Name: 摂食と身体異形性障害。クラッシュコース心理学#33 (Eating and Body Dysmorphic Disorders: Crash Course Psychology #33)
Uploaded: 2021-01-14T05:51:22.000Z
Duration: 10 min 12 s
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When Lauren was fifteen years old, her family moved across the country and she started going

to a new school. Already shy, Lauren suffered from low self-confidence and had a hard time

transitioning; nothing felt right and soon her changing body became a source of insecurity.

Eventually, she began thinking that maybe if she lost weight and focused on fitness,

she'd make more friends and feel better about herself and life would get better. Soon she

became obsessed with dieting and it quickly spiraled into her subsisting only on rice

cakes and apples and candy corn and celery.

She like this new feeling of control every time she stood on the scale and saw a lower

number. She was achieving something, and that made her feel good. Soon, she thought of nothing else.

But what Lauren couldn't see was that she was no longer healthy. Even when her hair

started falling out and her skin grew dry and cracked, and when she could never get warm.

When she looked in the mirror, she still saw a chubby girl.

Her family, though, did notice, and yet, at a visit to the doctor, she was just told to eat more.

One day while jogging, she had a heart attack and collapsed. As a teenager, she was 5'7"

and weighed eighty-two pounds. Lauren was finally admitted to a psychiatric hospital

where she was treated for anorexia nervosa. She was put on bed rest, saw a therapist twice

a week, joined a support group and slowly began eating small amounts of food again.

Her recovery was slow but, with the support of her family and doctors, she was released

eight months later. Though Lauren suffered a few relapses over the years, she is now healthy.

Ultimately, she was lucky. Anorexia, bulimia, and other eating and body dysmorphic disorders can kill.

Eating disorders are among the deadliest psychological disorders, with some of the highest rates

of death directly attributable to the illness. They slowly ruin the body, but, in order for

these conditions to be recognized and treated successfully, they have to be understood as

Here's some scary figures: According to the National Eating Disorder Association, forty-two

percent of first to third grade girls want to be thinner; eighty-one percent of ten year

olds are afraid of being fat; over half of teenage girls and nearly a third of teenage

boys have used troubling weight control methods like fasting, skipping meals, smoking, vomiting,

The rate of new cases of eating disorders in Western culture has been increasing since

the 1950's, and today in the US, an estimated twenty million women and ten million men have

suffered from a clinically significant eating disorder at some point in their lives.

But get this straight: we're not talking about fad diets or lifestyle choices spurred by

vanity. Eating disorders are psychological illnesses that often come with serious consequences.

These disorders tend to fall into three main categories: anorexia, bulimia, and binge eating disorders.

Those suffering from anorexia nervosa, most often adolescent females, essentially maintain

a starving diet and, eventually, and abnormally low body weight. As in Lauren's case, anorexia

can begin as a diet that quickly spirals out of control as a person becomes obsessed with

continued weight loss, all while still feeling overweight.

Our old friend, the DSM V, actually delineates two sub types of the disorder. The first involves

restriction, which usually consists of an extremely low-calorie diet, excessive exercise,

or purging, like vomiting or the use of laxatives. The second type is the binge/purge sub type,

which involves episodes of binge eating combined with the restriction behavior.

As you can easily imagine, the physiological effects of this psychological condition can

be devastating. As the body is denied crucial nutrients, it slows down to conserve what

little energy it has, often resulting in abnormally slow heart rate, loss of bone density, fatigue,

muscle weakness, hair loss, severe dehydration, and an extremely low body mass index.

And it's that low body mass that's the defining characteristic of anorexia nervosa - a refusal

to maintain a weight at or above what would normally be considered minimally healthy.

If this condition persists, of course, it can be deadly, which is why anorexia has what's

often estimated to be the highest mortality rate of any psychiatric disorder.

That might surprise you, given the host of troubling disorders we've already covered

here on Crash Course Psychology, but mortality rates associated with, say, major depression

or PTSD or schizophrenia tend to be the result of secondary behavior, like suicide. But with

anorexia, the mortality rate is especially high because people can die as a direct result

of extreme weight loss and physiological damage.

Another common eating disorder is bulimia nervosa.

While anorexia is characterized primarily by the refusal to maintain a minimal body

weight, bulimia is not. People with bulimia tend to maintain an apparently normal, or

at least minimally healthy, body weight, but alternate between binge eating, followed by

fasting or purging, often by vomiting or using laxatives.

A bulimic body may not be as obviously underweight as an anorexic one, but that addictive cycle

of binging and purging can seriously damage the whole digestive system, leading to irregular

heartbeat, inflammation of the esophagus and mouth, tooth decay and staining, irregular

bowel movements, peptic ulcers, pancreatitis, and other organ damage.

Sometimes the two diagnoses can be difficult to discern, especially because someone may

shift back and forth between anorexic diagnostic features and bulimic diagnostic features.

The DSM V recently added a third category called binge-eating disorder, which is marked

by significant binge-eating, followed by emotional distress, feelings of lack of control, disgust,

or guilt, but without purging or fasting.

Although sometimes triggered by stress or a need for, or lack of, control, the presence

of an eating disorder is not a tell-tale sign of childhood sexual abuse, as was once commonly

thought. Instead, these disorders are often predictive indicators of a person's feelings

of low self-worth, need to be perfect, falling short of expectations, and concern with others perceptions.

Although the prevalence of bulimia and binge-eating is similar among ethnic groups in the United

States, anorexia is is much more common among white women, often of higher socioeconomic status.

But the prevalence of these disorders is rising in males, too. Today, between ten and twenty

percent of people diagnosed with eating disorders are men who feel the same pressure to attain

what they imagine is physical perfection, and that's worth noting.

These disorders have strong cultural and gender components; the so-called "ideal standard

of beauty" varies wildly across cultures and time, and thinness is far from a universal

desire, especially in countries where malnutrition and starvation are problems.

But in the Western world, and increasingly in other countries, thinness is a common pursuit.

And being bombarded with images of unrealistically slender models and jacked celebrities has

increased many people's dissatisfaction, or even shame and disgust, with their own bodies.

These are all attitudes that can contribute to eating disorders.

Some people have even had plastic surgery to look more like Beyonce, or J-Lo, or...Barbie.

When taken to extremes, this kind of behavior starts inching into the realm of body dysmorphic disorder.

Body dysmorphic disorder is another psychological illness, one that centers on a person's obsession

with physical flaws - either minor or just imagined. Those suffering from this disorder

often obsess over their appearance, often staring into mirrors for hours, and feel distressed

Although it's often lumped in with the eating disorders, our growing understanding of body

dysmorphia suggests that it actually shares some traits with obsessive-compulsive disorder,

particularly the obsession with some imagined bodily perfection and the compulsion to check

oneself over and over to discern perceived flaws.

Not surprisingly, BDD and OCD may share some similar neurophysiological features, although

People suffering from BDD may exercise excessively, groom themselves excessively, or seek out

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摂食と身体異形性障害。クラッシュコース心理学#33 (Eating and Body Dysmorphic Disorders: Crash Course Psychology #33)

psychological

disorder

dopamine

suffer