Eating Disorders Flashcards
appetite regulation center
hypothalamus
eating behaviors are influenced by:
society
culture
more prevalent: bulimia nervosa or anorexia nervosa
bulimia nervosa
obesity has been defined as BMI of:
30 or greater
symptoms of anorexia nervosa
amenorrhea
feelings of anxiety or depression
gross distortion of body image
preoccupation with food
refusal to eat
hypothermia
bradycardia
hypotension
edema
lanugo
metabolic changes
weight loss for anorexia nervosa
usually more than 15% of expected weight
reasons for weight loss in anorexia nervosa
Reduction of food intake
Extensive exercising
Possible self-induced vomiting
Possible abuse of laxatives or diuretics
episodic, uncontrolled, compulsive , rapid ingestion of large quantities of food over a short period
binging
sign of bulimia nervosa
binging is followed by:
purging behaviors to rid body of excess calories
symptoms of purging behaviors
Self-induced vomiting or the misuse of laxatives, diuretics, or enemas
Inappropriate and compensatory behaviors
weight with bulimia nervosa
within a normal weight range, some slightly underweight, and some slightly overweight
symptoms assessed with bulimia nervosa
fasting
excessive exercise
depression
anxiety
substance misuse
excessive vomiting
laxative or diuretic abuse
dehydration and electrolyte imbalances
Individual binges on large amounts of food, as in bulimia nervosa
binge eating disorder
how does binge eating disorder differ from bulimia nervosa
individual does not engage in behaviors to rid the body of the excess calories
percentage of individuals with binge eating disorder have history of:
depression
genetic predisposing factors for eating disorders
Hereditary predisposition to eating disorders possible
Anorexia nervosa is more common among sisters and mothers of those with disorder
Possible chromosomal linkage sites
Primary hypothalamic dysfunction in anorexia nervosa
Neuroendocrine abnormalities
Bulimia nervosa may be associated with serotonin and norepinephrine
Anorexia nervosa may be associated with high levels of endogenous opioids
Neurochemical influences
BMI range for normal weight
20-24.9
anorexia nervosa is BMI of
17 or less
less than 15 in extremes
BMI equation
weight (kg) / height (m2)
outcomes for clients in eating disorders
Has achieved and maintained at least 80% of expected body weight
Has vital signs, blood pressure, and laboratory serum studies within normal limits
Verbalizes importance of adequate nutrition
Verbalizes knowledge regarding consequences of fluid loss caused by self-induced vomiting (or laxative/diuretic abuse) and importance of adequate fluid intake
Verbalizes events that precipitate anxiety and demonstrates techniques for its reduction
planning and implementation where hospitalization may be necessary
Malnutrition
Dehydration
Severe electrolyte imbalance
Cardiac arrhythmia or severe bradycardia
Hypothermia
Hypotension
Suicidal ideation
planning and implementation for imbalances nutrition/deficient fluid volume
Determine appropriate calories to provide adequate nutrition and weight gain
Do not focus on food and eating specifically
Keep a strict record of intake and output
Goals and interventions
planning and implementation for Disturbed body image/low self-esteem
Promoting feelings of control
Helping identify positive attributes
Goals and interventions
evaluation for the client with anorexia nervosa or bulimia nervosa
Is the client free of signs and symptoms of malnutrition and dehydration?
Have there been any attempts to self-induce vomiting?
Has the client admitted that a problem exists and that behaviors are maladaptive?
Evaluation for the client with binge eating disorder and associated obesity
Has the client shown a steady weight loss since starting the new eating plan?
Does the client verbalize a relapse prevention plan to avoid triggers and abstain from binging?
Evaluation for the client with anorexia, bulimia, or binge eating disorder
Has the client been able to develop a more realistic perception of body image?
Has the client acknowledged that past self-expectations may have been unrealistic?
successes for treatment of eating disorders have been observed when the client:
Is allowed to contract for privileges based on weight improvement
Has input into care plan
Clearly sees possible treatment choices
individual therapy as treatment for eating disorders
Helpful when underlying psychological problems are contributing to maladaptive behaviors
Not therapy of choice for clients with eating disorders
family therapy as treatment for eating disorders
Maudsley approach-positive parent role
Involves educating the family about disorder
Assesses family’s impact on maintaining disorder
Assists in methods to promote adaptive functioning by client
Medications that have been tried with some success for anorexia nervosa:
Fluoxetine (Prozac)
Clomipramine (Anafranil)
Cyproheptadine (Pariactin)
Chlorpromazine (Thorazine)
Olanzapine (Zyprexa)
Medications that have been tried with some success for bulimia nervosa:
Fluoxetine (Prozac)
Imipramine (Tofranil)
Desipramine (Norpramine)
Amitriptyline (Elavil)
Nortriptyline (Aventyl)
Phenelzine (Nardil)
Medication that has been tried with some success for BED with obesity
Topiramate (Topamax)
Medications that have been tried with some success for obesity:
Fluoxetine (Prozac)
Various anorexiants (central nervous system stimulants)
Lorcaserin (Belviq)
Phentermine/topiramate (Qsymia)
