PRESENTATION OVERVIEW

Introduction of the Eating Disorder

Etiology/ Causes

Assessment and Diagnostic Criteria

Treatment

Obesity

Conclusion
WHAT IS AN EATING DISORDER???
Eating Disorders describe illnesses that are
characterized by irregular eating habits and
1 severe distress or concern about body weight or
shape.

Eating disturbances may include inadequate or

2 excessive food intake which can ultimately
damage an individual’s well-being.

Disordered eating issues can develop during any

3 stage in life but typically appear during the teen
years or young adulthood.

Eating disorders commonly coexist with other

4 conditions, such as anxiety disorders, substance
abuse, or depression.
 TYPES OF EATING DISORDER
Binge
Bulimia Anorexia Eating
Nervosa Nervosa Disorder
 1. BULIMIA NERVOSA
• Bulimia nervosa is eating a larger amount of food and mostly non-nutritious food within a short time.
• This eating disorder is characterized by repeated binge eating followed by behaviours that
compensate for the overeating, such as forced vomiting, excessive exercise, or extreme use of
laxatives or diuretics.
• Men and women who suffer from bulimia may fear weight gain and feel severely unhappy with their
body size and shape.
• The binge-eating and purging cycle is typically done in secret, creating feelings of shame, guilt, and
lack of control.
• Bulimia can have injuring effects, such as gastrointestinal problems, severe dehydration, and heart
difficulties resulting from an electrolyte imbalance.
 2. ANOREXIA NERVOSA
• The male or female suffering from anorexia nervosa will typically have an obsessive
fear of gaining weight, refusal to maintain a healthy body weight and an unrealistic
perception of body image.
• Severe caloric restriction, often with excessive exercise and sometimes with purging to
the point of semi-starvation
• Many people with anorexia nervosa will fiercely limit the quantity of food they consume
and view themselves as overweight, even when they are clearly underweight.
• Anorexia can have damaging health effects, such as brain damage, multi-organ
failure, bone loss, heart difficulties, and infertility. The risk of death is highest in individuals
with this disease.
 3. BINGE-EATING DISORDER (BED)
• Similar to bulimia with out of control food binges, but no attempt to purge the food
(vomiting, laxatives, diuretics) or compensate for excessive intake.
• Marked physical and emotional stress; some sufferers binge to alleviate bad mood.
• Binge eaters share some concerns about weight and body shape as individual with
anorexia and bulimia
• They may also experience intense feelings of guilt, distress, and embarrassment
related to their binge-eating, which could influence the further progression of the
eating disorder.
• Tends to affect more older people than either bulimia or anorexia.
ETIOLOGY/ CAUSES
1 SOCIAL DIMENSIONS

2 BIOLOGICAL DIMENSIONS

PSYCHOLOGICAL
3 DIMENSIONS
 SOCIAL
DIMENSIONS

Cultural and social emphasis on slender ideal, leading to body dissatisfaction

01 and preoccupation with food and eating

02 Cultural pressures that glorify thinness and place value on obtaining the perfect
body ( Dietary Restraint)

Narrow definitions of beauty that include only women and men of specific body
03
weights and shapes

Cultural norms that value people on the basis of physical appearance and not
04 inner qualities and strength

Family influences made of the possible significances of family interaction pattern

05
in cases of eating disorder
 BIOLOGICAL
DIMENSIONS

Possible genetic tendency to poor impulse control, emotional instability and

01 perfectionistic traits

02 This biological vulnerability might then interact with social and psychological
factors to produce an eating disorder

Biological processes are quite active in regulation of eating and thus of eating disorder
03 and substantial evidence points to the hypothalamus as playing and important role.

The abnormalities in neurotransmitters may contribute to developing Eating

04 Disorder including dopamine, serotonin, and norepinephrine. Both of these
neurotransmitters are known to be associated with other psychiatric conditions.

Eating disorders can stimulate the production of the so-called ‘stress hormones’, which include cortisol,
growth hormone and noradrenaline. These hormones are usually released in higher concentrations at
05 periods of high stress and can lead to sleep problems, feelings of anxiety, depression and panic.
 PSYCHOLOGICAL
DIMENSIONS

Diminished sense of personal control and self-confidence, causing low self-esteem.

