The Roles of Psychosocial Factors and Nutritional Intervention on Eating Disorders

Year 2024, Volume: 15 Issue: 2, 309 - 318, 28.08.2024

Çilenay Tatlı , Perim Türker

https://doi.org/10.22312/sdusbed.1414584

Abstract

With a multifaceted and intricate etiology, eating disorders are classified as mental diseases. The etiology of eating disorders includes sociocultural factors such as family and childhood experiences, societal and cultural pressures, imposition of media standards, as well as psychological factors such as low self-esteem and body dissatisfaction, stress, anxiety, mood disorders, trauma, and perfectionism. To provide a nutritional intervention that includes the normalization of eating behavior, it is necessary to understand the psychosocial aspects underlying the illness of individuals with eating disorders. Because a dietitian may be the first person to recognize the symptoms of an individual's eating disorder, which is a psychiatric disorder, or the first healthcare professional to whom a patient applies for this condition, and dietitians are a critical member of the treatment team of these patients. During the planning of nutritional intervention; practices such as defining nutritional problems related to medical or physical condition, evaluating anthropometric measurements and biochemical data, examining behavioral and environmental factors, calculating energy and macronutrient requirements, increasing the amount and variety of foods consumed, and giving recommendations regarding the normal perception of hunger and satiety constitute the basic processes of nutrition intervention planned in line with appropriate weight restoration and health goals. In this process, providing psychosocial support and positive reinforcement by considering the changing needs of the individual may help to increase their commitment to the process. Being in constant cooperation and communication with the healthcare professionals involved in the treatment and the family of the individual during the treatment period constitutes an integral part of a well-managed treatment process. In this respect, the health professionals in the treatment team informing the other members of the team by considering the etiological factors of the eating disorder and providing a joint decision-making environment makes a great contribution to the treatment process.

Keywords

eating disorders, psychosocial factors, nutritional intervention

Psikososyal Faktörlerin ve Beslenme Müdahalesinin Yeme Bozuklukları Üzerindeki̇ Rolü

Abstract

Yeme bozuklukları, karmaşık ve çoklu faktörlü etiyolojiye sahip olan psikiyatrik bozukluklardır. Yeme bozukluklarının etiyolojisinde aile içi ve çocukluk dönemi deneyimleri, toplumsal ve kültürel baskı, medya standartlarının dayatılması gibi sosyokültürel faktörlerin yanı sıra düşük benlik saygısı ve beden memnuniyetsizliği, stres, kaygı, duygu durum bozuklukları, travma ve mükemmeliyetçilik gibi psikolojik faktörler bulunmaktadır. Yeme davranışının normalleştirilmesini içeren bir beslenme müdahalesi sağlamak için yeme bozukluğuna sahip bireylerin hastalığının altında yatan psikososyal yönlerin anlaşılması gerekmektedir. Çünkü bir bireyin psikiyatrik bir hastalık olan yeme bozukluğuna dair semptomlarını ilk tanıyan kişi veya bir hastanın bu durum için başvurduğu ilk sağlık uzmanı diyetisyen olabilmektedir ve diyetisyenler bu hastaların tedavi ekibinin kritik bir üyesidir. Beslenme müdahalesinin planlanması sırasında; tıbbi veya fiziksel durumla ilgili beslenme sorunlarının tanımlanması, antropometrik ölçümlerin ve biyokimyasal verilerin değerlendirilmesi, davranışsal ve çevresel faktörlerin incelenmesi, enerji ve makro besin ögesi gereksinimlerinin hesaplanması, tüketilen gıdaların miktar ve çeşitliliğinin arttırılması, açlık ve tokluğun normal algılanmasına ilişkin öneriler verilmesi gibi uygulamalar, uygun ağırlık restorasyonu ve sağlık hedefleri doğrultusunda planlanan beslenme müdahalesinin temel süreçlerini oluşturmaktadır. Bu süreçte bireyin değişen ihtiyaçları gözetilerek psikososyal destek ve olumlu pekiştirme sağlanması sürece olan bağlılığını arttırmaya yardımcı olabilmektedir. Tedavi süresince tedaviye dahil olan sağlık uzmanları ve bireyin ailesi ile sürekli bir iş birliği ve iletişim içinde olmak iyi yönetilen bir tedavi sürecinin ayrılmaz parçasını oluşturmaktadır. Bu açıdan tedavi ekibi içinde yer alan sağlık profesyonellerinin yeme bozukluğunun etiyolojik faktörlerini dikkate alarak ekip içerisindeki diğer üyeleri bilgilendirmesi ve ortak karar alma ortamı sağlaması tedavi sürecine oldukça büyük bir katkı sunmaktadır.

