when lauren was fifteen years old, her familymoved across the country and she started going to a new school. already shy, lauren sufferedfrom low self-confidence and had a hard time transitioning; nothing felt right and soonher changing body became a source of insecurity. eventually, she began thinking that maybeif she lost weight and focused on fitness, she'd make more friends and feel better aboutherself and life would get better. soon she
crash diet success, became obsessed with dieting and it quicklyspiraled into her subsisting only on rice cakes and apples and candy corn and celery. she like this new feeling of control everytime she stood on the scale and saw a lower number. she was achieving something, and that madeher feel good. soon, she thought of nothing else.
but what lauren couldn't see was that shewas 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 sawa chubby girl. her family, though, did notice, and yet, at a visitto the doctor, she was just told to eat more. she didn't. one day while jogging, she had a heart attackand collapsed. as a teenager, she was 5'7" and weighed eighty-two pounds. lauren wasfinally 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 slowlybegan eating small amounts of food again.
her recovery was slow but, with the supportof her family and doctors, she was released eight months later. though lauren suffered a fewrelapses over the years, she is now healthy. ultimately, she was lucky. anorexia, bulimia, and othereating and body dysmorphic disorders can kill. eating disorders are among the deadliest psychologicaldisorders, 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 treatedsuccessfully, they have to be understood as disorders of the mind. here's some scary figures: according to thenational eating disorder association, forty-two percent of first to third grade girls wantto be thinner; eighty-one percent of ten year
olds are afraid of being fat; over half ofteenage girls and nearly a third of teenage boys have used troubling weight control methodslike fasting, skipping meals, smoking, vomiting, or taking laxatives. the rate of new cases of eating disordersin western culture has been increasing since the 1950's, and today in the us, an estimatedtwenty million women and ten million men have suffered from a clinically significant eatingdisorder at some point in their lives. but get this straight: we're not talking aboutfad diets or lifestyle choices spurred by vanity. eating disorders are psychologicalillnesses 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, mostoften adolescent females, essentially maintain a starving diet and, eventually, and abnormallylow body weight. as in lauren's case, anorexia can begin as a diet that quickly spirals outof control as a person becomes obsessed with continued weight loss, all while still feelingoverweight. our old friend, the dsm v, actually delineatestwo sub types of the disorder. the first involves restriction, which usually consists of anextremely 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 combinedwith the restriction behavior. as you can easily imagine, the physiologicaleffects of this psychological condition can
be devastating. as the body is denied crucialnutrients, it slows down to conserve what little energy it has, often resulting in abnormallyslow 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 definingcharacteristic of anorexia nervosa - a refusal to maintain a weight at or above what wouldnormally be considered minimally healthy. if this condition persists, of course, itcan be deadly, which is why anorexia has what's often estimated to be the highest mortalityrate of any psychiatric disorder. that might surprise you, given the host oftroubling disorders we've already covered here on crash course psychology, but mortalityrates associated with, say, major depression
or ptsd or schizophrenia tend to be the resultof secondary behavior, like suicide. but with anorexia, the mortality rate is especiallyhigh because people can die as a direct result of extreme weight loss and physiological damage. another common eating disorder is bulimianervosa. while anorexia is characterized primarilyby the refusal to maintain a minimal body weight, bulimia is not. people with bulimiatend to maintain an apparently normal, or at least minimally healthy, body weight, butalternate between binge eating, followed by fasting or purging, often by vomiting or usinglaxatives. a bulimic body may not be as obviously underweightas an anorexic one, but that addictive cycle
of binging and purging can seriously damagethe whole digestive system, leading to irregular heartbeat, inflammation of the esophagus andmouth, tooth decay and staining, irregular bowel movements, peptic ulcers, pancreatitis,and other organ damage. sometimes the two diagnoses can be difficultto discern, especially because someone may shift back and forth between anorexic diagnosticfeatures and bulimic diagnostic features. the dsm v recently added a third categorycalled binge-eating disorder, which is marked by significant binge-eating, followed by emotionaldistress, feelings of lack of control, disgust, or guilt, but without purging or fasting. although sometimes triggered by stress ora need for, or lack of, control, the presence