01 Distorted body image

02 They also display more perfectionistic attitudes, perhaps learned or inherited from their
families, which may reflect attempts to exert control over important events in their lives

Women with eating disorder are intensely preoccupied with how they appear to other. Perceive
03 themselves as frauds, considering false any impressions they make of being adequate,
self-sufficient or worthwhile

Difficulty tolerating any negative emotion and may binge or engage in other behaviors
04 (e.g; self-induced vomiting or intense exercise) in an attempt to regulate their mood.
 Anorexia Nervosa versus Bulimia Nervosa comparison chart
DIMENSION Anorexia Nervosa Bulimia Nervosa
Eating disorder wherein sufferers fear weight gain and Eating disorder wherein sufferers go through a cycle of
About avoid eating as a result. Mainly affects young women. binging (overeating) followed by purging, due to a fear of
weight gain. Mainly affects young women.
Typical Age of Onset Early teen years Late teen years
Behavioral and Obsession with food, weight, and a "thin" body image; Obsession with food, weight, and a "thin" body image;
Psychological extreme fear of weight gain; compulsive extreme fear of weight gain; compulsive
Symptoms exercise; depression and anxiety; low self-esteem; body exercise; depression and anxiety; low self-esteem; body
dysmorphic disorder. dysmorphic disorder.
Usually extremely underweight and unhealthy figure; Many within "normal" weight range for height/age, but can
Physical Symptoms physical weakness, deterioration, and organ dysfunction; be underweight; physical weakness, deterioration, and organ
absent menstruation; memory loss, feeling faint, etc. dysfunction; absent menstruation; memory loss, feeling faint,
etc. Noticeable oral/dental deterioration.
Avoids eating, frequently goes on fasts or restrictive diets, Goes through periods of binging — overeating — and
Relationship to Food tendency to be secretive about eating habits and rituals. purging, usually by vomiting or heavy use of laxatives,
diuretics, etc.
Causes No official cause. Can be related to culture, family No official cause. Can be related to culture, family
life/history, stressful situations, and/or biology. life/history, stressful situations, and/or biology.
May require hospitalization. Outpatient or inpatient Unlikely to require hospitalization. Outpatient or inpatient
Treatment treatment options. Dietitians, doctors, therapists, and treatment options. Dietitians, doctors, therapists, and
psychiatrists often part of treatment. psychiatrists often part of treatment.
Varies. Slight majority who seek treatment report full Varies. Slight majority who seek treatment report full recovery
Prognosis recovery in years to come; up to one third still affected or in years to come; up to one third still affected or struggle with
struggle with relapses. One of the deadliest mental relapses.
disorders.
Prevalence in Women 0.3-0.5% 1-3%
????
 IDENTIFICATION

01 Eating disorder are very difficult to identify

There are RED flags of psychological, behavioral, and

physical symptoms that may been seen in a child 02
with an eating disorder.

03 Some of the symptoms may be easily identified

and others may not be seen at all

Identification of symptoms depends on the severity 04

of the disorder and how long it has been affecting
the child.
 Psychological Indicators
1

Behavioral Indicators
2

Physical Indicators
3
 PSYCHOLOGICAL INDICATORS
• Self injury • Minimizes feelings or extreme anger at
• Difficulty in following a conversation family regarding eating habits
• Poor concentration • Co- morbidity of depression
• Co- morbidity of OCD (Obsessive
• Poor memory
Compulsive Disorder)
• Feeling of pride when losing weight or
• Suicidal ideation
resisting hunger • Deception, lying to hide eating
• Feeling of shame in relationship to eating disorder
habits • Feelings of hopelessness
• Body distortion associated with anxiety • Feelings of self hatred
• Intense fear of gaining weight or • Extreme thought patterns or
becoming fat perfectionism
 BEHAVIORAL INDICATORS
• Missing school/classes • Eating the same foods every day/rigid food
• Social withdrawal rituals
• Constantly comparing body size to others • Becoming a vegetarian
• Excessive use of bathroom scale • Excessive water or diet soda intake
• Preoccupation with body reflection in • Refusal to maintain weight Excessive gum
mirrors/windows chewing
• Calorie intake reported below 800 kcal per day • Wearing baggy clothing
• Refusal to keep food down/purging • Wearing many layers of clothing despite
• Hiding and hoarding food the weather.
• Cutting food into tiny pieces and moving it around • Excessive exercise
the plate • Preparing food for others and not eating
• Excuses self from the table at meal time • Excessive baking for others
• Not eating in front of others • Constant obsessing about food
• Lying about having eaten • Over use of laxatives
• Over use of diet pills
• Over use of energy drinks
 PHYSICAL INDICATORS
Late Signs
• Early Signs • 80% below normal body weight
• Unexplained weight loss • BMI below 16
• Lightheadedness/Dizziness • Chest pain
• Syncope • Orthostatic blood pressure changes
• Constant complaints of headache • Bradycardia/Palpitations
• Cold intolerance • Dehydration
• Extreme fatigue • Yellow tint to skin
• Loss of hair • Blue tint to hands
• Lanugo on face, neck and arms • Amenorrhea
• Restlessness • Dental enamel erosion
• Insomnia • Swollen or tender parotid glands
• Severe abdominal pain and blotting
Early Signs • Constipation or diarrhea due to use of
laxatives
• Abdominal pain with consumption of food
• Constant indigestion and heart bur
 DIAGNOSTIC CRITERIA FOR BULIMIA NERVOSA
A. An episode of binge eating is characterized by both of the following :

