Eating Disorders in Youth: Prevention and Early Detection



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Eating disorders: anorexia nervosa, bulimia nervosa and related eating disorders

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Child Health Conference, KCC Eating Disorders in Youth: Prevention and Early Detection presented by: Mental Health America of Illinois (MHAI) Changing Minds, Changing Lives

Who is Mental Health America of Illinois? *Formerly Mental Health Association in Illinois Statewide, non-profit organization founded in 1909 Celebrating over 100-Years of Service in Illinois! Mission is to promote mental health, work for the prevention of mental illnesses, improve care and treatment of those suffering from mental and emotional problems Engage in public education, prevention, and advocacy

MHAI Works To Advocate. To Educate. To Serve Policy and Advocacy Disaster Mental Health Prevention and Promotion Public Education Information and Resource

Presentation Topics 1. Statistics and Impact 2. Warning Signs and Symptoms 3. Prevention and Early Intervention

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Prevalence: An epidemic In the U.S. 20 million women and 10 million men suffer at some point in their lives 500,000 teens struggle with eating disorders or disordered eating Age of onset typically 12-13 years old The prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, with the exception that anorexia nervosa is more common among Non- Hispanic Whites

The Reality The average American woman is 5 4 tall and weighs 165 pounds. The average Miss America winner is 5 7 and weighs 121 pounds

Funding Despite the prevalence of eating disorders, they continue to receive inadequate research funding Illness Prevalence NIH Research Funds (2011) Alzheimer s 5.1 million $450,000,000 Autism 3.6 million $450,000,000 Schizophrenia 3.4 million $276,000,000 Eating disorders 30 million $28,000,000.

Eating Disorders Defined An eating disorder is an unhealthy relationship with food and weight that interferes with many areas of a person s life Thoughts preoccupied with food, weight or exercise Unrealistic self-critical thoughts about body image, and eating habits may begin to disrupt normal body functions and affect daily activities Not just about food and weight. Food used as a coping mechanism to deal with uncomfortable or painful emotions or to help them feel more in control when feelings or situations seem over-whelming Adapted from www.nationaleatingdisorders.org

Types of Eating Disorders Anorexia Nervosa: Characterized by selfstarvation and excessive weight loss Symptoms: Resistance to maintaining body weight at or above a minimally normal weight for age and height Intense fear of weight gain or being fat, even though underweight Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight Loss of menstrual periods in girls and women postpuberty Adapted from www.nationaleatingdisorders.org

Warning Signs Dramatic weight loss Preoccupation with weight, food, calories, fat grams, and dieting Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.) Frequent comments about feeling fat or overweight despite weight loss Anxiety about gaining weight or being fat Denial of hunger Food rituals Excuses to avoid mealtimes or situations involving food Excessive, rigid exercise regimen Withdrawal from usual friends and activities In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns Adapted from www.nationaleatingdisorders.org

Health Consequences

Bulimia Nervosa Characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating Symptoms: Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise Extreme concern with body weight and shape Adapted from www.nationaleatingdisorders.org

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Warning Signs Evidence of binge eating Evidence of purging behaviors Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the compulsive need to burn off calories taken in Unusual swelling of the cheeks or jaw area Calluses on the back of the hands and knuckles from self-induced vomiting Discoloration or staining of the teeth Creation of lifestyle schedules or rituals to make time for binge-andpurge sessions Withdrawal from usual friends and activities In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns Adapted from www.nationaleatingdisorders.org

Health Consequences

Binge Eating Disorder Characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating Symptoms: Frequent episodes of consuming very large amount of food but without behaviors to prevent weight gain, such as self-induced vomiting A feeling of being out of control during the binge eating episodes Feelings of strong shame or guilt regarding the binge eating Eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior Adapted from www.nationaleatingdisorders.org

Health Consequences

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Not just women 1 in 10 cases involve men Goal is typically not to lose weight but as athletes, to make weight in a sport or improve muscle definition Adapted from www.anad.org

Disordered Eating Disordered eating refers to troublesome eating behaviors, such as restrictive dieting, bingeing, or purging, which occur less frequently or are less severe than those required to meet the full criteria for the diagnosis of eating disorders.

How does this happen? Psychological, Interpersonal, Biological and Social factors contribute Psychological: Low self-esteem, feelings of inadequacy or lack of control in life, depression anxiety, stress, anger or loneliness Interpersonal: Troubled personal relationships, difficulty expressing emotions and feelings, history of being teased or ridiculed based on size or weight, history of physical or sexual abuse Biological: In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced. Much research is still needed Adapted from www.nationaleatingdisorders.org

Social Factors

More Risk Factors for Eating Disorders Risk of an eating disorder is 8 times higher in a 15 year old girl who diets vs. one who doesn t Teasing or even supportive comments that target appearance is also a risk factor Having a mother who diets is a risk factor Being a part of a social group that is preoccupied with fat is a strong risk factor

Power of the Media to Affect Body Image Prior to introduction of TV on the island of Fiji in 1995, Harvard doctors interviewed teens and found 3% of teen girls were vomiting to lose weight and less than 10% were dieting Three years after TV came to Fiji, doctors found 15% of girls were vomiting to lose weight, and 62% were dieting to lose weight 74% of teen girls in 1998 said they felt too big or too fat

Power of the Media to Affect Body Image

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Self Awareness What is my attitude?

Knowledge What do I know? What do I need to know? My colleagues? Students? Parents?

Action Individual

To Consider: Talking to Students Own Comfort Biology: body type; genetics Impact of puberty onset Seriousness of disordered eating and eating disorders Privacy and confidentiality

Talking to Students Scenarios: 1.You are concerned about a student 2.Student comes to you about a friend 3.Student doesn t want you to tell parents

Talking to Parents To Consider: Provide facts, data Encourage listening to child, open communication What is family s relationship with food How do parents talk about appearance Impact of media Seriousness of eating disorders Referral Policies

Action Schoolwide/Collective

School Culture/Climate How does school demonstrate its values Social and emotional learning Education: in class; assemblies; discussion groups; advocacy; campaigns P.E. and health class Posters, media use in school Student leadership Lunch, vending

Resources for Treatment Linden Oaks Hospital at Edward, Naperville 630-305-5027 crisis intake line Timberline Knolls Residential Treatment Center, Lemont 888-673-9816 intake Insight Behavioral Health Centers, Chicago 312-540-9955 intake Alexian Brothers Behavioral Health Hospital, Center for Eating Disorders, Hoffman Estates 1-800-432-5005 intake

Resources National Eating Disorders Association www.nationaleatingdisorders.org National Association of Anorexia Nervosa and Associated Disorders www.anad.org National Institute of Mental Health www.nimh.nih.gov Mental Health America www.mentalhealthamerica.net

Questions? Katie Mason, LPC Program Director of Public Education kmason@mhai.org (312) 368 9070 x322 Caryn Curry, MA Interim Executive Director ccurry@mhai.org (312) 368 9070 x318 Thank You!