Eating disorders Flashcards
What is anorexia nervosa?
Body image distortion occurs when person perceives their body different than how society views it. They have a drive for thinness that overrides other physiological body cues and have a fear of becoming fat.
What is interoceptive awareness?
Term used to describe sensory response to emotional/visceral cues like hunger
Epidemiology in AN?
Occurs accross lifespan, increase risk among 1st degree relatives, onset in adolescence/early adulthood, associated with stressful transition, occurs mostly in women, comorbid with mood/anxiety disorders, age of onset 14-16 yrs, culturally defined weight expectation
What is social comparison?
Evaluate oneself against idealized others like models
What is body dissatification?
Belief that one’s body differs from ideal body size and causes negative appraisal (I feel fat). It can lead to purging, binge eating, dieting, and low self esteem.
Biological, spiritual, social, and psychological risk factors for AN?
B- dieting, altered metabolic rate, hx of overweight, over exercising
S- need for greater purpose
P- low self esteem, body dissatisfaction, sexual abuse, feelings of ineffectiveness
Social- media, fashion industry, focus on ideal body type, peer pressure, family attitudes, cultural
Treatment goals for AN?
Initiate nutritional rehab, increase effective coping, resolve conflict around body image, meds if necessary, and address underlying conflict.
Biological domain- assess, dx, interventions
A- evaluate systems, hx with patient/family, determine weight with BMI, menses hx, sleep pattern
D- inadequate nutritional status, sleep disturbance, less than body requirements
I- refeeding, monitor/record intakes, sleep hygiene, weight increasing protocols, exercise not permitted
Psychological domain- assess, dx, interventions
A- low weight, eating attitude test, unrealistic expectations/thinking, ritualistic behaviours
D- anxiety, disturbed body image
I- normalize shame experience, encourage journaling, indemnify/understand feelings, imagery/relaxation, psychotherapy, restructure cognitive distortions
Social- assessment, dx, interventions
A- school attendance, family interaction
Dx- social isolation, infective coping
I- facilitate transition to school, family therapy, family education
Spiritual domain?
Need to move forward (establish trust, rapport, consistency). Support client while enabling them to voice and make meaning of their eating disorder
What is bulimia nervosa?
Episodes of binge eating with lack of control, then self induced vomiting/use of laxative/enemas/diuretics/fasting/strict diets/excessive exercising after eating. They are preoccupied with weight/body shape/self perceived flaws.
BN cycle?
Hunger - binge eat - shame/humiliation - diet/purge via vomiting etc.
What is dietary restraint?
Effort to restrict food intake for weight loss/prevent weight gain. This was originally described to explain difference between eating patterns of obese people and those of a healthy weight
Epidemiology of BN?
More prevalent in men, r/t western culture social values, onset in adolescence/early adulthood (older than AN), comorbid disorders (substance use, depression, anxiety), 1st degree relative who had it=more likely to developed it
Nursing management for BN?
Focus on inadequate nutrition, malnourishment, anxiety, inability to exercise personal control, difficulties managing social expectation. They feel shame/guilt and have intense need to please others and be liked.
Biological- A, D, I
A- similar to AN, binging/purging behaviour
D- poor nutritional status, sleep disturbances
I- pharmalogic, nutrtion counselling
Psychological domain BN?
Assess cognitive distortions and body dissatisfaction. Interventions- CBT in group/self help, behavioural techniques
True or false: those with BN are less likely to require hospitalization
True
Psychosocial domain BN?
Psychoeducation, understand binge/purge cycle, misuse of laxative/diuretics. Assess family, group therapy,
Spiritual domain BN?
Assess expression of loss/powerlessness, self care capacity, quality of relationships, self judgements, hx of traumatic experiences, attitudes about food.
I- encourage to express feelings, journal writing, meditation, imagery, affirming positive self worth
What is binge eating disorder (BED)?
Ingestion of large amount of food in short period of time. They have loss of control during binge and eat until uncomfortably full. No purging involved. Feelings of guilt/depression following binge. BED associated with someone who’s overweight. They have lower dietary restraint. May miss social activities/work to binge eat.
Epidemiology of BED?
Beings in late adolescence and early adulthood, more prevalent in females, western culture influence, may run in families, outpatient care setting. Comorbid medical conditions are diabetes, HTN, pain conditions, and sleep problems. Comorbid disorders are substance use/mood.
Goals of treatment for BED?
Reduce binge eating, maintain weight loss, restructure dysfunctional thinking, alleviate comorbid depression anxiety, and address harassment.
Nursing focus of management for BED?
Excessive calorie intake, decreased energy, inability to engage in personal care amities/sustain actions to meet health needs, difficulty managing social expectation.
Biological domain BED?
Assess- binge eating patterns, symptoms of gastric distress, physical mobilty, activity, sleep pattern
Dx- altered nutrition, risk for overweight BMI, altered mobility, activity intolerance
I- food diary, pharmacological
Psychosocial domain BED?
A- cognitive distortions, knowledge deficits, dissociation
Dx- anxiety, knowledge deficit, connection with other/society
I- CBT, family support, psychoeducation
Spiritual domain BED?
A- self judgement/self acceptance, enable client to describe painful traumatic experiences
Dx- dissatisfaction with life, loss of self identity, loss of self worth
I- counselling, support
True or false: BED may have more favourable remission rate than other eating disorders
True
Criteria for AN?
Have significantly low body weight, intense fear of gaining weight/becoming fat, disturbance in the way one’s body and weight is experienced.
2 types of AN?
- Restricting
- Binge purge
