NUR 448

Eating Disorders

Theoretical Perspectives

HistoricalCulturalPsychoanalyticFamily systemsBehavioralFeministPhysiologic

Psychological factors

Developmental levelPersonality componentAffective componentInteraction with culture or socio-economic

class

Major disorders

Anorexia nervosaBulimia nervosaBinge eating disorderMorbid obesity

Anorexia Nervosa

Anorexia nervosa

Refusal to maintain body weight Weight less than 85% of expectedIntense fear of gaining weightAmenorrhea for three monthsLanugo, dysrhythmias, anxiety, Upper SECTypes

restricting type binge-eating/purging type

Types

Restricting –refusal to eatBinge-eating purging- eating small amount s

of food and purging

Signs

Laboratory Decreased BUN Hypokalemia Hyponatremia Hypochloremia Increased liver function tests

Physical Bradycardia

Bulimia nervosa

Recurrent episodes of binge eating eating within a discrete period of time a larger than

normal amount of food lack of control over eating

Recurrent compensatory behavior vomiting, misuse of diuretics, laxatives, enemas,

fasting or exercise Purging type Non-purging type

Types

Purging –induced vomiting laxatives diureticsNon-purging-ingesting large amounts of food

followed by abstinence or excessive exercise

Bulimia Nervosa

Signs

Laboratory Hypokalemia Hyponatremia HypochloremiaPhysical

Loss of tooth enamelEnlarged parotid glands

Binge eating disorder

Recurrent episodes of binge eatingRapid eating, eating until uncomfortableEating alone, being disgusted with eating

eating within a discrete period of time a larger than normal amount of food

lack of control over eating

Morbid Obesity

Eating massive amounts of food for long periods of time

Worry over money to buy foodObsession with foodClinical depression when on a weight loss

program

Nursing Diagnoses

Individual Individual coping ineffective Body image disturbance-view themselves as fat Disturbance in self esteem

Family Enmeshed Over protectiveness Conflict avoidance

Anorexia-Nursing intervention

Positive reinforcementFocus is on feelings and growthDevelopmental issuesControl issues ****Supportive life saving measures as necessary

Bulimia-Nursing intervention

Positive reinforcementControl impulsivenessAssist with not acting outSafety measures as needed

Morbid obesity-Nursing intervention

Positive reinforcementExercise programLong term supportive psychotherapyBiopsychology support

Morbid Obesity

Questions

What are the age characteristics of people with eating disorders?

What are the cultural issues of eating disorders?

What is a culture bound syndrome?