Etiology of Eating Disorders

Etiology of Eating Disorders


Hi. It’s Dr. Z. I will be discussing the etiology of eating
and feeding disorders today. By the end of this video, you will be able
to describe the biological and psychological perspectives related to the development of
these disorders. Please feel free to pause the video at any
time to take notes. Similar to anxiety disorders, there are two
paths a psychologist can take when determining the potential cause of eating disorders. One path focuses on the biological perspective
and the other focuses on the psychological perspective. Each perspective can be separated into more
specific causes. The biological perspective on abnormal behavior
focuses on the role of genetics, family history, neuroanatomy, and neurobiology. Biological research, particularly with the
use of animal models, has revolutionized our understanding of several psychological disorders. The first specific biological cause involves
the hypothalamus. Recall that the hypothalamus is a brain structure
that regulates hunger, thirst, sexual behavior, and a wide variety of emotional behaviors. Animal studies indicate that targeted damage
of certain areas of the hypothalamus result in extreme changes in eating. Though it’s important to note that, at this
time, there is no evidence of consistent abnormalities of the hypothalamus in humans. The second biological cause is related to
activity-based anorexia. Animal models of anorexia nervosa attempt
to understand the excessive hyperactivity seen in patients with the disorder. Experiments have shown that rodents with unlimited
access to a running wheel, and who also have scheduled feeding, engage in excessive use
of the running wheel AND decreased feeding as a result. This can lead to extreme weight loss and death
from emaciation. The third biological cause addresses an addiction
model of binge eating. When it comes to eating disorders with a binge
eating component, there appears to be similarities to addictive disorders. Brain imaging studies reveal the role of dopamine
and the orbitofrontal cortex in individuals with binge eating disorder. Recall that dopamine is a neurotransmitter
that plays a role in pleasure, reinforcement, and motivation. The orbitofrontal cortex is involved in decision
making, as well as contains areas associated with taste reward and smell. The fourth biological cause is related to
neuroendocrine and neurohormonal factors that affect feeding behavior and impulse control. Neurotransmitters serotonin and dopamine may
have an influence on feeding initiation, satiety (or the feeling of fullness or satisfaction),
craving, and appetite. Recall that serotonin plays a role in mood,
sleep, and appetite. Brain imaging studies also suggest that abnormalities
in the levels of serotonin and dopamine affect mood and pleasure, respectively. The fifth specific biological cause is related
to neuroanatomy. Brain imaging studies suggest that there are
structural brain abnormalities in patients with anorexia nervosa. Specifically, reduced brain mass and loss
of gray matter have been found. Studies using functional MRI to determine
any functional differences in the brain have found decreased brain glucose metabolism at
rest and increased serotonin activity in individuals with anorexia and bulimia nervosa. These brain abnormalities appear to be related
to rigid, inflexible, and overcontrolled behavior. The sixth specific biological cause is related
to family and genetic studies. This specific etiology indicates that eating
disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder may be
inherited. Studies have indicated that not all family
members share the same eating disorder, rather may experience a variety of eating disorders,
including types of OSFED, or other specified feeding and eating disorders. Additionally, genetic studies are promising
in identifying certain chromosomes associated with eating disorders. Now, let’s turn to the psychological perspective. The psychological perspective on abnormal
behavior arises from several different approaches, such as psychoanalytic, behavioral, and cognitive. The first specific cause is related to psychodynamic
theory. Recall that psychoanalytic theory focuses
on early childhood experiences. Thus, this approach views the role of family
dynamics and interpersonal relationships during formative years as important in the development
and maintenance of eating disorders. In the film Girl Interrupted (1999), the character
of Daisy appears to have been sexually abused as a child, which may be one contributing
factor to her eating disorder. The second specific cause is related to family
models of eating disorder. Salvador Minuchin studied how family dysfunction
may contribute to anorexia nervosa. He identified four dysfunctional patterns
of family interaction; one of which is called enmeshment. Enmeshment describes the overinvolvement of
all family members in the life of any one family member. The film Black Swan (2010) describes the story
of a young ballerina and her overcontrolling and overinvolved mother. The third specific cause is related to cognitive-behavioral
theory. Recall that the cognitive behavioral perspective
focuses on how distorted thoughts can lead to unhealthy behaviors. In the case of eating disorders, this model
describes how distorted and irrational thoughts about food, body shape, weight, and even personal
control may contribute to unhealthy eating and weight-related behaviors. In essence, thoughts have the power to influence
how one thinks, feels, and behaves. The film Lbs. (2010) is an example of an overweight
man who moves to the country to lose weight and, in the process, starts to think differently
about food and himself. The fourth specific cause is related to sociocultural
theories. In this case, the Western cultural preoccupation
with thinness as the main measure of beauty may contribute to disordered eating and unhealthy
behaviors. In societies where the ideal image of beauty
is not tied to thinness, research has observed less incidence of eating disorders. The film Thirteen (2003) illustrates how a
thirteen year old can be influenced by her peers and societal expectations. In summary, there are two broad perspectives
on the etiology of eating disorders, and each perspective is valuable in guiding the future
treatment of your client. The photos used in this video are property
of the abovementioned films. Thank you.

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