Keywords

yeme bozuklukları, psikososyal faktörler, beslenme müdahalesi

Supporting Institution

Başkent Üniversitesi

References

• [1] Hackert, A. N., Kniskern, M. A., Beasley, T. M. 2020. Academy of Nutrition and Dietetics: revised 2020 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in eating disorders. Journal of the Academy of Nutrition and Dietetics, 120(11), 1902-1919.
• [2] Toutonghi, J. 2014. EPA-1820–Nutritional Interventions for Eating Disorders. European Psychiatry, 29(S1), 1-1.
• [3] Winston, A. P. 2005. Management of physical aspects and complications of eating disorders. Psychiatry, 4(4), 22-26.
• [4] Ozier, A. D., Henry, B. W. 2011. Position of the American Dietetic Association: nutrition intervention in the treatment of eating disorders. Journal of the American Dietetic Association, 111(8), 1236-1241.
• [5] Köroğlu, 2014. Amerikan Psikiyatri Birliği Ruhsal Bozuklukların Tanısal ve Sayımsal El kitabı, Beşinci Baskı (DSM5), Tanı Ölçütleri Başvuru El kitabı. Hekimler Yayın Birliği, Ankara.
• [6] Pike, K. M., Dunne, P. E. 2015. The rise of eating disorders in Asia: a review. Journal of eating disorders, 3, 1-14.
• [7] Vardar, E., Erzengin, M. 2011. Ergenlerde yeme bozukluklarının yaygınlığı ve psikiyatrik eş tanıları iki aşamalı toplum merkezli bir çalışma. Türk Psikiyatri Dergisi, 22(4), 205-212.
• [8] Nattiv A., Loucks A.B., Manore M.M., Sanborn C.F., Sundgot-Borgen J., Warren M.P. 2007. American College of Sports Medicine. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc, 39(10): 1867–1882.
• [9] Gordon, K. H., Holm-Denoma, J. M., Crosby, R. D., Wonderlich, S. A. 2010. The classification of eating disorders. The Oxford handbook of eating disorders, 9-23.
• [10] Hinney, A., Volckmar, A. L. 2013. Genetics of eating disorders. Current psychiatry reports, 15, 1-9.
• [11] Zerbe, K. J. 2001. The crucial role of psychodynamic understanding in the treatment of eating disorders. Psychiatric Clinics of North America, 24(2), 305-313.
• [12] Leung, N., Waller, G., Thomas, G. 1999. Group cognitive‐behavioural therapy for anorexia nervosa: a case for treatment?. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 7(5), 351-361.
• [13] Fairburn, C. G. 2008. Cognitive behavior therapy and eating disorders. Guilford Press.
• [14] Polivy, J., Herman, C. P. 2002. Causes of eating disorders. Annual review of psychology, 53(1), 187-213.
• [15] Garner, D. M. 2002. Measurement of eating disorder psychopathology. Eating disorders and obesity: A comprehensive handbook, 2, 141-146.
• [16] Lamoureux, M. M., Bottorff, J. L. 2005. “Becoming the real me”: Recovering from anorexia nervosa. Health Care for Women International, 26(2), 170-188.
• [17] Weaver, K., Wuest, J., Ciliska, D. 2005. Understanding women’s journey of recovering from anorexia nervosa. Qualitative health research, 15(2), 188-206.
• [18] Rohde, P., Stice, E., Marti, C. N. 2015. Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders, 48(2), 187-198.
• [19] Bratland-Sanda S., Sundgot-Borgen J. 2013. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci, 13(5): 499-508.
• [20] Fairburn, C. G., Cooper, Z., Doll, H. A., Norman, P., O'Connor, M. 2000. The natural course of bulimia nervosa and binge eating disorder in young women. Archives of General psychiatry, 57(7), 659-665.
• [21] Jacobi, F., Wittchen, H. U., Hölting, C., Höfler, M., Pfister, H., Müller, N., Lieb, R. 2004. Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychological medicine, 34(4), 597-611.
• [22] Treasure, J., Claudino, A.M., Zucker, N. 2010. Eating disorders. The Lancet, 375(9714): 583-593.
• [23] Lilenfeld L.R., Kaye W.H., Greeno C.G., Merikangas K.R., Plotnicov K., Pollice C. 1998. A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry, 55:603-10.
