Eating Disorders (Week 13) Flashcards
Eating disorders
- AnorexiaNervosa
- BulimiaNervosa
- Binge-eatingdisorder
Types of anorexia nervosa
- Restricting Type (Dont eat at all, eat very little, ritualistic eating habits)
- Binge-Eating/Purging Type (Restrictive + purging or laxatives or vomit)
Prevalance of AN
- More women than men (10:1 ratio)
- Bimodal occurrence of onset (early and late adolescence, ↑ diagnoses of women in their twenties/thirties)
- Likely many cases not diagnosed
4 main features of AN
- weight loss
- food restriction
- pursuit and maintenance of low body weight
- rituals
Types of bulimia nervosa
- purging type (eat a time of food and then purge/ vomit)
- nonpurging type
Five key feature of BN
- Often at or above “normal” weight
- Food takes on symbolic meaning
- purging is also addictive
- usually aware of their abnormal eating patterns
- related to strict and prolonged dieting
Medical complications of AN and BN
- dermatologic (lack of micronutrients, skin rashes)
- gastrointestinal (cells atrophy)
- cardiovascular (heart attack with low K)
- renal/electrolyte
- hematologic (not enough iron, SOB)
- metabolic
- endocrine
- CNS (tremors, seizures)
- Musculo-skeletal
- Dental
refeeding syndrome
feeding too fast after a period of starvation especially CHO
Risk for refeeding syndrome
Focus on high risk
* important to start low and go slow
* Often need extra thiamin to protect heart
* extra vitamins
* Low CHO delivery such as 40% to start
* Some need BW checked multiple times a day
* Want to avoid rapid accumulation.
* Slowly introduce new calories
Purpose of nutrition care AN & BN
- Must include physical, psychological, spiritual and social components
- To provide nutrition guidance that fosters a nourishing eating style and promotes normal physiologic function and physical activity
- To support eating behaviors that bring about a peaceful, satisfying relationship with food and eating
Goals for ED nutrition assessment
- To determine the level of malnutrition and muscle wasting
- To ascertain the level of eating disturbance based on food beliefs, present eating patterns, and purging behaviors
- To understand the weight, exercise and diet histories of clients
- Identify the clients goals for nutrition counseling
- Onset of concerns with food, weight and body shape
- Extent of nutrition knowledge and food beliefs that guide eating habits
- Food restrictions (especially entire groups)
- Calories “allowed” or “permitted”/meal or day
- Fluid intake (used to suppress hunger)
ED nutrition assessment
Patterns of binge-eating/purging
* onset and relation to other symptoms
* frequency
* related rituals
If binge eating
* time, location, duration, foods
* trigger environments/foods/emotions
If purging (behaviors)
* exercise, vomiting, laxatives, enemas, diuretics, emetic
* abuse of thyroid meds, diabetics not using insulin
ED treatment models
Always multi-disciplinary and treatment may involve combination of models
* Psychological: designed to address behavioral/history of disease
* Pharmacological: targets destructive behaviors that can be reduced through medication
* Addiction Model: belief that individuals with BED are addicted to physiological and/or psychological feelings associated with uncontrolled eating
What is binge eating disorder?
Recurrent episodes of binge eating in the absence of regular use of inappropriate compensatory behaviours characteristic of bulimia nervosa
Criteria for BED
- Recurrent episodes of binge eating
- The binge-eating episodes are associated with 3 features
- Marked distress regarding binge eating present
- The binge eating occurs, on average, at least 1 day/week for 3 months
- The binge eating is not associated with regular use of inappropriate compensatory behaviors (ie purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.