BULIMIA i. Eating in discrete period of time (e.g; within any 2 hour period) , an amount of
food that is definitely larger than most people would eat during a similar period
NERVOSA of time and under similar circumstances.

ii. A sense of lack of control over eating during the episode (e.g; a feeling that
one cannot stop eating or control what or how much one is eating)

B. Recurrent inappropriate compensatory behaviour in order to prevent weight gain,

such as self-induced vomiting; misuse of laxatives, diuretics or other medications;
fasting or excessive eversice.

C. The binge eating and inappropriate compensatory behaviors both occur, on

average, at least once a week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
 DIAGNOSTIC CRITERIA FOR ANOREXIA NERVOSA
ANOREXIA A. Restriction of energy intake relative to requirements, leading to a significantly low
body weight in the context of age, sex, developmental trajectory, and physical
NERVOSA health. Significantly low weight is defined as a weight that less than minimally
normal or, for children and adolescents, less than that minimally expected.

B. Intense fear of gaining weight or of becoming fat, or persistent behaviour that

interferes with weight gain, even though at a significantly low weight.

C. 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 persistent lack of
recognition of the seriousness of the current low body weight.
 DIAGNOSTIC CRITERIA FOR BINGE-EATING DISORDER
A. An episode of binge eating is characterized by both of the following :

BINGE-EATING i. Eating in discrete period of time (e.g; within any 2 hour period) , an amount of food
that is definitely larger than most people would eat during a similar period of time and
DISORDER under similar circumstances.

ii. A sense of lack of control over eating during the episode (e.g; a feeling that one
cannot stop eating or control what or how much one is eating)

B. The binge-eating episode are associated with three (or more) of the following:
i. Eating much more rapidly than normal.
ii. Eating until feeling uncomfortably full.
iii. Eating large amounts of food when not feeling physically hungry.
iv. Eating alone because of feeling embarrassed by how much one is eating
v. Feeling disgusted with oneself, depressed or very guilty afterward.

C. Marked distress regarding binge eating is present

D. The binge eating occurs, on average at least once a week for 3 months
E. The binge eating is not associated with the recurrent use of inappropriate
compensatory behaviour as in bulimia nervosa and does not occur exclusively
during the course of bulimia nervosa or anorexia nervosa.
 WHY
SCREEN???
GAPS- Guidelines for Adolescent Preventive
01 Services (2009) Recommendation 13:
“All adolescents should be screened
annually for eating disorders and obesity by
determining weight, and stature, and asking
about body image and dieting patterns ”. “It is important to aggressively treat
patients who have traits of eating
disorders but who do not meet the full 02
criteria for anorexia or bulimia”
(American Family Physician, 2003, p 298)

Early identification increases the chance

03 of a successful recovery.
Once a student turns eighteen, he/she
may legally refuse treatment.
TYPES OF SCREENING TOOLS
Eating Attitudes Test (EAT) (Garner & Garfinkle,1979)
1  40-item self report for AN
 14 items were later found unnecessary. =EAT-26

EAT-26 (Garner et al,1982)

2  Measurement of a general eating disorder
 20/26 cut off identifies problematic attitudes with eating.

Bulimia Test-Revised (BUILTR)(Thelen, Farmer, Wonderlich & Smith, 1991)

3  28-item questionnaire
 Measurement of Bulimia

Eating Disorder Examination (EDE) (Fairburn & Cooper, 1993)

4  Clinician interview
 Considered the “method of choice” for assessing specific
eating disorders.
SCREENING QUESTIONS
TREATMENT
MEDICAL
1 TREATMENTS

PSYCHOLOGICAL
2 TREATMENTS

PREVENTING
3 PROGRAM
 MEDICAL
1 TREATMENTS

01 02
ANTIDEPRESSANT HOSPITALIZATION
Antidepressant medications can help people Outpatient treatment to restore
with bulimia nervosa reduce their weight and correct dysfunction
uncontrolled overeating, as well as improve attitudes on eating and body
their mood. shape
 PSYCHOLOGICAL
TREATMENTS

Psychological therapy is the most important component of eating disorder treatment.

It involves seeing a psychologist or another mental health professional on a regular basis.