• [24] Sullivan P.F., Kendler K.S. 1998. Typology of common psychiatric syndromes. An empirical study. Br J Psychiatry, 173:312-9.27.
• [25] Sullivan P.F., Bulik C.M., Fear J.L., Pickering A. 1998. Outcome of anorexia nervosa: a case-control study. Am J Psychiatry, 155:939-46.
• [26] Erriu, M., Cimino, S., Cerniglia, L. 2020. The role of family relationships in eating disorders in adolescents: a narrative review. Behavioral sciences, 10(4), 71.
• [27] Woodside, D. B., Bulik, C. M., Halmi, K. A., Fichter, M. M., Kaplan, A., Berrettini, W. H., ... Kaye, W. H. 2002. Personality, perfectionism, and attitudes toward eating in parents of individuals with eating disorders. International Journal of Eating Disorders, 31(3), 290-299.
• [28] Andersen, A.E., Yager, J. 2005. Eating disorders. Comprehensive Textbook of Psychiatry, 8. baskı, cilt 1. B Sadock, V Sadock (Ed), Philadelphia. Lippincott Williams & Wilkins, s. 2005-2021.
• [29] Keel, P. K., Forney, K. J. 2013. Psychosocial risk factors for eating disorders. International Journal of Eating Disorders, 46(5), 433-439.
• [30] Fallon, E. A., Harris, B. S., Johnson, P. 2014. Prevalence of body dissatisfaction among a United States adult sample. Eating Behaviors, 15(1), 151–158.
• [31] Holland, G., Tiggemann, M. 2016. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image, 17, 100–110.
• [32] Stice, E., Marti, C. N., Durant, S. 2011. Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behaviour Research and Therapy, 49(10), 622–627.
• [33] Frieiro Padin, P., González Rodríguez, R., Verde Diego, M. D. C., Vázquez Pérez, R. 2021. Social media and eating disorder psychopathology: A systematic review. Cyberpsychology Journal of Psychosocial Research on Cyberspace.
• [34] Frederick, D. A., Daniels, E. A., Bates, M. E., Tylka, T. L. 2017. Exposure to thin-ideal media affect most, but not all, women: Results from the Perceived Effects of Media Exposure Scale and open-ended responses. Body Image, 23, 188–205.
• [35] Polanczyk, G.V., Salum, G.A., Sugaya, L.S., Caye, A., Rohde, L.A. 2015. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J. Child Psychol. Psychiatry, 56, 345–365.
• [36] Godart, N.T., Flament, M.F., Perdereau, F., Jeammet, P. 2002. Comorbidity between eating disorders and anxiety disorders: A review. Int. J. Eat. Disord, 32, 253–270.
• [37] Godart, N.T., Perdereau, F., Rein, Z., Berthoz, S., Wallier, J., Jeammet, P., Flament, M.F. 2007. Comorbidity studies of eating disorders and mood disorders. Critical review of the literature. J. Affect. Disord. 97, 37–49.
• [38] Swanson, S.A., Crow, S.J., Le Grange, D., Swendsen, J., Merikangas, K.R. 2011. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch. Gen. Psychiatry, 68, 714–723.
• [39] De Young, K.P. 2016. Comorbidities: Anxiety disorders. In Encyclopedia of Feeding and Eating Disorders; Wade, T., Ed.; Springer: Singapore, pp. 1–5.
• [40] Bardone-Cone, A.M., Harney, M.B., Maldonado, C.R., Lawson, M.A., Robinson, D.P., Smith, R., Tosh, A. 2010. Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity. Behav. Res. Ther, 48, 194–202.
• [41] Vall, E., Wade, T.D. 2015. Predictors of treatment outcome in individuals with eating disorders: A systematic review and meta-analysis. Int. J. Eat. Disord, 48, 946–971.
• [42] Smith, K.E., Mason, T.B., Leonard, R.C., Wetterneck, C.T., Smith, B.E.R., Farrell, N.R., Riemann, B.C. 2018. Affective predictors of the severity and change in eating psychopathology in residential eating disorder treatment: The role of social anxiety. Eat. Disord, 26, 66–78.
