Eating Disorders Flashcards
are characterized by a repeated disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly diminishes physical health or psychosocial functioning.
Eating disorders
can be viewed on a continuum, with clients with anorexia nervosa eating too little or starving themselves, client with bulimia eating chaotically, and clients with obesity eating too much.
Eating disorders
Although many believe that eating disorders are relatively new, documentation from the Middle Ages indicates willful dieting leading to self-starvation in female saints who fasted to achieve
Purity
In the late 1800s, doctors in England and France described young women who apparently used
self-starvation to avoid obesity
that anorexia nervosa was established as a mental disorder
1960’s
Bulimia nervosa was first described as a distinct syndrome in
1979
life-threatening eating disorder characterized by the client’s refusal or inability to maintain a minimally normal body weight, intense fear of gaining weight or becoming fat, significantly disturbed perception of the shape or size of the body, and steadfast inability or refusal to acknowledge the seriousness of the problem or even that one exists.
Anorexia Nervosa
is an eating disorder characterized by recurrent episodes (at least twice a week for 3 months) of binge eating followed by inappropriate compensatory behaviors to avoid weight gain such as purging, fasting, or excessively exercising.
Bulimia Nervosa
characterized by recurrent episodes of binge eating but it is not associated with the recurrent use of inappropriate compensatory behaviours as in bulimia nervosa, and does not occur exclusively during the course of bulimia nervosa, or anorexia nervosa methods to compensate for overeating, such as self-induced vomiting.
Binge eating Disorder
involves persistent eating of non-nutritive substances such as hair, dirt, and paint chips for a period of at least one month.
Pica
repeatedly and persistently regurgitating food after eating, but it’s not due to a medical condition or another eating disorder such as anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder
Rumination disorder
persistent failure to meet appropriate nutritional or energy needs due to having no interest in eating regarding food with certain sensory characteristics, such as color, texture, smell or taste; or fear of choking.
Avoidant/Restrictive Food Intake Disorder (ARFID)
are eating behaviors that cause clinically compelling distress and impairment in areas of functioning, but do not meet the full criteria for any of the other feeding and eating disorders.
Other Specified Feeding or Eating Disorder (OSFED).
A specific cause for eating disorders
Unknown
may be the stimulus that leads to their
development of ED
Dieting
Studies of anorexia nervosa have shown that these disorders tend to run in families; genetic vulnerability also might result from a particular personality type or a general susceptibility to psychiatric disorders.
Biologic factors
Onset of anorexia nervosa usually occurs during
adolescence or young adulthood
Onset of anorexia nervosa usually occurs during adolescence or young adulthood; some researchers believe its causes are related to developmental issues.
Developmental factors
Girls growing up amid family problems and abuse are at higher risk for both anorexia and bulimia; disorders eating is a common response to family discord.
Family influences
Adolescents often idealize actresses and models as having the perfect “look” or body even though many of these celebrities are underweight or use special effects to appear thinner than they are; pressure from others also may contribute to eating disorders.
Sociocultural factors
has been identified as a major health problem in the United States; some call it an epidemic.
Obesity
normal-weight people with bulimia have a history of anorexia nervosa and low body weight,
30% to 35%
% of people with anorexia nervosa exhibit bulimic behavior.
50%
% of cases of anorexia nervosa and bulimia occur in females
More than 90%
The prevalence of both eating disorders is estimated to be — of the general population in the United States.
1% to 3%
Inflexible thinking.
Anorexia Nervosa
Cold intolerance.
Anorexia Nervosa
Emaciation.
Anorexia Nervosa
Hypotension, hypothermia, bradycardia.
Anorexia Nervosa
Hypertrophy of salivary glands.
Anorexia Nervosa
Leukopenia and mild anemia.
Anorexia Nervosa
Elevated liver function studies.
Anorexia Nervosa
Elevated BUN.
Anorexia Nervosa
Compensatory behavior
Bulimia Nervosa
within normal weight range, possible underweight or overweight.
Bulimia Nervosa
Possible substance use involving alcohol and stimulants.
Bulimia Nervosa
Metabolic alkalosis (from vomiting)
Bulimia Nervosa
Fluid and electrolyte abnormalities.
Bulimia Nervosa
metabolic acidosis (from diarrhea)
Bulimia Nervosa
Mildly elevated serum amylase levels.
Bulimia Nervosa
Assessment and Diagnostic Findings
Physical and mental status evaluation.
CBC
Blood chemistries
Liver function tests
CBC
Hemoglobin are ↑ if dehydrated
↓ WBC due to margination
Thrombocytopenia
Blood chemistries
Hyponatremia
Hypokalemia
Hypoglycemia
↑BUN
*Hypokalemic hypochloremic metabolic alkalosis
Acidosis
reflects excess water intake or the inappropriate secretion of antidiuretic hormone
Hyponatremia
results from diuretic or laxative use
Hypokalemia
results from the lack of glucose precursors in the diet or low glycogen stores; may also be due to impaired insulin clearance
Hypoglycemia
renal function is generally normal except in patients with dehydration
↑ BUN
observed with vomiting
Hypokalemic hypochloremic metabolic alkalosis
observed in cases of laxative abuse
Acidosis
are minimally elevated, but levels encountered in patients with active hepatitis are not observed
Liver function test
levels are usually normal, because although the amount of food intake is restricted, it usually contains high-quality –
Albumin and protein
Clients receive nutritionally balanced meals and snacks that gradually increase caloric intake to a normal level for size, age, and activity.
Nutritional rehabilitation and weight restoration
Individuals with anorexia nervosa may respond best to this treatment,
Family-based therapy
an established therapeutic modality for achieving and maintaining remission from anorexia nervosa.
Maudsley method
an evidence-based, effective treatment for bulimia nervosa (BN); behavioral approaches to avoiding undesirable eating habits are used
Cognitive behavioral therapy
behavioral approaches to avoiding undesirable eating habits
diary keeping; behavioral analyses of the antecedents, behaviors, and consequences (so-called ABCs)
addresses specific issues in the interpersonal arena that create the context for and stimulate dynamic tensions that spur the patient’s symptoms; these generally encompass such processes as grief, role transitions, role conflicts or disputes, and interpersonal deficits.
Interpersonal psychotherapy
Pharmacologic Management
Electrolyte supplements
Fat-soluble vitamins
Antidepressants, SSRIs
is necessary in patients with profound malnutrition, dehydration, and purging behaviors, my be done orally or parenterally, depending on the patient’s clinical state.
Electrolyte repletion
are used to meet necessary dietary requirements. They are utilized in metabolic pathways, as well as in deoxyribonucleic acid (DNA) and protein synthesis.
Fat soluble vitamins
These agents have been reported to reduce binge eating, vomiting, and depression and to improve eating habits, although their impact on body dissatisfaction remains unclear.
Anti depressant, SSRI
perfectionists with above-average intelligence, achievement oriented, dependable, eager to please, and seeking approval before their condition began
Anorexia Nervosa
often have a history of impulsive behavior such as substance abuse, shoplifting, as well as anxiety, depression, and personality disorders
Bulimia Nervosa
appear slow, lethargic, and fatigued; they may be emaciated depending on the amount of weight loss
Anorexia Nervosa
may be underweight or overweight but are generally close to expected body weight for age and size.
Bulimia Nervosa
Clients with eating disorders have — moods that usually correspond to their eating or dieting behaviors.
Labile
Clients with eating disorders spend most of the time thinking about dieting, food, and food-related behavior.
Though processes and content
Self concept that is prominent in clients with eating disorders
Low self-esteem
