Disordered Eating: Implications for Midlife and Beyond

Transcription

1 Disordered Eating: Implications for Midlife and Beyond NAADAC October 2015 Upon completion of this workshop, attendees will be able to: 1) Explain the differences between disordered eating and eating disorders 2) Identify at least two themes unique to men who are dealing with disordered eating 3) Discuss the implications of complimentary weightism and negative commentary, and how these can be linked to disordered eating Connie Ducaine, LPC, LCADC, ACS, BCPC, NCC

2 Disordered Eating Presentation Overview Section 1 Section Section 2 2 Section 3 Section 4 Section 5 Disordered Eating: Implications for Midlife and Beyond Housekeeping Upon completion of this workshop, attendees will be able to: 1) Explain the differences between disordered eating an d eating disorders 2) Identify at least two themes unique to men who are dealing with disordered eating 3) Discuss the implications of complimentary weightism and negative commentary, and how these can be linked to disordered eating Introductions and Interest Discuss Concepts and Terminology Statistics and Issues Review Implications

3 Feeding and Eating Disorders DSM-5 Section 1 Section Section 2 2 Section 3 Section 4 Notable DSM-5 Changes DSM-IV-TR: Feeding disorder of infancy and early childhood DSM-5: Avoidant/Restrictive food intake disorder Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder Section 5 Allen, K. L., Byrne, S. M., Oddy, W. H., & Crosby, R. D. (2013). DSM-IV-TR and DSM-5 eating disorders in adolescents: Prevalence, stability, psychosocial correlates in a population-based sample of male and female adolescents. Journal of Abnormal Psychology. 122, doi: /a

4 Definitions Key Concepts Body Image: Attitudes towards the way one looks and the behaviors that we employ to maintain these self-perceptions (Grosick et al., 2013) Disordered Eating: Attitudes and behaviors that range from worries about body image to self-injurious behaviors like binging, purging, and extreme exercise (Ricciardelli & McCabe, 2004) Feeding and Eating Disorders: Characterized by persistent disturbance of eating or eating-related behaviors that results in the altered consumption or absorption of food and that significantly impairs physical health or psychological function (American Psychiatric Association, 2013, p. 329) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Grosick, T.L., Talbert-Johnson, C., Myers, M. & Angelo, R. (2013). Assessing the landscape: Body image values and attitudes among middle school boys and girls. American Journal of Health Education, 44, doi: / Ricciardelli, L.A. & McCabe, M.P. (2004). A biopsychosocial model of disordered eating and the pursuit of muscularity in adolescent boys. Psychological Bulletin, 130(2),

5 Definitions A Few More Key Concepts Lookism: a bias against people as a result of their appearance (Cavico, Uffler, & Mujtaba, 2012) Weightism: discrimination based on body size (weight bias, obesity discrimination, size bias) Cavico, F. J., Muffler, S. C., & Mujtaba, B. G. (2012). Appearance discrimination in employment: Legal and ethical implications of lookism and lookphobia. Equality, Diversity and Inclusion: An International Journal, 32(1),

6 On-set DE Starts Early Child Identity Development Section 1 Section Section 2 22 Section 3 Section 4 Industry vs. Inferiority - Egocentric to who am I in relation to others or a possibly a belief that I am what I achieve Onset of Body Image Disturbance Body dissatisfaction at five years old predicted disordered eating attitudes and behaviors at age nine (Davison et al., 2003) Disordered Eating Attitudes and Behaviors By age of eight, children exhibited disordered eating habits including food restriction and excessive exercise (Comb et al., 2011) Section 5 Davison, K.K., Markey, C.N., & Birch, L.L. (2003). A longitudinal examination of patterns in girls weight concerns and body dissatisfaction from ages 5 to 9 years. International Journal of Eating Disorders, doi: /eat Combs, J. L., Pearson, C. M., & Smith, G. T. (2011). A risk model for preadolescent disordered eating. International Journal of Eating Disorders, 44(7), doi: /eat.20851

7 Disordered Eating More than Young White Middle Class Females Section 1 Section Section 2 2 Section 3 Section 4 Similarities and Differences: Gender LGB Impact of Race and Ethnicity Adolescents & Emerging Adults Section 5 Austin, S. B., Nelson, L. A., Birkett, M. A., Calzo, J. P., Everett, B. (2013) Eating disorder symptoms and obesity at the intersection of gender, ethnicity, and sexual orientation in US high school students. American Journal of Public Health, 103, e16-e22. doi: /ajph Goerke, C. K., Mazzeo, S. E., Stern, M. Palmberg, A. A., Evan R. K., & Wickman III, E. P. (2013). The stress process and eating pathology among racially diverse adolescents seeking treatment for obesity. Journal of Pediatric Psychology, 38, doi: /jpepsy/jst042 Norris, M. L., Apsimon, M., Harrison, M., Obeid, N., Buchhotz, A., Henderson, K. A., Spettigue, W. (2012). An examination of medical and psychological morbidity in adolescent males with eating disorders. Eating Disorders: the Journal of Treatment & Prevention, 20, , doi: 10,1080/ Thompson-Brenner, H., Thompson, D. R., Richards, L. K., Bulik, C. M., Devlin, M. J., Kristeller, J. L., Mitchell, J. E., Safer D. L., Wilfley, D. E., Franko, D. ll., Grilo, C. M., Roehrig, J. P., Bryson, S. w., Crow, S. J., Gorin, A. A., Masheb, R., Peterson, C. B., Striegel, R. H., Wilson, G. T. (2013). Race/ethnicity, education, and treatment parameters as moderators and predictors of outcome in binge eating disorder. Journal of Counseling and Clinical Psychology, 31, doi: /a