of an eating disorder is not a tell-tale signof childhood sexual abuse, as was once commonly thought. instead, these disorders are oftenpredictive indicators of a person's feelings of low self-worth, need to be perfect, falling short ofexpectations, and concern with others perceptions. although the prevalence of bulimia and binge-eatingis similar among ethnic groups in the united states, anorexia is is much more common amongwhite women, often of higher socioeconomic status. but the prevalence of these disorders is risingin males, too. today, between ten and twenty percent of people diagnosed with eating disordersare 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 gendercomponents; the so-called "ideal standard
of beauty" varies wildly across cultures andtime, and thinness is far from a universal desire, especially in countries where malnutritionand starvation are problems. but in the western world, and increasinglyin other countries, thinness is a common pursuit. and being bombarded with images of unrealisticallyslender models and jacked celebrities has increased many people's dissatisfaction, oreven shame and disgust, with their own bodies. these are all attitudes that can contributeto eating disorders. some people have even had plastic surgery tolook more like beyonce, or j-lo, or...barbie. when taken to extremes, this kind of behavior startsinching into the realm of body dysmorphic disorder. body dysmorphic disorder is another psychologicalillness, one that centers on a person's obsession
with physical flaws - either minor or justimagined. those suffering from this disorder often obsess over their appearance, oftenstaring into mirrors for hours, and feel distressed or ashamed by what they see. although it's often lumped in with the eatingdisorders, our growing understanding of body dysmorphia suggests that it actually sharessome traits with obsessive-compulsive disorder, particularly the obsession with some imaginedbodily perfection and the compulsion to check oneself over and over to discern perceivedflaws. not surprisingly, bdd and ocd may share somesimilar neurophysiological features, although that's still being researched.
people suffering from bdd may exercise excessively,groom themselves excessively, or seek out extreme cosmetic procedures, but, unless treated,they usually remain critical and unsatisfied with their looks, to the point of fearingthat they have a deformity. people with bdd may suffer from anxiety anddepression, start avoiding social situations, and stay home for fear that others will noticeand judge their appearance negatively. obviously, this causes a lot of emotionaldistress and dysfunction. some bodybuilders suffer from a particular type of bdd calledmuscle dysmorphia, sort of the opposite of anorexia, where they become obsessed withthe notion that they aren't muscular enough, even if they're ripping shirts like the hulk.
and again, this isn't mere vanity; peoplesuffering from body dysmorphia disorder look in the mirror and often see a distorted, evengrotesque, image in their reflection. so, how do these disorders come about? well, to be honest, we still have a lot ofdots to connect. neurologically, there are a few compellingclues. in the case of eating disorders, for example, research has long suggested thatneurotransmitters like serotonin and dopamine may play a role. dopamine is involved in regions of the brainconnected to hunger and eating, like the hypothalamus and nucleus accumbens, and some research hasfound that binge eating appears to alter the
regulation of dopamine production in a waythat can reinforce further binging. the result is a neurological pattern thatcan resemble drug addiction, although the addiction comparison is still pretty controversial. genetics appear to play a role, too, as thereseems to be increased risk among genetic relatives with eating disorders as compared to controls. but a lot of attention is also being paidto environmental and familial factors, particularly the behavioral modeling and learning processesthat shape how we think about ourselves and our bodies. specifically, children who growup observing problematic or unhealthy eating behavior in parents may be at higher riskfor developing an eating disorder. and explicitly
learning unreasonable or unhealthy valuesabout your weight or your shape from your family, and definitely from your peers, canhave a powerful effect. eating and body dysmorphic disorders are seriousbusiness, but they are treatable -- and perhaps even preventable. if cultural learning contributes to how weeat and how we want to look, then maybe education can help increase our acceptance of our ownappearance, and be more accepting of others. today, you learned about the symptoms andsub types of anorexia, bulimia, and binge-eating disorder, as well as various types of bodydysmorphic disorder, and some of the physiological and environmental roots of these conditions.
thank you for watching, especially to allof our subbable subscribers. this episode of crash course psychology was co-sponsoredby subbable subscriber matthew woolsey and by rich brown of beach ready auto repair inouter banks, north carolina. to find out how you can become a co-sponsorfor one of our videos, just go to subbable.com/crashcourse. this episode was written by kathleen yale,edited by blake de pastino, and our consultant is dr. ranjit bhagwat. our director and editoris nicholas jenkins, the script supervisor and sound designer is michael aranda, andthe graphics team is thought cafã©.
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