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Eating disorder

eating disorder

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Eating disorder

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  1. Eating Disorders

  2. Learning objectives By the end of this lecture each student will be able to: • Differentiate among the various eating disorders. • Discuss epidemiological statistics related to eating disorders. • Describe symptomatology associated with anorexia nervosa, bulimia nervosa, and obesity, and use the information in client assessment. • Identify predisposing factors in the development of eating disorders. • Formulate nursing diagnoses and outcomes of care for clients with eating disorders • Describe appropriate interventions for behaviors associated with eating disorders.

  3. Introduction

  4. Definitions Eating Disorders Real, life-threatening illnesses with potentially fatal consequences. Involve extreme emotions, attitudes, and behaviors surrounding weight, food, and size. Caused by a range of biological, psychological, and sociocultural factors

  5. Who Do Eating Disorders Affect? • Everyone. People of all genders, ages, races, religions, ethnicities, and sexual orientations can be affected. • As many as 20 millionwomen and 10 million men will struggle with an eating disorder at some point in their lives.

  6. Epidemiological Factors • The disorder occurs predominantly in females 12 to 30 years of age. • Fewer than 10 percent of the cases are male. • Anorexia nervosa was once believed to be more prevalent in the higher socioeconomic Classes • Bulimia nervosa is more prevalent than anorexia nervosa, with estimates up to 4 percent of young Women

  7. Epidemiological Factors • Onset of bulimia nervosa occurs in late adolescence or early adulthood • Obesity statistics indicate that, among adults 20 years of age or older, 68.5 percent are overweight, with more than 35 percent of these in the obese range • The prevalence of obesity is greater among the lower socioeconomic group

  8. Predisposing Factors Associated with AnorexiaNervosa and Bulimia Nervosa Biological Influences • Genetics A hereditary predisposition to eating disorders has been hypothesized on the basis of family histories Anorexia nervosa is more common among sisters and mothers of those with the disorder

  9. Predisposing Factors Associated with AnorexiaNervosa and Bulimia Nervosa Neuroendocrine Abnormalities • Studies consistent with this theory have revealed elevated cerebrospinal fluid cortisol levels and a possible impairment of dopaminergic regulation in individuals with anorexia nervosa

  10. Predisposing Factors Associated with AnorexiaNervosa and Bulimia Nervosa Neurochemical Influences • Neurochemical influences in bulimia nervosa may be associated with the neurotransmitters serotonin and norepinephrine

  11. Predisposing Factors Associated with AnorexiaNervosa and Bulimia Nervosa Psychodynamic Influences • Psychodynamic theories suggest that eating disorders result from very early and profound disturbances in mother-infant interactions. • The result is delayed ego development in the child and an unfulfilled sense of separation-individuation.

  12. Predisposing Factors Associated with AnorexiaNervosa and Bulimia Nervosa Family Influences • Conflict Avoidance In the theory of the family as a system, psychosomatic symptoms, including anorexia nervosa, are reinforced in an effort to avoid spousal conflict. • Elements of Power and Control The issue of control may become the overriding factor in the family of the client with an eating disorder.

  13. Warning signs, symptoms, & health consequences

  14. EMOTIONAL/BEHAVIORAL Common Warning Signs • Weight loss, dieting, and control of food are primary concerns • Food rituals • Social withdrawal • Frequent dieting, body checking • Extreme mood swings

  15. Physical Common Warning Signs • Noticeable weight fluctuations • Gastrointestinal complaints • Dizziness upon standing • Difficulty concentrating, sleeping • Issues with dental, skin, hair, and nail health

  16. Anorexia Nervosa DSM-5 Diagnoses Prolonged loss of appetite. Characterized primarily by self-starvation and excessive weight loss. • Symptoms include: • Inadequate food intake leading to a weight that is clearly too low • Disturbance in the experience of body weight or shape • Intense fear of weight gain, obsession with weight, and persistent behavior to prevent weight gain • Inability to appreciate the severity of the situation

  17. Bulimia Nervosa (BN) DSM-5 Diagnoses • Characterized by binge eating and compensatory behaviors, such as self-induced vomiting, in an attempt to undo the effects of binge eating. Symptoms include: • Frequent episodes of consuming very large amounts of food followed by behaviors to prevent weight gain, such as vomiting, laxative abuse, and excessive exercise • Feeling of being out of control during the binge-eating episodes • Extreme concern with body weight and shape • Most people are of a normal weight

  18. Bulimia Nervosa (BN)

  19. Bulimia Nervosa (BN)

  20. Bulimia Nervosa (BN)

  21. Bulimia Nervosa (BN)

  22. Binge Eating Disorder (BED) DSM-5 Diagnoses • Characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating. • Symptoms include: • Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior • Feelings of strong shame or guilt regarding the binge eating

  23. Binge Eating Disorder (BED) DSM-5 Diagnoses

  24. Food Craving A food craving is an intense desire for a specific food. This desire can seem uncontrollable and may cause a person to crave typically unhealthy foods.

  25. Causes

  26. Causes

  27. Co-Occurring Disorders

  28. Health Consequences

  29. Serious, Potentially Fatal Illnesses

  30. Eating Disorders Treatment Ongoing Support Intervention Recovery Professional Treatment

  31. Treatment Modalities • Behavior Modification • Efforts to change the maladaptive eating behaviors of clients with anorexia nervosa and bulimia nervosa have become the widely accepted treatment.

  32. Treatment Modalities

  33. Treatment Modalities

  34. Treatment Modalities • Psychopharmacology

  35. Client/Family Education

  36. Client/Family Education MANAGEMENT OF THE ILLNESS 1. Principles of nutrition (foods for maintenance of wellness) 2. Ways client may feel in control of life (aside from eating) 3. Importance of expressing fears and feelings, rather than holding them inside 4. Alternative coping strategies (to maladaptive eating behaviors) 5. For the obese client: a. How to plan a reduced-calorie, nutritious diet b. How to read food content labels c. How to establish a realistic weight loss plan d. How to establish a planned program of physical activity 6. Correct administration of prescribed medications 7. Indication for and side effects of prescribed medications 8. Relaxation techniques 9. Problem-solving skills

  37. Questions ????

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