disordered eating, if they concentrate solely on warning parents and children about the signs, symptoms, and dangers of eating disorders. Therefore, any attempt to prevent eating disorders must also address:

  • Our cultural obsession with slenderness as a physical, psychological, and moral issue
  • The distorted meaning of both femininity and masculinity in today’s society
  • The development of people’s self-esteem and self-respect

If at all possible, prevention “programs” for schools, churches, and athletics should be coordinated with opportunities for individuals in the audience to speak confidentially with a trained professional and, where appropriate, to receive referrals to sources of competent, specialized care.

Questionnaire:

Do you have an eating disorder?

  1. Do you overeat until you feel sick?

  2. Do you feel guilt and remorse when you eat?

  3. Are you terrified of being overweight?

  4. Does it feel as though food controls your life?

  5. Do you isolate so that you can eat?

  6. Do you have a history of dieting?

  7. Do you avoid eating when you’re hungry?

  8. Do you weigh yourself at least once a day?

  9. Do you eat large amounts of food in a brief amount of time?

  10. Do other people say you’re thin but you think you’re fat?

  11. Do you make yourself vomit?

  12. Do you regularly take laxatives or diuretics to lose weight?

  13. Do you exercise no matter how tired or sick you may feel and feel upset when you miss a day?

  14. Do you go to the gym or exercise more than once a day?

  15. Do you take longer than other people to eat a meal or do you usually finish before everyone else?

  16. Are you preoccupied with food or your body size much of the day most days?

  17. Do you hide foods?

  18. Do you cook for others but never eat what you’ve made?

  19. Do you resist foods when in public but eat them when you’re alone?

  20. Do you eat or refuse to eat when tense, anxious, or disappointed?

  21. Do you feel exhilarated or “in control” when you don’t eat?

  22. Have you taken drugs to curb your appetite?

  23. Do you exercise instead of eating?

  24. Do you count calories or fat grams?

  25. Do you make unfulfilled promises to yourself about what you will or will not eat?

  26. Do you feel defeated or hopeless about food or your body size?

  27. Have you kept any of these issues secret?

If you have answered “Yes” to any of these questions, you may have an eating disorder. Eating disorders are very serious. You should get help immediately. Ask a trusted family member, teacher, or friend to help you find professional assistance.

Eating Disorders-Amercian Psychiatric Association

Eating disorders are illnesses in which people experience severe disturbances in their eating behaviors and related thoughts and emotions. Those suffering from eating disorders typically become obsessed with food and their body weight as well. Eating disorders affect some several million people at any given time, most often women between the ages of 12 and 35. There are three main types of eating disorders, anorexia nervosa, bulimia nervosa, and binge eating disorder. People with anorexia nervosa and bulimia nervosa tend to be perfectionists who suffer from low self-esteem and are extremely critical of themselves and their bodies. They usually “feel fat” and see themselves as overweight, sometimes even despite life-threatening semi-starvation (or malnutrition). An intense fear of gaining weight and of being fat may become all pervasive. In early stages of these disorders, patients often deny that they have a problem.

In many cases, eating disorders occur together with other psychiatric disorders like anxiety, panic, obsessive compulsive disorder, and alcohol and drug abuse problems. New evidence suggests that heredity may play a part in why certain people develop eating disorders, but these disorders also afflict many people who have no prior family history. Without treatment of both the emotional and physical symptoms of these disorders, malnutrition, heart problems, and other potentially fatal conditions can result. However, with proper medical care, those suffering from eating disorders can resume suitable eating habits, and return to better emotional and psychological health.

Anorexia Nervosa
Anorexia nervosa is diagnosed when patients weigh at least 15 percent less than the normal healthy weight expected for their height. People with anorexia nervosa do not maintain a normal weight because they refuse to eat enough, often exercise obsessively, and sometimes force themselves to vomit or use laxatives to lose weight. Over time, the following symptoms may develop as the body goes into starvation:

• Menstrual periods cease
• Osteopenia or osteoporosis (thinning of the bones) through loss of calcium
• Hair/nails become brittle
• Skin dries and can take on a yellowish cast
• Mild anemia and muscles, including the heart muscle, waste away
• Severe constipation
• Drop in blood pressure, slowed breathing and pulse rates
• Internal body temperature falls, causing person to feel cold all the time
• Depression, and lethargy

Bulimia Nervosa
Although they may frequently diet and vigorously exercise, individuals with bulimia nervosa can be slightly underweight, normal weight, overweight or even obese. However, they are never as underweight as anorexia nervosa sufferers. Patients with bulimia nervosa binge eat frequently, and during these times sufferers may eat an astounding amount of food in a short time, often consuming thousands of calories that are high in sugars, carbohydrates, and fat. They can eat very rapidly, sometimes gulping down food without even tasting it. Their binges often end only when they are interrupted by another person, or they fall asleep, or their stomach hurts from being stretched beyond normal capacity.

During an eating binge sufferers feel out of control. After a binge, stomach pains and the fear of weight gain are common reasons that those with bulimia nervosa purge by throwing up or using a laxative. This cycle is usually repeated at least several times a week or, in serious cases, several times a day. Many people don’t know when a family member or friend has bulimia nervosa because sufferers almost always hide their binges. Since they don’t become drastically thin, their behaviors may go unnoticed by those closest to them. But bulimia nervosa does have symptoms that should raise red flags:

• Chronically inflamed and sore throat
• Salivary glands in the neck and below the jaw become swollen. Cheeks and face often become puffy, causing sufferers to develop a “chipmunk” looking face
• Tooth enamel wears off, teeth begin to decay from exposure to stomach acids
• Constant vomiting causes gastroesophageal reflux disorder
• Laxative abuse causes irritation, leading to intestinal problems
• Diuretics (water pills) cause kidney problems
• Severe dehydration from purging of fluids

Binge Eating Disorder
Presently, the criteria for binge eating disorder are under investigation or are still being defined. However, people with binge eating disorder have episodes of binge eating in which they consume very large quantities of food in a brief period and feel out of control during the binge. Unlike people with bulimia nervosa, they do not try to get rid of the food by inducing vomiting or by using other unsafe practices such as fasting or laxative abuse. The binge eating is chronic and can lead to serious health complications, particularly severe obesity, diabetes, hypertension and cardiovascular diseases.

Treatment
Eating disorders clearly illustrate the close links between emotional and physical health. The first step in treating anorexia nervosa is to assist patients with regaining weight to a healthy level; for patients with bulimia nervosa interrupting the binge-purge cycle is key. For patients with binge eating disorder it is important to help them interrupt and stop binges. However, restoring a person to normal weight or temporarily ending the binge-purge cycle does not address the underlying emotional problems that cause or are made worse by the abnormal eating behavior.

Psychotherapy helps individuals with eating disorders to understand the thoughts, emotions and behaviors that trigger these disorders. In addition, some medications have also proven to be effective in the treatment process. Because of the serious physical problems caused by these illnesses, it is important that any treatment plan for a person with anorexia nervosa, bulimia nervosa, or binge eating disorder include general medical care, nutritional management and nutritional counseling. These measures begin to rebuild physical well-being and healthy eating practices.