Efek Eating Disorder terhadap
Remaja
Nindy Sabrina, S.Gz, M.Sc
(Nutrition and dietetics department, Monash University)
(Prodi Gizi, Universitas Sahid Jakarta)
Name : Nindy Sabrina, SGz, MSc
Education : 2010- Nutrition and Health Sciences,
Medical Faculty, Brawijaya University
2015- Nutrition and Health Sciences,
Taipei Medical University
Current – Nutrition and Dietetics, Monash
University Australia
Work Experience:
• Lecturer at Nutrition Department Sahid University, Jakarta
• Research Assistant at Nutirition and Health Sciences
Department Brawijaya University
• Nutrition research journal reviewer
• Nutrition Consultant – Milo Nestle indonesia
Google scholar profile : Nindy Sabrina
Linkedin
https://au.linkedin.com/in/nindysabrina
Resarchgate
https://www.researchgate.net/profile/Nindy-Sabrina
Email : [email protected]
What Are Eating Disorders?
• Real, life-threatening illnesses with potentially fatal
consequences.
• Involve extreme emotions, attitudes, and behaviors surrounding
weight, food, and size.
• Caused by a range of biological, psychological, and sociocultural
factors
Who Do Eating Disorders Affect?
Everyone
People of all genders, ages, races, religions, ethnicities, and
sexual orientations can be affected.
Types of eating disorders
Anorexia nervosa
Characterised by restricted
eating, loss of weight and a
fear of putting on weight
Bulimia nervosa
Periods of binge eating
(often in secret), followed
by attempts to compensate
Excessively exercising,
vomiting, or periods of
strict dieting.
Binge eating is often
accompanied by
feelings of shame and
being 'out of control'
Binge eating disorder
characterised by recurrent periods of binge
eating (can include eating much more than
normal, feeling uncomfortably full, eating large
amounts when not physically hungry).
•Feelings of guilt, disgust and depression can
follow binge eating episodes.
•does not involve compensatory behaviours
Other specified feeding or eating
disorder (OSFED)
feeding or eating behaviours that cause the
individual distress and impairment, but do not
meet criteria for the first three eating disorders.
boys girls
Co-occurrence of eating disorder behaviours
across genders: (a) boys (n = 2688); (b) girls (n =
3374).
Adolescent eating disorder behaviours and cognitions: gender-specific
effects of child, maternal and family risk factors (2015)
Risk Factors of Eating Disorders
Psychological Social or environmental Biological factors
•low self-esteem •being teased or bullied
•a belief that high expectations adolescence and its
•perfectionism from family and others must be met associated physical
•difficulties •major life changes such as family changes
expressing feelings break-up, or the accumulation of
like anger or anxiety many minor stressors genetic or familial
•being a 'people •peer pressure to behave in factors – for example,
particular ways families that are overly
pleaser'
•a parent or other role model who
•difficulties being focused on food,
consistently diets or who is
assertive with others unhappy with their body weight, shape and
•fear of adulthood. •media and advertising images of appearance.
the ideal body size and shape as
slim and fit
•a cultural tendency to judge
people by their appearance.
Boys and Girls 13-14 y. o, 4.467 adolescent
Ethnicity: Caucasian
63.2% of girls were described as being afraid of gaining weight or getting fat;
Percentages were lower among boys
Being upset or distressed about weight and shape was reported at a high level (a lot) for 4.9% of girls
and 2.4% of boys, with a positive association with female gender
Frequency and Patterns of Eating Disorder Symptoms in Early Adolescence (Nadia Micali, et al. 2013)
Short term effects of Anorexia Nervosa
Physical Psychologica
• Underweight l
• Loss of 15% of minimal normal weight, • Intense fear of gaining weight or
Bmi <17.5 in adults ongoing behaviour that does not
enable weight gain
• Development of bloating, constipation and
food intolerance • Anxiety and irritability around meal
times
• Loss of periods (in women) and failure to
begin a menstrual cycle (in girls) – • Depression and anxiety
although you can still have your periods • Low self-esteem, along with
and have anorexia nervosa perfectionism
• Cold, mottled hands and feet due to poor • Slowed thinking and decreased ability
blood flow, even in warm weather to concentrate
• Heart problems, kidney failure • Distorted body image – for example, a
person who believes they are ‘fat’
• Fatigue and fainting without reason when they are underweight
• An increase in dental decay without • Expressions of low self-worth.
reason
• Fine hair appearing on the face and body.