• [43] Smyth, J. M., Hockemeyer, J. R., Heron, K. E., Wonderlich, S. A., Pennebaker, J. W. 2008. Prevalence, type, disclosure, and severity of adverse life events in college students. Journal of American College Health, 57(1), 69-76.
• [44] Karaoğlu, M., Erzi, S. 2019. Yeme tutumları ve travmatik yaşantılar: Öz şefkat ve duygu düzenlemenin aracı rolü. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 1(3), 145-151.
• [45] Shafran R., Cooper Z, Fairburn C.G. 2003. ‘‘Clinical perfectionism’’ is not ‘‘multidimensional perfectionism’’: A reply to Hewitt, Flett, Besser, Sherry & McGee. Behav Res Ther, 41:1217–1220.
• [46] Scribner Reiter C., Graves L. 2010. Nutrition therapy for eating disorders. Nutr Clin Pract, 25:122-136.
• [47] Wilson G.T., Grilo C.M., Vitousek K.M. 2007. Psychological treatment for eating disorders. Am J Psychol, 62:199-216.
• [48] Rollnick S., Miller W.R., Butler C.C. 2007. Motivational interviewing in health care: Helping patients change behavior. New York, NY: Guilford Press, 74–75.
• [49] Kruger, S., Kennedy, S. H. 2000. Psychopharmacotherapy of anorexia nervosa, bulimia nervosa and binge-eating disorder. Journal of Psychiatry and Neuroscience, 25(5), 497.
• [50] Ebeling, H., Tapanainen, P., Joutsenoja, A., Koskinen, M., Morin‐Papunen, L., Järvi, L., ... Wahlbeck, K. 2003. A practice guideline for treatment of eating disorders in children and adolescents. Annals of medicine, 35(7), 488-501.
• [51] Wilson, G. T., Sysko, R. 2009. Frequency of binge eating episodes in bulimia nervosa and binge eating disorder: Diagnostic considerations. International Journal of Eating Disorders, 42(7), 603-610.
• [52] Klump K.L., Bulik C.M., Kaye W.H., Treasure J., Tyson E. 2009. Academy for Eating Disorders position paper: Eating disorders are serious mental illnesses. Int J Eat Disord, 42:97-103.
• [53] Rosen D.S. 2010. American Academy of Pediatrics Committee on Adolescence. Identification and management of eating disorders in children and adolescents. Pediatrics. 126:1240-1253.
• [54] Golden, N.H, Jacobson M.S, Schebendach J., Solanto M.V., Hertz S.M., Shenker I.R. 1997. Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med, 151:16-21.
• [55] Parry-Jones W.L. 1991. Target weight in children and adolescents with anorexia nervosa. Acta Paediatr Scand Suppl, 373:82-90.
• [56] Marshall M.H. 1978. Anorexia nervosa: dietary treatment and re-establishment of body weight in 20 cases studied on ametabolic unit. J Hum Nutr, 32:349-57.
• [57] Kaye W. 2008. Neurobiology of anorexia and bulimia nervosa. Physiol Behav, 94:121-135.
• [58] Stice E., NG J., Shaw H. 2010. Risk factors and prodromal eating pathology. J Child Psychol Psychiatry. 51:518-525.
• [59] Monteleone, A. M., Fernandez‐Aranda, F., Voderholzer, U. 2019. Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach. World Psychiatry, 18(3), 369.
• [60] Kreipe, R. E., Golden, N. H., Katzman, D. K., Fisher, M., Rees, J., Tonkin, R. S., Silber, M., Sigman, G., Schebendach, J., Ammerman, S., Hoberman, M. M. 1995. Eating disorders in adolescents: A position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 16, 476–480.
• [61] Robin, A. L., Gilroy, M., Dennis, A. B. 1998. Treatment of eating disorders in children and adolescents. Clinical Psychology Review, 18(4), 421-446.
• [62] Treasure J., Stein D., Maguire S. 2015. Early Interv Psychiatry, 9:173-84.
• [63] National Institute for Health and Care Excellence. 2017. Eating disorders: recognition and treatment. Version 2.0. London: National Institute for Health and Care Excellence.
• [64] Grenon, R., Carlucci, S., Brugnera, A., Schwartze, D., Hammond, N., Ivanova, I., ... Tasca, G. A. 2019. Psychotherapy for eating disorders: A meta-analysis of direct comparisons. Psychotherapy Research, 29(7), 833-845.