8 Adults Statistics of Interest Section 1 Section Section 2 2 Section 3 Section 4 Section 5 Among Adults from ( Tiggerman, 2004): Satisfaction in overall appearance decreased Desire to lose weight increased If this analysis were done today would it be different? Middle aged women may have higher frequency of BED (Mangweth-Matzek et al., 2014) Less disordered eating in women over 65 than in women (Tiggerman, 2004) Dieting may present health risks (e.g. nutritional deficiencies) Mangweth-Matzek, B., Hoek, H. W., Rupp, C. I., Lackner-Seifert, K., Frey, N., Whitworth, A. B., &... Kinzl, J. (2014). Prevalence of eating disorders in middle-aged women. International Journal Of Eating Disorders, 47(3), doi: /eat Tiggemann, M. (2004). Body image across the adult life span: Stability and change. Body Image, 1(1),

9 Adults Statistics of Interest Section 1 Section Section 2 2 Section 3 Section 4 Section 5 Women 50+ = 13% reported behaviors associated with ED (N = 1849) (Gagne et al., 2012) Sample over age 65 reported a later on-set of BED and longer duration (N = 20) (Guerdjikova et al., 2012) One in two seniors (N= 1793) were dissatisfied with their weight mirroring the rates of younger groups (Roy et al., 2014) Approximately 1/3 of weight loss in older adults is caused by depression (Morley, 2012) Gagne, D. A., Von Holle, A., Brownley, K. A., Runfola, C. D., Hofmeier, S., Branch, K. E., & Bulik, C. M. (2012). Eating disorder symptoms and weight and shape concerns in a large webbased convenience sample of women ages 50 and above: Results of the gender and body image (GABI) study. International Journal Of Eating Disorders, 45(7), doi: /eat Guerdjikova, A. I., O'melia, A. M., Mori, N., Mccoy, J., & Mcelroy, S. L. (2012). Binge eating disorder in elderly individuals. International Journal of Eating Disorders, 45(7), doi: /eat Morley, J. (2012). Anorexia of aging: A true geriatric syndrome. Journal of Nutrition, Health & Aging, 16(5), doi: /s Roy, M., Shatenstein, B., Gaudreau, P., Morais, J. A., & Payette, H., (2014). Seniors' body weight dissatisfaction and longitudinal associations. Journal of Aging and Health, 1, 1-19.

10 Adults Implications of Physiological Changes Associated with Aging Biological Psychological Sociocultural * Body Dissatisfaction * Disordered Eating * Middle Age Slevec, J., & Tiggermann, M. (2011). Predictors of body dissatisfaction and disordered eating in middle-aged women. Clinical Psychology Review, 31(4) doi: /j.cpr

11 Adults Midlife - Women Factors Impacting Body Image in Older Women Pregnancy Those who dieted before pregnancy are more dissatisfied after childbirth After birth - increases in disordered eating Aging Importance of appearance may change Becoming Invisible Menopause Closer monitoring for health complications may be warranted Newton, J. R. (2013). Presentations of eating disorders later in life. Journal of Pharmacy Practice & Research, 43(3), Slevec, J., & Tiggermann, M. (2011.) Predictors of body dissatisfaction and disordered eating in middle-aged women. Clinical Psychology Review, 31(4), doi: /j.cpr

12 Adults Midlife - Men Themes The Lone Wolf Limited Experiences Body Image Bigorexia Body Hair Penis Size Emotions Treatment Efficacy (< 50%) Russell, L., & Laszlo, B. (2013). A group for men with eating disorders: when Lone Wolves come together. Men & Masculinities, 16(2), doi: / x Schuster, E., Negy, C., & Tantleff-Dunn, S. (2013). The effects of appearance-related commentary on body dissatisfaction, eating pathology and body change behaviors in men. Psychology of Men & Masculinity, 14(1), doi: /a

13 Adults Factors to Consider Self-Objectification Sexually Objectified Cognitive Control Self Esteem/Global Self Esteem Appearance Management Strategies Appearance Investment Lack of Willpower Complimentary Weightism Negative Commentary Perfectionism Aging Anxiety Body Surveillance Boredom Habit

14 Implications As counselors what can we do? Section 1 Section Section 2 2 Let s Talk What do you think? Section 3 Section 4 Section 5

15 Implications As counselors what can we do? Section 1 Section Section 2 2 Section 3 Section 4 Section 5 Image from Brainden:

16 As Practitioners We Can Learn more Be prepared Advocate Reflect on our perspective regarding this topic Consider our own biases

17 What about Educators and Supervisors? Education/Training/Coaching Populations and Characteristics Skills - Evidence-based Technical (e.g. medical implications) Supervisor Coping Skills Managing Negative Reactions Maintain Realistic Sense of Body Image Countertransference Boie, I., & Lopez, A. (2011). Supervision of counselors working with eating disorders: Utilizing the integrated developmental model. Clinical Supervisor, 30(2), doi: / Delucia-Waack, J. l. (1999). Supervision for counselors working with easting disorder groups: Countertransference issues related to body image, food and weight. Journal of Counseling & Development, (77(4),

18 Disordered Eating For more Info You can make a difference.

19 Connie Ducaine Any? Disordered Eating: Implications at Midlife & Beyond