Eating Or Feeding

Disorder And
Obesity
O Saira Sandhu 511156
O Anmol Zahra 511147
O Zainab Bibi 511113
O Anam Shahzadi 511141
O Wajiya Shoukat 511144
Eating disorder
An eating disorder is a mental disorder
defined by abnormal eating behaviors that
negatively affect a person's physical or
mental health.
Disordered eating may include restrictive eating,
compulsive eating, or irregular or inflexible
eating patterns
 pica
diagnosis criteria (DSm_5

Persistent eating of nonnutritive, nonfood

substances over a period of at least 1 month. The
eating of such substances is inappropriate to the
developmental level of the individual. The eating
behavior is not part of a culturally supported or
socially normative practice.
 prevalence
Prevalence data of the rumination Disorder are
inconclusive, but disability.disorder is commonly reported
to be higher in cartain groups, such as individual with
intellectual disability.
 Risk and Prognostic factor
Environment : Neglect, Lack of supervision,
and developmental delay can increase the risk
for the condition
Differnal Diagnosis
1: Anorexia Nervosa
2: factitious disorder
 *Rumination
Disorder*
Diagnostic criteria:
Repeated regurgitation of food over a period
of at leat 1 month. Regurgitated food may be
re-chewed, re-swallowed or spit up.
 prevalence
Prevalence data of the rumination Disorder are
inconclusive, but the disorder is commonly reported to be
higher in cartain groups, such as individual with
intellectual disability.
 Risk and Prognostic factor:
Environment: Psychological problem such as Lack of
stimulation, neglect, stressful life situation, and problems
in the parent-child , relationship may be predisposing
factors in infants and young children.
 Differential
diagnosis
Differential diagnosis
1: Gastrointestinal conditions
2: Anorexia Nervosa and bulimia Nervosa
 Anorexia nervosa

Anorexia means “lack of desire to eat”.

It is an eating disorder characterized by
restricting energy food intake, excessive
wait loss, irrational fear of gaining
weight and a distorted body self-image
 Diagnostic criteria of
anorexia Nervosa
O Criteria A:
Restriction of energy intake relative
to requirements This is often defined
as a weight less than minimally normal
or expected leading to low body weight.
 Adult BMI lower than 17kg/m2 considered as low body
weight.
 Adult with BMI 17,18,18.5kg/m2 is likely to consider
significantly low weight if clinical history and
physiological information supports the judgments
 Diagnostic criteria of
anorexia Nervosa
O Criteria B:
Intense fear of gaining weight
or becoming fat even though
underweight.
O The fear is not decreased by wait loss.
O Concerns about weight gain may increase even
weight falls.
 Diagnostic criteria of
anorexia Nervosa
O Criteria C:
O Disturbance in self-perceived weight or shape.There is a
persistent lack of recognition of the seriousness of the
current low body weight.
O Some individuals fell globally overweight.
O Some realize they are thin but still concerned certain
body parts.
O Frequently weighing obsessive
measurement of body parts.
O Persistent use of mirror.
 Specify current severity
The minimum level of severity is based on:
O for adults, on current body mass index (BMI)
O for children and adolescents, on BMI percentile.

Mild: BMI ≥ 17 kg/m2

Moderate: BMI 16–16.99 kg/m2
Severe: BMI 15–15.99 kg/m2
Extreme: BMI < 15 kg/m2
 Prevalence rate of anorexia
nervosa
Prevalence According to two U.S. epidemiological studies
O the 12-month prevalence ranges from 0.0% to 0.05%
with much higher rates in women than in men (0% to
0.08% in women; 0% to 0.01% in men)
O lifetime prevalence ranges from 0.60% to 0.80% (0.9%
to 1.42% in women; 0.12% to 0.3% in men).
O By contrast, one study of adolescents found similar rates
in both genders.
O most prevalent in high-income countries than in low
income countries
 Etiology
Biopsychosocial factors
O genetic
O Biological (neurobiological factors)
O psychological
O developmental
O environmental
O Fear of stigma
O Media influence
O sociocultural pressure
O Social and peer influence
O Comorbid mental health conditions(coexist with mood and anxiety disorder)

