eating disorders

eating disorders

29 million people dx in the US

highest mortality rates of any psychiatric disorder

comorbidity

secondary conditions

other s/s

anorexia nervosa

a restriction of caloric intake relative to body requirements

have an intense fear of gaining weight or becoming overweight

have persistent behaviors that focus on not gaining weight

do not generally lose their appetite

age at dx is between 10 and 14

majority occurrence in women, but cases in males has been increasing

anorexia s/s

objective:

• deliberate weight loss

• two groups: restricting and purging

• competitive, compulsive, obsessive about activities

• insomnia

subjective:

• concerned about being overweight

• rather be dead than fat

• psychological symptoms r/t semi starvation- irritability, obsessions, social withdrawal

etiology of anorexia

biological, sociocultural, family, cognitive, behavioral, psychodynamic

bulimia nervosa

recurrent episodes of binge eating

continuing inappropriate compensatory behaviors to avoid weight gain

an evaluation of self that is significantly influenced by body weight and shape

peak onset between 15 and 19

bulimia s/s

objective:

• binge eating and purging behavior

• normal body weight

• binging episodes end when they induce vomiting, are physically exhausted or have run out of food

• fluid and electrolyte imbalances

• laxative abuse

• erosion of dental enamel

• russell’s sign

subjective:

• gravely concerned about body image

• anxiety

• fear

• mood irregularities/disorders

bulimia etiology

biological, sociocultural, family, cognitive, behavioral, psychodynamic

similarities of anorexia and bulimia

restriction of intake at times, especially anorectics

binging or overeating at times, especially bulimics

purging through vomiting, laxatives, or diuretics

over exercise

perfectionistic traits

belief that self worth is based on appearance

discomfort in social settings

misperception of body size, shape, and level of fat

low self esteem

differences of anorexia and bulimia

anorexia- early onset, very low weight, hormonal imbalance, fluid and electrolyte imbalances, constipation if not using laxatives

bulimia- later onset, more normal weight, fluid and electrolyte imbalance, GI problems related to binging and purging

eating disorders in men

increasing cases

men and women similar regarding weight and comorbidities

tx is similar to women, but with slightly different focus

nursing interventions

monitor daily caloric intake and electrolyte status while in hospital

monitor activity level

weight daily

dietary consultation

support groups

promote positive self concept

listen empathetically

encourage regular eating patterns