{"id":127,"date":"2020-07-13T18:59:54","date_gmt":"2020-07-13T18:59:54","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/chapter\/hunger-and-eating\/"},"modified":"2023-06-16T20:56:39","modified_gmt":"2023-06-16T20:56:39","slug":"hunger-and-eating","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/hunger-and-eating\/","title":{"raw":"Hunger and Eating","rendered":"Hunger and Eating"},"content":{"raw":"<div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Describe how hunger and eating are regulated in the human body<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<section>\r\n<h2>Understanding Hunger<\/h2>\r\nThere are a number of physiological mechanisms that serve as the basis for hunger. When our stomachs are empty, they contract, causing both hunger pangs and the secretion of chemical messages that travel to the brain to serve as a signal to initiate feeding behavior. When our blood glucose levels drop, the pancreas and liver generate a number of chemical signals that induce hunger (Konturek et al., 2003; Novin, Robinson, Culbreth, &amp; Tordoff, 1985) and thus initiate feeding behavior.\r\n\r\nFor most people, once they have eaten, they feel <strong>satiation<\/strong>, or fullness and satisfaction, and their eating behavior stops. Like the initiation of eating, satiation is also regulated by several physiological mechanisms. As blood glucose levels increase, the pancreas and liver send signals to shut off hunger and eating (Drazen &amp; Woods, 2003; Druce, Small, &amp; Bloom, 2004; Greary, 1990). The food\u2019s passage through the gastrointestinal tract also provides important satiety signals to the brain (Woods, 2004), and fat cells release <strong>leptin<\/strong>, a satiety hormone.\r\n\r\nThe various hunger and satiety signals that are involved in the regulation of eating are integrated in the brain. Research suggests that several areas of the hypothalamus and hindbrain are especially important sites where this integration occurs (Ahima &amp; Antwi, 2008; Woods &amp; D\u2019Alessio, 2008). Ultimately, activity in the brain determines whether or not we engage in feeding behavior (Figure 1).\r\n<figure>\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"560\"]<img class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23224936\/CNX_Psych_10_02_Hunger.jpg\" alt=\"An outline of the top half of a human body contains illustrations of the brain and the stomach in their relative locations. A line extends from the location of the hypothalamus in the brain illustration, out to the left, past the outline, where it meets a box labeled \u201cHunger.\u201d Down-facing arrows connect that box to a box labeled \u201cFood,\u201d and the box labeled \u201cFood\u201d to a box labeled \u201cSatiety.\u201d A line extends out to the right from the box labeled \u201cSatiety,\u201d and meets with the illustration of the stomach.\" width=\"560\" height=\"471\" \/> <strong>Figure 1<\/strong>. Hunger and eating are regulated by a complex interplay of hunger and satiety signals that are integrated in the brain.[\/caption]<\/figure>\r\n<\/section><section>\r\n<h2>Metabolism and Body Weight<\/h2>\r\nOur body weight is affected by a number of factors, including gene-environment interactions, and the number of calories we consume versus the number of calories we burn in daily activity. If our caloric intake exceeds our caloric use, our bodies store excess energy in the form of fat. If we consume fewer calories than we burn off, then stored fat will be converted to energy. Our energy expenditure is obviously affected by our levels of activity, but our body\u2019s metabolic rate also comes into play. A person\u2019s <strong>metabolic rate<\/strong> is the amount of energy that is expended in a given period of time, and there is tremendous individual variability in our metabolic rates. People with high rates of metabolism are able to burn off calories more easily than those with lower rates of metabolism.\r\n\r\nWe all experience fluctuations in our weight from time to time, but generally, most people\u2019s weights fluctuate within a narrow margin, in the absence of extreme changes in diet and\/or physical activity. This observation led some to propose a set-point theory of body weight regulation. The <strong>set-point theory<\/strong> asserts that each individual has an ideal body weight, or set point, which is resistant to change. This set-point is genetically predetermined; efforts to move our weight significantly from the set-point are resisted by compensatory changes in energy intake and\/or expenditure (Speakman et al., 2011).