While the exact cause is not fully understood, several key factors contribute to
the development of anorexia nervosa
 Complications:
O Physical Complications
 Cardiovascular Issues
 Arrhythmia
 Increased risk of heart failure
 Electrolyte Imbalances(e.g., potassium, sodium)
 Risk of cardiac arrhythmias and sudden death
 Constipation and other digestive issues
 Amenorrhea (absence of menstrual periods)
 Infertility Hormonal imbalances (e.g., low estrogen levels)
 Musculoskeletal Issues: Osteoporosis (reduced bone
density)Increased risk of fractures and bone breaks
 complications
O Muscle atrophy and weakness
O Neurological Complications
O Cognitive Impairment
O Risk of seizures due to electrolyte imbalances
Psychological and Behavioral Complications:
O Depression and Anxiety
O Suicidal Ideation
O Social Isolation
O Dermatological Complications
 Treatment or interventions:
O CBT
O Exposure response prevention
O Family therapy
O Psycho- education
O psychopharmacology
 Bulimia Nervosa
• Bulimia Nervosa is an eating disorder characterized by recurrent
episodes of overeating
• Typically accompanied by a sense of loss of control
• Followed by compensatory behaviors such as vomiting,
excessive exercise, or fasting.
• Individuals with bulimia often experience a preoccupation with
body weight, shape, and self-esteem, leading to a cycle of binge-
eating and purging.

By Zainab Bibi
 Diagnostic Criteria
A. Recurrent episodes of binge eating. An episode of binge eating is
characterized by both of the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an
amount of food that is definitely larger than what most individuals
would eat in a similar period of time under similar circumstances.
2. 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 behaviors in order to prevent

weight gain, such as self-induced vomiting; misuse of laxatives, diuretics,
or other medications; fasting; or excessive exercise
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.
• Specify current severity:
level of severity is based on the frequency of inappropriate
compensatory behaviors .
Mild: 1–3 episodes
Moderate: 4–7 episodes
Severe: 8–13 episodes
Extreme:14 or more episode
 Prevalence
O Begins in late adolescence or early adulthood.
O About 90 percent of cases are women
O prevalence among women is about 1 to 2 percent of the population

Etiology
Genetic Factors:
• Bulimia nervosa has genetic predisposition
• Studies are found for bulimia nervosa, where first-degree
relatives of women with bulimia nervosa are about four times
more likely than average to have the disorder
O Biological Factors:
O Abnormalities in neurotransmitters, such as serotonin, have been
linked to bulimia nervosa.
O These neurotransmitters play a role in mood regulation and
appetite control.

Psychological Factors:
• Low self-esteem, body dissatisfaction,
• Individuals may develop unhealthy coping mechanisms like
strict dieting
Environmental Factors:
O Sociocultural influences, such as societal pressure for thinness
and an emphasis on appearance
O Media portrayal of idealized body images can also impact self-
perception.
O Family dynamics, including a focus on appearance and weight,
can contribute. Childhood trauma or abuse may also be a factor.
Social and Interpersonal Factors:
Peer influences and social comparison can play a role,
especially during adolescence.
O Traumatic life events, such as bullying or relationship
issues, may trigger Bulimia nervosa.

Physical and Psychological Symptoms

• Electrolyte Imbalance
• Dehydration
• Gastrointestinal Issues
• Dental problems
• Swelling of salivary Glands
• Bleeding in the esophagus
 Treatment of Bulimia Nervosa
Medication:
Antidepressants, such as selective serotonin reuptake inhibitors
(SSRIs), may be prescribed to help manage co-occurring mood
disorders.
Psychotherapy:
Cognitive-behavioral therapy (CBT) is often effective,
addressing distorted thought patterns and behaviors related to
food and body image.
Group Therapy:
Participation in group therapy sessions, providing a
supportive in the treatment process.
Family-Based Treatment:
In cases involving adolescents, family-based treatment
(FBT) can be effective, involving the family in the
treatment process.

