1229 Exam 6: Eating Disorders Flashcards
Anorexia Nervosa
an eating disorder marked by weight loss, emaciation, a disturbance in body image, and fear of gaining weight
Bulimia Nervosa
a disorder marked by recurrent episodes of binge eating, self induced vomiting and diarrhea, excessive exercise, strict dieting or fasting, and an exaggerated concern about body shape and weight
Binge Eating
a form of compulsive overeating w/ episodes of binge eating occur. Some authorities do not consider it a separate form of compulsive eating disorder
Not otherwise specified (NOS)
an eating disorder that contains some but not all of the criteria to meet a specific disorder
Read pg 306 for criteria of NOS
4 Theory Types of Eating disorders
Neurobiological Psychological Sociocultural Genetic Theses are the 4 types of theories and significance of each has evolved over time and remain in a state of flux
Neurobiological Theory
more evidence is in favor for biological cause for some eating disorder, especially Bulimia and Anorexia
Serotonin is becoming more likely suspect in the cause of most eating disorders
REMEMBER
Eating disorders are not considered specific diseases but are syndromes
Psychological Theory
This is the weakest theory based on studies
The currently accepted psychopathology in eating disorders is low self esteem and doubts about self worth.
Sociocultural Theory
The world has an idea that the thinner a woman is the more desirable she is. Culture has a very strong influence on females in the US. Culture plays a large role in the increase in eating disorders
Genetic Theory
There is a strong link in genetics in all eating disorders, studies on families with anorexia and bulimia have revealed strong genetic links to eating disorders, the stronger the evidence becomes that genetics play a major role
Characteristics of Anorexia and Bulimia
fear of weight gain
have body image distortions
low self esteem issues
have high incidence of depression
more prevalent in metro areas than rural areas
affect about the same percentage of females vs males: about 9-1 females
S/S of Anorexia
extreme weight loss
thin appearance (emaciated in extreme cases)
abnormal blood counts (anemia & leukopenia)
Fatigue (usually a later symptom)
Insomnia
Dizziness or fainting
A bluish discoloration of the fingers
Brittle nails
Hair that thins, breaks or falls out
Soft, downy hair covering the body (lanugo)
S/S Anorexia cont..
Absence of menstruation Constipation Dry Skin Intolerance of cold Irregular heart rhythms (electrolytes) Low BP Dehydration Osteoporosis Swelling of arms or legs (decreased albumin)
S/S of Bulimia
Feeling that cant control eating behavior
Eating until the point of discomfort or pain
Eating much more in a binge episode than in a normal meal
Self induced vomiting after eating
Exercising excessively
Misuse of laxatives, diuretics or enemas
Being preoccupied with body shape and weight
Going to bathroom after or during meals
Abnormal bowel function
Damaged teeth and gums
Sores in throat and mouth (anorexics too)
Dehydration
S/S Bulimia cont..
Irregular heartbeat
Sores, scars or calluses on the knuckles or hands
Menstrual irregularities or loss of menstruation (amenorrhea)
Depression
Anxiety
Bulimia may be categorized in two ways:
Purging Bulimia-regularly engage in self induced vomiting or the misuse of laxatives, diuretics or enemas too compensate for binges
Non Purging Bulimia- use other methods to rid yourself of calories and prevent weight gain, such as fasting or over exercising
Treatment
Milieu Therapy-controlled or inpatient environment with a team of health care professionals that usually include psychiatrist, psychologist, or therapist
It is best if treated in a specialized clinic for eating disorders
Psychiatrist or Psychiatric Nurse Pract. will manage overall care, including meds and therapies.
Comparison between Anorexia and Bulimia
Anorexia’s fear eating, Bulimics don’t fear eating but panic if they can’t purge
Co morbidity with clinical depression is common in both around 50%
Both on the increase among teen girls, increase in males in the past 2-3 decades
Clinical care for clients whose weight is below 75% of ideal body weight takes priority
Medical Care
First focus is the clients physical well being
Suicide precautions are routine on admission
Restoring weight to a more normal level is first priority
Central coordinator of care for an eating disorder client is almost always the RN
Complications
Observe for s/s of electrolyte imbalance, heart arrhythmias, low BP, check if cold, Re-feeding syndrome
Re-feeding Syndrome
a rare but serious complication seen in victims of starvation when they start to feed
Rare in clinical settings
Occurs in clients who are starved or severely malnourished
usually occurs in 4 days or less from start of feeding
Symptoms of Re-feeding syndrome
confusion, lethargy, convulsions, severe bradycardia
Binge Eating Treatment
Cognitive Behavioral Therapy-focuses on dysfunctional thoughts and behaviors involved in binge eating
Interpersonal Psychotherapy- focuses on the relationship problems and interpersonal issues that contribute to compulsive eating
Dialectical Behavior Therapy-combines cognitive behavior techniques with meditation, teaching how to accept themselves, tolerate stress, and regulate emotions
Drugs used in Binge Treatment
Drugs most be in conjunction with therapy
Useful in treating the depression associated with binge eating
Best effective treatment is a combined medical and psychological regimen
Effective meds are Paxil, Prozac & Zoloft
With proper therapy a high percentage recover
