Eating Disorders

Question 1

Eating Disorders

Answer 1

pattern of dysfunctional food intake

Question 2

Eating Disorders: Etiology

Answer 2

specific cause is unknown

genetics: bulimia and anorexia tend to run in families

developmental factors: autonomy may be difficult for the adolescent w/ an overprotective family

family influence: hx of abuse

sociocultural: media influence
* anorexia and bulimia are more prevalent in industrialized societies where food is abundant, and thinness is linked to beauty

Question 3

Anorexia Nervosa

Answer 3

perception of self as significantly overweight when they are significantly underweight (objectively)

self perception is distorted

insight is poor

Question 4

Anorexia Nervosa: Onset and Clinical Course

Answer 4

onset: 14-18YO

early stages: see denial as defense mechanism

see isolation and depression growing w/ progression of disorder

complex medical problems w/ progression

6x more likely to die from medical complications or suicide compared to general population

Question 5

Anorexia Nervosa: Dx

Answer 5

• restriction of energy intake
• intense fear of gaining weight, becoming fat, behavior that interferes w/ weight gain
• undue influence of body weight on self-evaluation
• lack of acknowledgement about seriousness of low body weight

two types:

• restricting
• binge-eating/purging

Question 6

Anorexia Nervosa: Restricting Type

Answer 6

weight loss is accomplished through dieting, fasting, excessive exercise

Question 7

Anorexia Nervosa: Binge-eating/Purging Type

Answer 7

Recurrent episodes of binge eating or purging behaviors (self-induced vomiting, misuse of laxatives, diuretics, enemas)

Question 8

Anorexia Nervosa: Physical Problems

Answer 8

• Amenorrhea
• Constipation
• Loss of body fat
• Muscle atrophy
• Hair loss
• Cardiac! Arrhythmias- heart failure- bradycardia
• Electrolyte imbalances – hypokalemia/hypoglycemia
• Renal- dehydration-kidney damage

Question 9

Anorexia Nervosa: Medical Management

Answer 9

• weight restoration
• nutritional rehab
• rehydration
• correction of electrolyte imbalances

Question 10

Anorexia Nervosa: Tx

Answer 10

• Medication: amiltryptiline, olanzapine, fluoxetine (keep in mind that SSRI’s can cause weight loss)
• Therapy: CBT, family therapy
• Contraindications: Welbutrin b/c there is increased for seizures and SE is weight loss

Question 11

Bulimia Nervosa

Answer 11

recurrent episodes of bing eating (eating in discrete period of time, lack of control over the eating)

recurrent compensatory behaviors to prevent weight gain

occur at least once a week for 3 months

self evaluation is influenced by. body shape and weight (effects self-esteem)

Question 12

Bulimia Nervosa: Onset and Clinical Course

Answer 12

onset: late adolescence/early adulthood

insight that eating behavior is pathologic

usually maintain an average weight

Question 13

Bulimia Nervosa: Tx

Answer 13

• meds: antidepressants (usually SSRIs)

- Therapy: CBT

Question 14

Bulimia Nervosa: Co-occurring Disorders

Answer 14

• mood disorders
• anxiety
• SUD
• depression more common
• link between bulimia and BPD
• link to hx of sexual abuse

Question 15

Binge Eating Disorder

Answer 15

• periods of binge eating averaging once a week for three months
• rapid consumption of food while unable to control behavior
• may be overweight
• no purging behavior

Question 16

Binge Eating Disorder: Nursing Diagnoses

Answer 16

• imbalanced nutrition
• ineffective coping
• disturbed body image
• chronic low self-esteem