\r\n\r\n<\/section><section>\r\n<h2>Obesity<\/h2>\r\nOne common measure of health and body weight, and to differentiate the status of someone's weight from underweight, normal, overweight, and obese is the <strong>Body Mass Index (BMI)<\/strong>.\r\n\r\nWhen someone weighs more than what is generally accepted as healthy for a given height, they are considered overweight or obese. According to the Centers for Disease Control and Prevention (CDC), an adult with a <strong>body mass index<\/strong> (BMI) between 25 and 29.9 is considered <strong>overweight<\/strong> (Figure 2). An adult with a Body Mass Index (BMI)\u00a0of 30 or higher is considered <strong>obese<\/strong> (Centers for Disease Control and Prevention [CDC], 2012). People who are so overweight that they are at risk for death are classified as morbidly obese. <strong>Morbid obesity<\/strong> is defined as having a BMI over 40.\r\n\r\nHowever, it should be noted that recently the utility of the BMI has been questioned.[footnote]Robert H. Shmerling, M. D. (2020, June 23). How useful is the body mass index (BMI)? https:\/\/www.health.harvard.edu\/blog\/how-useful-is-the-body-mass-index-bmi-201603309339.[\/footnote] Specifically, the\u00a0BMI has been used as a healthy weight indicator by the World Health Organization (WHO), the CDC, and other groups, its value as an assessment tool has been questioned. The BMI is most useful for studying populations, which is the work of these organizations. It is less useful in assessing an individual since height and weight measurements fail to account for important factors like fitness level. An athlete, for example, may have a high BMI because the tool doesn\u2019t distinguish between the body\u2019s percentage of fat and muscle in a person\u2019s weight.\r\n\r\n[caption id=\"attachment_5308\" align=\"aligncenter\" width=\"614\"]<img class=\"wp-image-5308\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2015\/02\/27034211\/CNX_Psych_10_02_Bodymass_n1.jpg\" alt=\"A chart has an x-axis labeled \u201cweight\u201d (pounds\/kilograms) and a y-axis labeled \u201cheight\u201d (meters and feet\/inches). Four areas are shaded different colors indicating the BMI for ranges of weight and height. The \u201cunderweight BMI &lt;18.5\u201d area begins at approximately 90 pounds and 4\u201911\u201d and extends to approximately 160 pounds and 6\u20196\u201d. The \u201cnormal range BMI 18.5\u201325\u201d area covers approximately 90\u2013120 pounds at height 4\u201911\u201d and extends to approximately 160\u2013220 pounds at height 6\u20196\u201d. The \u201coverweight BMI 25\u201330\u201d area covers approximately 120\u2013140 pounds at height 4\u201911\u201d and extends to approximately 220\u2013265 pounds at height 6\u20196\u201d. The \u201cobese range BMI &gt;30\u201d area covers approximately 140\u2013350 pounds at height 4\u201911\u201d and extends to approximately 265\u2013350 pounds at height 6\u20196.\u201d\" width=\"614\" height=\"502\" \/> <strong>Figure 2<\/strong>. This chart shows how adult BMI is calculated. Individuals find their height on the<em> y<\/em>-axis and their weight on the <em>x<\/em>-axis to determine their BMI.[\/caption]\r\n<figure><\/figure>\r\nBeing extremely overweight or obese is a risk factor for several negative health consequences. Negative health consequences include, but are not limited to, an increased risk for cardiovascular disease, stroke, Type 2 diabetes, liver disease, sleep apnea, colon cancer, breast cancer, infertility, and arthritis. Given that it is estimated that around one-third of the adult U.S. population is obese and that nearly two-thirds of adults and one in six children qualify as overweight (CDC, 2012), there is substantial interest in trying to understand how to combat this important public health concern.\r\n<div class=\"textbox examples\">\r\n<h3>Watch It<\/h3>\r\nWatch <a href=\"https:\/\/www.youtube.com\/watch?v=1HEXSwP-wsI\" target=\"_blank\" rel=\"noopener\">this video from Psych hub to learn about abnormal eating behaviors<\/a>, including the most common eating disorders (which we'll examine in detail soon), and a summary of basic treatment strategies.\r\n\r\nYou can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/EatingDisorderPresentationAndTreatment_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for \"Eating Disorder: Presentation &amp; Treatment\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<figure><\/figure>\r\n<div>\r\n<div class=\"textbox exercises\">\r\n<h3>Dig Deeper: Prader-Willi Syndrome<\/h3>\r\n[caption id=\"\" align=\"alignright\" width=\"202\"]<img class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23224941\/CNX_Psych_10_02_Obesity.jpg\" alt=\"A painting shows Eugenia Mart\u00ednez Vallejo.