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Chapter 11

Chapter 11. Eating Disorders. Eating disorders. Severe disruptions in normal eating patterns & a significant disturbance in the perception of body shape and weight Can often lead to death Categories

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Chapter 11

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  1. Chapter 11 Eating Disorders

  2. Eating disorders • Severe disruptions in normal eating patterns & a significant disturbance in the perception of body shape and weight • Can often lead to death • Categories • Anorexia Nervosa: self-starvation, fear of gaining wt, disturbances in self-evaluation wt & amenorrhea • Bulimia: repeated episodes of binge eating followed by self-induced vomiting • Eating Disorders NOS: disorders of eating that do not meet criteria of anorexia or bulimia • Prevalence & Comorbidity • Culturally influenced with varying prevalence • >50% have a concurrent psychiatric disorder

  3. Theory • Etiology • Varied & complex • Include a biological predisposition activated by psychological, environmental & cultural factors • Models • Neurobiological & Endocrine • Neuroendocrine abnormalities are noted in both anorexia & bulimia • Genetic • Strong evidence of genetic vulnerability • Psychological • Play a role in setting off biological predisposition

  4. Application of nursing process: anorexia nervosa • Assessment • Cachectic, lanugo, mottled cool skin, 85% < ideal body weight • Assessment guidelines • Diagnosis: Imbalanced nutrition: less than body requirements • Outcomes Identification • Planning • Implementation • Acute Care, Communication Guidelines, Health Teaching and Promotion, Milieu Therapy, Psychotherapy (CBT, Psychodynamic, Group & Family) • Medication: Prozac-useful reducing occurrence relapse • Recovery requires long term treatment • Evaluation

  5. Application of nursing process: bulimia nervosa • Assessment -May not appear physically or emotionally ill -May be slightly above or below ideal body wt -Assessment guidelines • Diagnosis: Disturbed body image, Chronic low self esteem • Outcomes Identification • Planning • Implementation -Acute Care, Communication Guidelines, Health Teaching and Promotion, Milieu Therapy, Psychotherapy (CBT is the most effective) -Medication: SSRI (Fluoxetine) produces most improvement • Evaluation -Short & immediate goals are revised

  6. Binge eating disorders • Variant of compulsive overeating • Overeating a symptom of depression • High rates of mood & personality disorders • Majority recover • Pharmacology • SSRIs: Sertraline (Zoloft) reduced the frequency of binges & overall severity of the illness • CBT is the most effective treatment

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