Long-term risks of ongoing anorexia nervosa
• Weakened bones (osteoporosis)
• Slowed growth (in young people)
• Infertility
• Disorders of the bowel and gut
• Problems with concentration and
thinking
• Problems with decision-making
• Social, emotional and educational
problems
Short term effects of
Bulimia Nervosa
Physical Psychological
• Frequent fluctuations in body weight
• Signs of damage from frequent • Preoccupation or obsession with eating,
vomiting, such as swelling around the dieting, exercise or body image
cheeks and jaw, damaged teeth and • Sensitivity to comments about eating,
bad breath dieting, exercise or body image
• Frequent constipation, diarrhea or new • Feelings of shame, guilt and disgust,
food intolerances especially after eating and/or purging
• Fainting or dizziness that is not due to • A distorted body image or extreme
another illness or another health dissatisfaction with body shape –
condition people can think they are fat even when
• Fatigue and inability to sleep well they have a healthy body weight
• In women, loss of periods or altered • Low self-esteem, depression, anxiety or
menstrual cycles, although you can still irritability.
have periods and have bulimia nervosa.
Long-term risks of ongoing bulimia nervosa
Mouth Problems Gastrointestinal Problems
•Enamel erosion •Ulcers in the lining of the intestines
•Damage to the salivary glands •Constipation
•Tooth sensitivity and decay •Diahrrea
•Gum disease •Irritable bowel syndrome
•Tooth loss •Bowel obstruction and perforation
•Partial colon resection
Bone Damage •Use of colostomy bag
•Low bone density
•Brittle bones Throat Damage
•Osteopenia •Weakness in the esophageal sphincter
•Osteoporosis •Tearing of the esophagus
•Gastroesophageal reflux disease (chronic
Heart Issues acid reflux)
•Low blood pressure •Esophagitis (inflammation of the
•Heart palpitations esophagus that can lead to scarring)
•Irregular heartbeat •Esophageal cancer
•Coronary heart disease
•Cardiomyopathy (weakened heart walls)
•Cardiac arrest
Behavioural symptoms of bulimia nervosa
• Unexplained disappearance of food – hiding
of binge-eating episodes
• Secretive behaviour around food – hiding
uneaten food or saying they have eaten
when they haven’t
• Becoming more antisocial and withdrawn
• Eating alone and avoiding other people at
meal times
• Frequent trips to the bathroom after eating
• Dieting behaviour – obsessive dieting,
counting kilojoules, avoiding certain food
groups
• Use of laxatives, enemas, diuretics or
appetite suppressants
• Spending large amounts of money on food
• Self-harming behaviour, use of illegal
substances and suicide attempts.
Early warning signs of eating disorders
•Rapid weight loss or weight gain • Compulsive exercising and a need to be
•Changes in shape active all the time
•Feelings of unhappiness with body • Eating in secret
shape and size • Cutting out particular food groups, such as
•An intense fear of gaining weight meat or dairy products
•Denial of being hungry • Developing food rituals – such as always
•Deceptive behaviour around food. For using the same bowl, cutting food up into tiny
instance, throwing out or hiding school pieces or eating very slowly
lunches • Behavioural changes – such as social
•Avoiding food and eating in social withdrawal, irritability or depression
situations • Sleep disturbance.
•Excessive physical activity
Screening Tools Assessment Tools
SCOFF (BMJ 1999; 319:1467) Eating Attitudes Test (EAT-26)
Do you make yourself Sick because you feel This 26-item test
uncomfortably full?
Do you worry you have lost Control over how Compulsive Exercise Test (CET)
much you eat?
This 24-item test
Have you recently lost more than Over 6kg in a 3
month period?
Eating Disorder Examination
Do you believe yourself to be Fat when others
Questionnaire (EDE-Q)
say you are too thin?
This 28-item test
Would you say that Food dominates your life?
Score one point for every “yes”; a score of ≥2
indicates a likely case of an eating disorder.
Eating Disorder Examination
Questionnaire - Short (EDE-QS)
The questionnaire comprises 12 scaled questions,
where higher scores indicate higher symptoms
https://www.nedc.com.au/assets/files/Resources/NEDC-Video-Handout.pdf
Investigation of Physical Conditions and
Psychological Symptoms of Eating Disorders
• Physical investigations
• Food diaries
• Height and weight (Growth charts)
• Psychiatric assessment
• Family history and involvement
• Observation of family meal
• Routine blood tests: glucose, thyroid, electrolytes,
liver function tests, pregnancy, complete blood count
• Electrocardiogram
• Bone density
The 9 Truths About
Eating Disorders
1. Many people with eating disorders look healthy, yet may be
extremely ill.
2. Families are not to blame, and can be the patients’ and
providers’ best allies in treatment.
3. An eating disorder diagnosis is a health crisis that disrupts personal
and family functioning.
The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders (2017)
4. Eating disorders are not choices, but serious biologically influenced
illnesses.
5. Eating disorders affect people of all genders, ages, races,
ethnicities, body shapes and weights, sexual orientations, and
socioeconomic statuses.
6. Eating disorders carry an increased risk for both suicide and
medical complications.
The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders (2017)
7. Genes and environment play important roles in the development
of eating disorders.
8. Genes alone do not predict who will develop eating
disorders.
9. Full recovery from an eating disorder is possible. Early detection
and intervention are important.
The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders (2017)