\" width=\"202\" height=\"315\" \/> <strong>Figure 3<\/strong>. Eugenia Mart\u00ednez Vallejo, depicted in this 1680 painting, may have had Prader-Willi syndrome. At just eight years old, she weighed approximately 120 pounds, and she was nicknamed \u201cLa Monstrua\u201d (the monster).[\/caption]\r\n\r\nPrader-Willi Syndrome (PWS) is a genetic disorder that results in persistent feelings of intense hunger and reduced rates of metabolism. Typically, affected children have to be supervised around the clock to ensure that they do not engage in excessive eating. Currently, PWS is the leading genetic cause of morbid obesity in children, and it is associated with a number of cognitive deficits and emotional problems.\r\n\r\nWhile genetic testing can be used to make a diagnosis, there is a number of behavioral diagnostic criteria associated with PWS. From birth to two years of age, lack of muscle tone and poor sucking behavior may serve as early signs of PWS. Developmental delays are seen between the ages of six and 12, and excessive eating and cognitive deficits associated with PWS usually onset a little later.\r\n\r\nWhile the exact mechanisms of PWS are not fully understood, there is evidence that affected individuals have hypothalamic abnormalities. This is not surprising, given the hypothalamus\u2019s role in regulating hunger and eating. However, as you will learn in the next section of this module, the hypothalamus is also involved in the regulation of sexual behavior. Consequently, many individuals suffering from PWS fail to reach sexual maturity during adolescence.\r\n\r\nThere is no current treatment or cure for PWS. However, if weight can be controlled in these individuals, then their life expectancies are significantly increased (historically, sufferers of PWS often died in adolescence or early adulthood). Advances in the use of various psychoactive medications and growth hormones continue to enhance the quality of life for individuals with PWS (Cassidy &amp; Driscoll, 2009; Prader-Willi Syndrome Association, 2012).\r\n\r\n<\/div>\r\n<\/div>\r\n<\/section><section><section>\r\n<div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>leptin:\u00a0<\/strong>satiety hormone\r\n\r\n<strong>metabolic rate:\u00a0<\/strong>amount of energy that is expended in a given period of time\r\n\r\n<strong>morbid obesity:\u00a0<\/strong>adult with a BMI over 40\r\n\r\n<strong>obese:\u00a0<\/strong>adult with a BMI of 30 or higher\r\n\r\n<strong>overweight:\u00a0<\/strong>adult with a BMI between 25 and 29.9\r\n\r\n<strong>satiation:<\/strong>\u00a0fullness; satisfaction\r\n\r\n<strong>set point theory:\u00a0<\/strong>assertion that each individual has an ideal body weight, or set point, that is resistant to change\r\n\r\n<\/div>\r\n<\/div>\r\n<\/section><\/section>","rendered":"<div>\n<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Describe how hunger and eating are regulated in the human body<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<section>\n<h2>Understanding Hunger<\/h2>\n<p>There are a number of physiological mechanisms that serve as the basis for hunger. When our stomachs are empty, they contract, causing both hunger pangs and the secretion of chemical messages that travel to the brain to serve as a signal to initiate feeding behavior. When our blood glucose levels drop, the pancreas and liver generate a number of chemical signals that induce hunger (Konturek et al., 2003; Novin, Robinson, Culbreth, &amp; Tordoff, 1985) and thus initiate feeding behavior.<\/p>\n<p>For most people, once they have eaten, they feel <strong>satiation<\/strong>, or fullness and satisfaction, and their eating behavior stops. Like the initiation of eating, satiation is also regulated by several physiological mechanisms. As blood glucose levels increase, the pancreas and liver send signals to shut off hunger and eating (Drazen &amp; Woods, 2003; Druce, Small, &amp; Bloom, 2004; Greary, 1990). The food\u2019s passage through the gastrointestinal tract also provides important satiety signals to the brain (Woods, 2004), and fat cells release <strong>leptin<\/strong>, a satiety hormone.<\/p>\n<p>The various hunger and satiety signals that are involved in the regulation of eating are integrated in the brain. Research suggests that several areas of the hypothalamus and hindbrain are especially important sites where this integration occurs (Ahima &amp; Antwi, 2008; Woods &amp; D\u2019Alessio, 2008). Ultimately, activity in the brain determines whether or not we engage in feeding behavior (Figure 1).