Chapter 12

Eating Disorders
(continued)
 Binge Eating Disorder: DSM-5

 Same binge-eating criteria as Bulimia Nervosa.

 The binge-eating episodes are also associated

with three (or more) of the following:
1. Eating much more rapidly than normal.
2. Eating until feeling uncomfortably full.
3. Eating large amounts of food when not feeling
physically hungry.
4. Eating alone because of feeling embarrassed
by how much one is eating.
5. Feeling disgusted with oneself, depressed, or
very guilty afterward.
 Binge Eating Disorder: DSM-5

 Marked distress regarding binge eating is

present.

 The binge eating occurs, on average, at least

once a week for 3 months.

 The binge eating is not associated with the

regular use of inappropriate compensatory
behaviors as in Bulimia Nervosa.

 Occurs in about 2-3.5% of the general

population, slightly more common in females,
and they also have high rates of anxiety and
depression.
 Binge Eating Disorder Severity:
DSM-5
 Mild: 1-3 binge-eating episodes per week.

 Moderate: 4-7 binge-eating episodes per week.

 Severe: 8-13 binge-eating episodes per week.

 Extreme: 14 or more binge-eating episodes per

week.

 What is Night Eating Syndrome?

TABLE 2 Comparison of Eating
Disorders
TABLE 2 Comparison of Eating Disorders
The eating disorders vary on several characteristics.
Characteristic Anorexia Anorexia Bulimia Nervosa Binge-eating
Nervosa Nervosa Disorder
Restricting Binge/Purge
Type Type
Body weight Significantly Significantly Often normal weight Often significantly
underweight underweight or overweight overweight

Body image Severely Severely Overconcerned with Often very

disturbed disturbed weight and shape distressed with
overweight
Bingeing No Yes Yes Yes

Purging or other No Yes Yes No

compensatory
behaviors
Sense of lack of No During binges Yes Yes
control over
eating
 Understanding Eating Disorders:
Biological Factors

 Genetic factors
 Changes of puberty in girls
 Imbalance or dysregulation of any of the
neurochemicals
 Lowered functioning of the hypothalamus
 Abnormalities in the systems regulating the
neurotransmitter serotonin
 Psychodynamic View

 Hilde Bruch

 Eating disorders are the result of disturbed

mother-child interactions, which lead to
serious ego deficiencies in the child and to
severe perceptual disturbances.

 Effective versus ineffective parenting

 This theory also includes cognitive elements.

 Understanding Eating Disorders:
Sociocultural and Psychological Factors

 Social pressures and cultural norms

 Thin ideal promoted by media and body
dissatisfaction
 Athletes and eating disorders
 Cognitive factors can also play a role
in the internalization of this thin ideal
 Cognitive Factors

 Cognitive factors such as obsessive

thoughts, perfectionism, dissociation,
impaired cognitive style and cognitive
bias

 All-or-nothing (dichotomous) thinking

 Lack of interoceptive awareness

 Environmental Risk Factors

 Childhood abuse

 Life stress

 Teasing
 Multicultural Risk Factors

 In the U.S., race/ethnicity no longer protects

individuals from an eating disorder. SES?

 Western society’s double standard for

attractiveness is, at the very least, one reason
for sex differences.

 A second reason for sex differences may be the

different methods of weight loss favored

 Reverse anorexia nervosa (muscle dysmorphia)