Family-Based Treatment:
In cases involving adolescents, family-based treatment
(FBT) can be effective, involving the family in the
treatment process.
 Binge eating disorder
Binge eating disorder refers to the consumption of a
large amount of food in a short period of time,
accompanied by a sense of loss of control during the
eating episode. This behavior is often characterized by
eating rapidly, eating when not physically hungry, and
continuing to eat even when feeling uncomfortably full.
 Diagnostic Criteria
The diagnostic criteria for BED, according to the DSM-5 (Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition), include:
A.Recurrent episodes of binge eating. An episode of binge eating is
characterized by both of the following:
1. Eating, in a discrete period of time (e.g.. Within any 2-hour period),
an amount of food that is definitely larger than what most people would
eat in a similar period of time under similar circumstances.
2. 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 episodes are 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.
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 behavior as in bulimia Nervosa and
doesn’t occur exclusively during the course of bulimia Nervosa or
anorexia Nervosa.
. prevalence
The prevalence of binge-eating disorder ranges two to three times
higher in women than in men (0.6% to 1.6% in women; 0.26% to
0.8% in men).
O ETIOLOGY
O •Genetic factors
O Neurobiological factors cognitive factors
O Sociocultural factors
O Gender Influences
O Cross-cultural steadies
O Personality Influences characteristics of Families
O Child Abuse
PHYSICAL COMPLICATIONS
AND CONSEQUENCES
O Diabetes
O Cardio vascular disease
O Weigt gain
O Digestive problems
O Nutritional deficiencies
O Joint and muscle pains
O Sleep disturbance
Differential Diagnosis
O Bulimia nervosa : Binge-eating disorder has recurrent binge
eating in common with bulimia nervosa but differs from the latter
disorder in some fundamental respects In terms of clinical
presentation, the recurrent inappropriate compensatory behavior eg.
Purging driven exercise) seen in bulimia nervosa is absent in binge-
eating disorder .
O Report frequent attempts at dieting. Binge-eating disorder also
differs from bulimia nervosa in terms of response to treatment.
Rates of improvement are consistently higher among individuals
with binge-eating disorder than among those with bulimia Nervosa.
O Obesity: Binge-eating disorder is associated with overweight and
obesity but has several key features that are distinct from obesity.
First, levels of overvaluation of body weight and shape are higher
in obese individuals with the disorder than in those without the
disorder
Intervention
O Medication
O Dietitians
O Interpersonal therapy,
O cognitive behavioral
therapy
Avoidant / Restrictive Food
Intake Disorder

Avoidant / Restrictive Food Intake Disorder

(ARFID) is a fairly new eating disorder. People with
ARFID are extremely selective eaters and sometimes
have little or no interest in eating food.
 Diagnostic criteria
O A . An eating or feeding disturbance (e.g., apparent lack
of interest in eating or food; avoidance based on the
sensory characteristics of food; concern about aversive
consequences of eating) associated with one (or more) of
the following:
1. Significant weight loss (or failure to achieve expected
weight gain or faltering growth in children).
2. Significant nutritional deficiency.
3. Dependence on enteral feeding or oral nutritional
supplements.
4. Marked interference with psychosocial functioning.
O B. The disturbance is not better explained by lack of available
food or by an associated culturally sanctioned practice.
O C. The eating disturbance does not occur exclusively during
the course of anorexia nervosa or bulimia nervosa, and there is
no evidence of a disturbance in the way in which one’s body
weight or shape is experienced.
O D. The eating disturbance is not attributable to a concurrent
medical condition or not better explained by another mental
disorder. When the eating disturbance occurs in the context of
another condition or disorder, the severity of the eating
disturbance exceeds that routinely associated with the
condition or disorder and warrants additional clinical attention.
 Prevalence
O Little information is available on the
prevalence of avoidant/restrictive food
intake disorder. A study in Australia
reported a frequency of 0.3% among
individuals age 15 years or older.

Etiology
O Genetic Factors:
O Social and environmental factors
O Psychological factors
ARFID And Sensory Issues
O ARFID is associated with sensory
characteristics such as appearance, color,
smell, texture, temperature or taste. Sensory
differences have impact on eating, and in
some cases can present challenges such as
aversive consequences choking, phobias,
difficulty in eating among people i.e less
socializing.
O ARFID and AUTISM
 Complications
O Malnutrition
O Dehydration
O Electrolyte Imbalance
O Low Blood Pressure
O Weakened Bones
O Delayed Puberty
 Treatment
O Cognitive Behavior Therapy (CBT)
O Exposure Therapy
O Interpersonal Therapy
O Family Therapy
ARFID is best treated by a team that include
a doctor, dietitian, and therapist. Treatment may
include nutrition counselling, medical care, and
feeding therapy. If chocking is a concern a speech-
language pathologist can do swallowing and feeding
evaluation.
 Obesity

Obesity is a condition in which excess body

fat accumulates to the extent that it may have
a negative effect on health.
Latin word “OBESUS” meaning fat
 Causes
O On the most basic level, obesity is caused by
consuming more calories than your body can
use. Many factors contribute to this :
O Fast and convenience foods
O Psychological factors
O Hormones
O Certain medication
O Screen culture
 Mental Health Linked To
Obesity
O Obesity is tied to mental health disorder but
the correlation is complex. Here is the link of
obesity with anxiety, depression, anxiety:
Anxiety:
Body size may be linked to mood
and anxiety disorders. If you have a large body
size, you may be more likely to have a mental
health condition .
O Depression
Depression and weight gain go hand in
hand. Certainly, increased appetite, reduced
activity and weight gain can be symptom of
depression, and people with depression are more
likely to binge eat and less likely to exercise
regularly.
 REFERANCES
O DSM-5TR
O Abnormal Psychology