<\/p>\n<figure>\n<div style=\"width: 570px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23224936\/CNX_Psych_10_02_Hunger.jpg\" alt=\"An outline of the top half of a human body contains illustrations of the brain and the stomach in their relative locations. A line extends from the location of the hypothalamus in the brain illustration, out to the left, past the outline, where it meets a box labeled \u201cHunger.\u201d Down-facing arrows connect that box to a box labeled \u201cFood,\u201d and the box labeled \u201cFood\u201d to a box labeled \u201cSatiety.\u201d A line extends out to the right from the box labeled \u201cSatiety,\u201d and meets with the illustration of the stomach.\" width=\"560\" height=\"471\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 1<\/strong>. Hunger and eating are regulated by a complex interplay of hunger and satiety signals that are integrated in the brain.<\/p>\n<\/div>\n<\/figure>\n<\/section>\n<section>\n<h2>Metabolism and Body Weight<\/h2>\n<p>Our body weight is affected by a number of factors, including gene-environment interactions, and the number of calories we consume versus the number of calories we burn in daily activity. If our caloric intake exceeds our caloric use, our bodies store excess energy in the form of fat. If we consume fewer calories than we burn off, then stored fat will be converted to energy. Our energy expenditure is obviously affected by our levels of activity, but our body\u2019s metabolic rate also comes into play. A person\u2019s <strong>metabolic rate<\/strong> is the amount of energy that is expended in a given period of time, and there is tremendous individual variability in our metabolic rates. People with high rates of metabolism are able to burn off calories more easily than those with lower rates of metabolism.<\/p>\n<p>We all experience fluctuations in our weight from time to time, but generally, most people\u2019s weights fluctuate within a narrow margin, in the absence of extreme changes in diet and\/or physical activity. This observation led some to propose a set-point theory of body weight regulation. The <strong>set-point theory<\/strong> asserts that each individual has an ideal body weight, or set point, which is resistant to change. This set-point is genetically predetermined; efforts to move our weight significantly from the set-point are resisted by compensatory changes in energy intake and\/or expenditure (Speakman et al., 2011).<\/p>\n<\/section>\n<section>\n<h2>Obesity<\/h2>\n<p>One common measure of health and body weight, and to differentiate the status of someone&#8217;s weight from underweight, normal, overweight, and obese is the <strong>Body Mass Index (BMI)<\/strong>.<\/p>\n<p>When someone weighs more than what is generally accepted as healthy for a given height, they are considered overweight or obese. According to the Centers for Disease Control and Prevention (CDC), an adult with a <strong>body mass index<\/strong> (BMI) between 25 and 29.9 is considered <strong>overweight<\/strong> (Figure 2). An adult with a Body Mass Index (BMI)\u00a0of 30 or higher is considered <strong>obese<\/strong> (Centers for Disease Control and Prevention [CDC], 2012). People who are so overweight that they are at risk for death are classified as morbidly obese. <strong>Morbid obesity<\/strong> is defined as having a BMI over 40.<\/p>\n<p>However, it should be noted that recently the utility of the BMI has been questioned.<a class=\"footnote\" title=\"Robert H. Shmerling, M. D. (2020, June 23). How useful is the body mass index (BMI)? https:\/\/www.health.harvard.edu\/blog\/how-useful-is-the-body-mass-index-bmi-201603309339.\" id=\"return-footnote-127-1\" href=\"#footnote-127-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a> Specifically, the\u00a0BMI has been used as a healthy weight indicator by the World Health Organization (WHO), the CDC, and other groups, its value as an assessment tool has been questioned. The BMI is most useful for studying populations, which is the work of these organizations. It is less useful in assessing an individual since height and weight measurements fail to account for important factors like fitness level. An athlete, for example, may have a high BMI because the tool doesn\u2019t distinguish between the body\u2019s percentage of fat and muscle in a person\u2019s weight.