Family-based Group Cognitive

Cognitive
Behavioral Therapy 01 Therapy 02 Behavioral Therapy 03
1. During this therapy, family members 1. This type of therapy involves meeting with
1. This type of psychotherapy
learn to help you restore healthy a psychologist or other mental health
focuses on behaviors, thoughts
eating patterns and achieve a professional along with others who are
and feelings related to patient
healthy weight until patient can do it diagnosed with an eating disorder.
eating disorder.
on their self. 2. It can help patient address thoughts,
2. After helping patient gain
2. This type of therapy can be feelings and behaviors related to patient
healthy eating behaviors, it
especially useful for parents learning eating disorder, learn skills to manage
helps to recognize and change
how to help a teen with an eating symptoms, and regain healthy eating
distorted thoughts that lead to
disorder. patterns.
eating disorder behaviors.
 PSYCHOLOGICAL
TREATMENTS

BULIMIA ANOREXIA BINGE-

NERVOSA 01 NERVOSA 02 EATING 03
1. Short-term cognitive-behavioral 1. Short-term CBT to address
1. Family Therapy
therapy(CBT) to address behavior and attitudes
2. Tends to be chronic if left
behavior and attitudes on on eating and body
untreated; more resistant
eating and body shape shape
to treatment than bulimia
2. Interpersonal 2. IPT to improve
psychotherapy(IPT) to improve interpersonal functioning
interpersonal functioning 3. Self-help approaches
3. Tends to be chronic if left
untreated
 PREVENTING
3 PROGRAM

Prevention is any systematic attempt to change the circumstances that promote, initiate, sustain, or
intensify problems like eating disorders. Eating disorders arise from a variety of physical, emotional, and
social issues, all of which must be addressed for effective prevention and treatment.

Universal/Primary
Prevention 01 Selective
Prevention 02
Indicated/Targeted
Prevention 03
1. Aimed at all people in a population
1. Intended to prevent eating 1. Targets people who are at high risk
2. To change public policy, institutions,
disorders by targeting individuals due to warning signs (e.g., mild ED
and normative cultural attitudes
symptoms) and/or clear risk factors
and practices who do not yet have symptoms of
(e.g., high levels of body
3. To prevent the development of a disorder and are at risk for an
dissatisfaction).
eating disorders in large groups with eating disorder due to biological,
2. to stop the development of a
varying degrees of risk psychological, or sociocultural
serious problem and is aimed at
factors the individual, rather than at
effecting change in social policies,
systems, or interpersonal behavior
WHAT ISLAM SAYS ABOUT THE RIGHT DIET
AND RIGHT FOOD???

Starting with a cup of coffee?

But did you know all this

simply make you less
productive and efficient.

Gearing up with snacks and

coke in break?
 EATING AT THE WRONG TIME ,
THE WRONG QUANTITY OF MEAL

So how you can increase your productivity?

 Eating at the wrong time with overburdened work life and few sleeping
hours increase your waist and make you fall in the fat body list. Islam has
given healthy diet plans with a scheduled life to help us in becoming
healthy and happy
 Try to start your day early with a healthy diet and eat the least amount of
food before sleep.
 Focus on the Diet
 Always eat in your senses, focus on your food not on TV or cellphone. Eat
less and chew more as it would reduce the chances of gaining fat.
 Always eat variety of food rather than eating only red, white meat or
vegetables.
WHAT QURAN SAYS ABOUT THE DIET?
ACCORDING THE GLORIOUS AL-QURAN
 OBESITY
01

02

03
WHAT IS YOUR BMI ????

BMI calculate link :

https://www.calculator.net/bmi-calculator.html
 CAUSES & CONSEQUENCES OF OBESITY
Social Psychological
STEP
Biological
Influences Influences
Influences

01
Advancing
technology
Genes
influences an
Affects impulse
control, attitudes
individual’s and motivation
promotes
number of fat towards eating
sedentary and
cells,
lifestyle and responsiveness to
tendency
consumption toward fat the
of high fat storage and consequences of
foods activity levels eating
 2
Self-directed weight loss
program
1
Commercial self-
help program

TREATMENT

Surgery

Professionally directed 3
behavior modification
program

4
DO YOU AGREE ???
STATISTICS OBESITY IN ASEAN

Source: World Population Review, 2019

NEED REST YOUR MIND ??
LETS WATCH THIS SHORT FILM
…………………………………………………………………………….
WHAT KIND OF EATING DISORDER ???
WHAT KIND OF EATING DISORDER ???
WHAT KIND OF EATING DISORDER ???
NOW YOU UNDERSTAND MORE
ABOUT EATING DISORDERS
Let’s do
Do You Have an Eating Disorder?
Click this link to evaluate yourself
Assessment…………

https://psychcentral.com/quizzes/eating-disorders-quiz#1
THANK YOU
PRESENTATION BY:

• Noor Azleen Binti Yusop (3201347)

GROUP
2 • Ahmad Syariffuddin Bin Sarmin (3201352)

• Nur – Abidah Binti Ayob ( 3201349)