1 / 23

anorexia nervosa & bulimia nervosa

Learn about the symptoms, diagnosis, treatment options, and potential complications of anorexia nervosa (AN) and bulimia nervosa (BN). Discover the epidemiology, etiology, and various consequences related to these eating disorders.

normal
Download Presentation

anorexia nervosa & bulimia nervosa

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. anorexia nervosa &bulimia nervosa By : Payam Farahbakhsh Clinical Nutritionist

  2. AN & BN • Both are characterized by an overvalued fear of fatness that drives a set of disturbed behaviors, including : • restricting food intake • binge eating • excessive exercise • self-induced vomiting • abuse of laxatives, diuretics, and diet pills

  3. OVERVIEW OF EATING DISORDERS Anorexia Nervosa • AN is a syndrome of self-starvation characterized by weight loss to a level below 85% of expected body weight. • Weight loss is accompanied by fear of fatness and, in girls and women, amenorrhea or the absence of 3 or more consecutive menstrual cycles.

  4. OVERVIEW OF EATING DISORDERS Bulimia Nervosa 1 • BN is a dieting disorder characterized by episodes of binge eating followed by compensatory behaviors aimed at preventing weight gain.

  5. Bulimia Nervosa • consumption of an amount of food definitely larger than most people would eat in a similar period, under similar circumstances, and is associated with a sense of loss of control over eating. • Typical binge foods are high-fat , high- calorie, “forbidden” foods, and amounts consumed are 1000 to 2000 calories or more per binge.

  6. BED (binge-eating disorder) • regular binge eating, twice a week or more, associated with a subjective sense of loss of control over eating but lacking the compensatory behaviors typical of BN. • Patients with BED are more likely to be overweight or obese.

  7. Atypical eating disorders Globushystericus, or fear of swallowing, resulting in : • severe weight loss • functional impairment • psychogenic vomiting syndromes.

  8. EPIDEMIOLOGY Epidemiologic data on eating disorders is limitedfor several reasons. AN : The prevalence of AN among young women is approximately 0.3% F/M : 10 Onset :15 to 19 years BN : The prevalence of BN among young women is approximately 1% F/M : 10 Onset :20 to 24 years

  9. EPIDEMIOLOGY BED prevalence : 2% to 3% female-to-male 2:1 Onset : 30 to 50 years . • Rates of BED are much higher, on the order of approximately 25% , in clinical samples of obese individuals seeking weight-loss treatment.

  10. ETIOLOGY 1 • Genetics • polymorphisms in serotonin and dopamine-relatedgenes • leptin and estrogenreceptors • Personality • low self-esteem • Perfectionism

  11. ETIOLOGY • Socio cultural Factors • Mass Media • Peers • Family • Developmental Factors • ovarian hormones • sexual development

  12. CONSEQUENCES AND COMPLICATIONS 1 • Social and Developmental Complications • PsychologicComplications • low mood • apathy • anhedonia • decreased concentration and energy • alcohol abuse • anxiety disorders

  13. CONSEQUENCES AND COMPLICATIONS • Physical Complications and Signs 1-Starvation-Related Complications: • Malnutrition and starvation • muscle wasting and weakness • bradycardia • hypotension • hypothermia • amenorrhea and infertility • cold intolerance • constipation • Anemia • Osteoporosis • hypoglycemia

  14. CONSEQUENCES AND COMPLICATIONS 2-Purging-Related Complications: • parotid and salivary gland hypertrophy • Dental caries • reflux • renal damage and nephrocalcinosis • electrolyte and acid–base imbalances

  15. TREATMENT • Initial treatment goals include normalizing eating patterns and restoring weight in underweight patients by using behavioral psychotherapeutic interventions.

  16. TREATMENT • Evidence-Based Treatment • cognitive behavioral treatment (CBT) • Interpersonal psychotherapy(IPT) • Family therapy • Medications • Olanzapine • fluoxetine

  17. TREATMENT • Role of the Nutritionist • Three regular meals a day • eating normal portion sizes • expanding food repertoire (which is often very narrow) • avoiding diet foods Patients should be encouraged to consume all foods in moderation and in normal combinations and to avoid fat-free or sugar-free diet products.

  18. TREATMENT • Vegetarianism that develops after the onset of dieting behavior is common in both AN and BN • diabetic exchange system without focus on calorie counting • with BN or BED should be instructed to eat approximately2000 kcal/day with an initial goal of weight maintenance.

  19. TREATMENT • Patients with AN who need to gain weight should be instructed to consume the same normal, healthy, 2000-cal diet plus three high-calorie liquid supplements between meals, totaling an additional 1000 to 1500 kcal/day to gain weight. • patients are strongly motivated to restrict their intake to low–calorie density foods

  20. Enteral and Parenteral Feeding • When access to a specialized behavioral inpatient eating disorders program is limited, however, an attempt at enteral feeding for severely underweight individuals who fail to gain weight with oral feeding may be warranted. • The use of TPNhas been described as a means of supplementation for AN patients who are refusing oral or nasogastric feeding.

  21. Prognosis and Outcomes • Outcome studies of AN and BN suggest that approximately: • 50% recover fully • 25% to 30% improve significantly • 15% to 20% continue to have unrelenting eating disorders • mortality rates: • 1% to 13% in AN • 0% to 3% in BN

  22. Thank you

More Related