<\/p>\n<div id=\"attachment_5308\" style=\"width: 624px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5308\" class=\"wp-image-5308\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2015\/02\/27034211\/CNX_Psych_10_02_Bodymass_n1.jpg\" alt=\"A chart has an x-axis labeled \u201cweight\u201d (pounds\/kilograms) and a y-axis labeled \u201cheight\u201d (meters and feet\/inches). Four areas are shaded different colors indicating the BMI for ranges of weight and height. The \u201cunderweight BMI &lt;18.5\u201d area begins at approximately 90 pounds and 4\u201911\u201d and extends to approximately 160 pounds and 6\u20196\u201d. The \u201cnormal range BMI 18.5\u201325\u201d area covers approximately 90\u2013120 pounds at height 4\u201911\u201d and extends to approximately 160\u2013220 pounds at height 6\u20196\u201d. The \u201coverweight BMI 25\u201330\u201d area covers approximately 120\u2013140 pounds at height 4\u201911\u201d and extends to approximately 220\u2013265 pounds at height 6\u20196\u201d. The \u201cobese range BMI &gt;30\u201d area covers approximately 140\u2013350 pounds at height 4\u201911\u201d and extends to approximately 265\u2013350 pounds at height 6\u20196.\u201d\" width=\"614\" height=\"502\" \/><\/p>\n<p id=\"caption-attachment-5308\" class=\"wp-caption-text\"><strong>Figure 2<\/strong>. This chart shows how adult BMI is calculated. Individuals find their height on the<em> y<\/em>-axis and their weight on the <em>x<\/em>-axis to determine their BMI.<\/p>\n<\/div>\n<figure><\/figure>\n<p>Being extremely overweight or obese is a risk factor for several negative health consequences. Negative health consequences include, but are not limited to, an increased risk for cardiovascular disease, stroke, Type 2 diabetes, liver disease, sleep apnea, colon cancer, breast cancer, infertility, and arthritis. Given that it is estimated that around one-third of the adult U.S. population is obese and that nearly two-thirds of adults and one in six children qualify as overweight (CDC, 2012), there is substantial interest in trying to understand how to combat this important public health concern.<\/p>\n<div class=\"textbox examples\">\n<h3>Watch It<\/h3>\n<p>Watch <a href=\"https:\/\/www.youtube.com\/watch?v=1HEXSwP-wsI\" target=\"_blank\" rel=\"noopener\">this video from Psych hub to learn about abnormal eating behaviors<\/a>, including the most common eating disorders (which we&#8217;ll examine in detail soon), and a summary of basic treatment strategies.<\/p>\n<p>You can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/EatingDisorderPresentationAndTreatment_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for &#8220;Eating Disorder: Presentation &amp; Treatment&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<figure><\/figure>\n<div>\n<div class=\"textbox exercises\">\n<h3>Dig Deeper: Prader-Willi Syndrome<\/h3>\n<div style=\"width: 212px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images-archive-read-only\/wp-content\/uploads\/sites\/902\/2015\/02\/23224941\/CNX_Psych_10_02_Obesity.jpg\" alt=\"A painting shows Eugenia Mart\u00ednez Vallejo.\" width=\"202\" height=\"315\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 3<\/strong>. Eugenia Mart\u00ednez Vallejo, depicted in this 1680 painting, may have had Prader-Willi syndrome. At just eight years old, she weighed approximately 120 pounds, and she was nicknamed \u201cLa Monstrua\u201d (the monster).<\/p>\n<\/div>\n<p>Prader-Willi Syndrome (PWS) is a genetic disorder that results in persistent feelings of intense hunger and reduced rates of metabolism. Typically, affected children have to be supervised around the clock to ensure that they do not engage in excessive eating. Currently, PWS is the leading genetic cause of morbid obesity in children, and it is associated with a number of cognitive deficits and emotional problems.<\/p>\n<p>While genetic testing can be used to make a diagnosis, there is a number of behavioral diagnostic criteria associated with PWS. From birth to two years of age, lack of muscle tone and poor sucking behavior may serve as early signs of PWS. Developmental delays are seen between the ages of six and 12, and excessive eating and cognitive deficits associated with PWS usually onset a little later.<\/p>\n<p>While the exact mechanisms of PWS are not fully understood, there is evidence that affected individuals have hypothalamic abnormalities. This is not surprising, given the hypothalamus\u2019s role in regulating hunger and eating. However, as you will learn in the next section of this module, the hypothalamus is also involved in the regulation of sexual behavior. Consequently, many individuals suffering from PWS fail to reach sexual maturity during adolescence.