Statistik
Gejala
– Resistensi untuk menjaga BB pada minimal normal
BB
– Ketakutan akan kelebihan BB meskipun underweight
– Gangguan pada evaluasi bentuk tubuh
– Gangguan siklus menstruasi
Anorexia
Personality Traits
Genetics
Environmental Influences
Biochemistry
Personality Traits
Kepercayaan diri yang rendah
Kontrol diri yang rendah
Ketakutan menjadi gemuk
Depresi, khawatir, marah, perasaan sendiri
Perfectionists
Achievement oriented
– Good students
– Excellent athletes
– Competitive careers
Personality traits berkontribusi pada eating
disorder karena:
Makanan biasanya berhubungan dengan emosi dan
perasaan
Orang yang binge eating untuk menurunkan stress
Highly value external reinforcement and acceptance
Faktor Genetik:
Meningkatkan resiko eating disorders
Meningkatkan resiko mood disorder
Twin studies
Keluarga yang terlalu memperhatkan penampilan fisik anaknya
akan meningkatkan resiko anaknya memiliki eating disorders
Genetics Linked to Anorexia, Bingeing
- Indianapolis Star, March 12, 2006
2 new studies show that genetics may outweigh
environmental factors in producing eating disorders.
1) Records from 30,000 Swedish twins found identical
twins more likely to share an eating problem than
fraternal twins or non twin siblings
• found that genes were responsible for 56% of the
cases.
Genetics linked to anorexia, bingeing
- Indianapolis Star, March 12, 2006
2) Strong genetic contribution to binge-eating - Dr. James Hudson at
Harvard Medical School
– Interviewed the parents, siblings, and children of 300 people,
half with a history of binge-eating
– Findings:
• family members of binge-eaters were twice as likely to
have a similar eating disorder than those without a
history.
• relatives of binge-eaters were more than twice as likely to
be obese
Faktor Lingkungan
Interpersonal Factors
– Hubungan Keluarga
– Kesulitan dalam mengekspresikan emosi dan
perasaan
– Riwayat dibully akibat bentuk tubuh
– history of trauma, sexual, physical and/or mental
abuse
• 60-75% of all bulimia nervosa patients have a history of
physical and/or sexual abuse
Faktor Lingkungan
Social Factors (media and cultural pressures)
– Fenomena Kurus = Cantik
– Norma social yang lebih mengedepankan tampilan fisik disbanding
inner beauty
– Profesi yang mengharuskan memiliki badan langsing
• ie. Modeling, dancing, gymnastics, long distance running
- Media Televisi, majalah fashion
Faktor Biokimia
Chemical imbalances in the neuroendocrine system
– these imbalances control hunger, appetite, digestion, sexual function,
sleep, heart and kidney function, memory, emotions, and thinking
Serotonin and norepinephrine are decreased in acutely ill
anorexia and bulimia patients
– representing a link between depression and eating disorders
Excessive levels of cortisol in both anorexia and depression
– caused by a problem that occurs in or near the hypothalamus
Treatment Strategies:
Treatment fisik dan psikologis
Orang dengan eating disorders biasanya tidak merasa
bahwa mereka ‘sakit’
Treatment sangat kompleks karena melibatkan berbagai
pihak:
– General practitioners, Physicians, Dieticians, Psychologists,
Psychiatrists, Counselors, etc.
Tergantung dari tingkat keparahan :
– Rawat jalan: individual, family, and group therapy
– Rawat inap: for more extreme cases
Anorexia Treatment
3 Fase utama:
– Mengembalikan BB
– Treatment psikologis:
• Distortion of body image, low self-esteem, and
interpersonal conflicts.
– Rehabilitasi jangka panjang.
Diagnosis dini dan treatment dapat
meningkatkan tingkat kesembuhan
Anorexia Treatment
Rawat inap
– Pada kasus ekstrim dengan kehilangan BB yang berat
– Perencanaan makan sesuai kebutuhan
• Parenteral food bisa digunakan untuk pasien yang menolak makan
dengan tingkat keparahan yang tinggi
Peningkatan BB
• Usually 1 to 2 pounds per week
• In the beginning 1,500 calories are given per day
• Calorie intake may eventually go up to 3,500 calories per day
Nutritional Therapy
– Meal planning dan memberikan edukasi ke pasien dan keluarga
pasien
– Useful for achieving long-term remission
Bulimia Treatment
Primary Goal
– Mengurangi binge dan purge
– Meningkatkan pola makan yang teratur
Treatment Involves:
– Psychological support
• Improve attitude
• Olahraga yang sehat, seimbang, dan tidak berlebihan
• Menjaga mood dan anxiety
– Nutritional Counseling
• Menjelaskan tentang nutritional value dari makanan
• Strategi perencanaan makanan
– Medication management
• Antidepressants (SSRI’s) perlu diberikan untuk pasien dengan maslah
psikologis, depresi
• Mencegah penyakit timbul kembali