Obesity, Anorexia and Bulimia

1. Obesity

a. Adiposity may be a better term

b. What controls weight?

i. energy input vs. output

ii. set point theory-vmh-lh-pvn

iii. fat cell theory

2. Weight control

a. Medical model - amphetamines, gastric surgery (staples), and ping pong balls.
-new medicine

b. Diets - restricting caloric input

c. Behavioral model

i. eating behaviors analysis

-some general rules

-only eat in one room

-eat from a small plate

-eat slowly

-eat only three times per day

-exercise or relaxation procedures as a distraction

ii. Medically supervised diet

iii. Medically supervised exercise program

d. Groups and social support TOPS, Weight Watchers and Overeaters Anonymous

3. The problem of adiposity in children

a. It is estimated that 13% of children are overweight (+20%) in the US. This figure (these figures?) is reportedly increasing at an alarming rate.

b. Adiposity at two+. The Sesame St. generation

c. Diets are not recommended as they limit growth

d. TOPS etc. are not available for kids are not appropriate for caloric reduction dieting.

e. Behavior modification and exercise

4. Anorexia Nervosa is a disorder of mostly female adolescent and young adults

a. Loss of a least 25% (15%?) of body weight -life threatening

b. A function of culture it appeared in the 20's and again in the 60's and may now be mostly disappearing again.

c. symptoms include amenorrhoea, lanugo and distorted body image (Pirke and Ploog--focus on abdomen).

d. Casper and Davis' three stages-premorbid, morbid and recovery.

e. successful approaches to therapy include family therapy and systematic desensitization. The interesting treatment of self esteem in Vancouver.

5. Bulimia Nervosa or eating like a bull has a later onset and is again mostly in women -

a. purging is not a necessary requirement for the diagnosis

b. it may be the third stage of anorexia nervosa

c. difficult to diagnose but easier to treat than anorexia

d. -self help peer groups.