<\/p>\n<p>There is no current treatment or cure for PWS. However, if weight can be controlled in these individuals, then their life expectancies are significantly increased (historically, sufferers of PWS often died in adolescence or early adulthood). Advances in the use of various psychoactive medications and growth hormones continue to enhance the quality of life for individuals with PWS (Cassidy &amp; Driscoll, 2009; Prader-Willi Syndrome Association, 2012).<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section>\n<section>\n<div>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>leptin:\u00a0<\/strong>satiety hormone<\/p>\n<p><strong>metabolic rate:\u00a0<\/strong>amount of energy that is expended in a given period of time<\/p>\n<p><strong>morbid obesity:\u00a0<\/strong>adult with a BMI over 40<\/p>\n<p><strong>obese:\u00a0<\/strong>adult with a BMI of 30 or higher<\/p>\n<p><strong>overweight:\u00a0<\/strong>adult with a BMI between 25 and 29.9<\/p>\n<p><strong>satiation:<\/strong>\u00a0fullness; satisfaction<\/p>\n<p><strong>set point theory:\u00a0<\/strong>assertion that each individual has an ideal body weight, or set point, that is resistant to change<\/p>\n<\/div>\n<\/div>\n<\/section>\n<\/section>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-127\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification and adaptation, addition of link to learning. <strong>Authored by<\/strong>: Margaret Krone for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Hunger and Eating. <strong>Authored by<\/strong>: OpenStax College. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:7y4p-I4a@6\/Hunger-and-Eating\">http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:7y4p-I4a@6\/Hunger-and-Eating<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em>. <strong>License Terms<\/strong>: Download for free at http:\/\/cnx.org\/content\/col11629\/latest\/.<\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>Eating Disorder: Presentation &amp; Treatment. <strong>Provided by<\/strong>: Psych Hub Education. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=1HEXSwP-wsI&#038;feature=emb_logo\">https:\/\/www.youtube.com\/watch?v=1HEXSwP-wsI&#038;feature=emb_logo<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-127-1\">Robert H. Shmerling, M. D. (2020, June 23). How useful is the body mass index (BMI)? https:\/\/www.health.harvard.edu\/blog\/how-useful-is-the-body-mass-index-bmi-201603309339. <a href=\"#return-footnote-127-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":3,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Hunger and Eating\",\"author\":\"OpenStax College\",\"organization\":\"\",\"url\":\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:7y4p-I4a@6\/Hunger-and-Eating\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"Download for free at http:\/\/cnx.org\/content\/col11629\/latest\/.\"},{\"type\":\"original\",\"description\":\"Modification and adaptation, addition of link to learning\",\"author\":\"Margaret Krone for Lumen Learning\",\"organization\":\"Lumen Learning\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"copyrighted_video\",\"description\":\"Eating Disorder: Presentation & Treatment\",\"author\":\"\",\"organization\":\"Psych Hub Education\",\"url\":\"https:\/\/www.youtube.com\/watch?v=1HEXSwP-wsI&feature=emb_logo\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Standard YouTube License\"}]","CANDELA_OUTCOMES_GUID":"b9344553-15a1-42b0-a224-9c4f4223c3e8, 35b22df1-fcfa-483a-aecb-9aadd9f68379","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-127","chapter","type-chapter","status-publish","hentry"],"part":148,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapters\/127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/wp\/v2\/users\/29"}],"version-history":[{"count":26,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapters\/127\/revisions"}],"predecessor-version":[{"id":7610,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapters\/127\/revisions\/7610"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/parts\/148"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapters\/127\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/wp\/v2\/media?parent=127"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/pressbooks\/v2\/chapter-type?post=127"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/wp\/v2\/contributor?post=127"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/wp-json\/wp\/v2\/license?post=127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}