Eating Disorders

Eating Disorders

Disorders characterized by abnormal eating behaviors and attitudes towards food, often resulting in severe physical and psychological consequences.

Anorexia Nervosa

A life-threatening eating disorder characterized by severe restriction of food intake, intense fear of gaining weight, distorted body image, and refusal to acknowledge the seriousness of the problem.

Bulimia Nervosa

An eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging, fasting, or excessive exercise to avoid weight gain.

Binge Eating Disorder

An eating disorder characterized by recurrent episodes of binge eating without compensatory behaviors, leading to marked psychological distress and guilt.

Night Eating Syndrome

An eating disorder characterized by morning anorexia, evening hyperphagia, and nighttime awakenings to consume snacks, often associated with stress, low self-esteem, and adverse reactions to weight loss.

Orthorexia Nervosa

An obsession with proper or healthful eating, characterized by compulsive checking of ingredients, cutting out food groups, and excessive preoccupation with food and eating habits.

Comorbid Psychiatric Disorders

Commonly occurring psychiatric disorders alongside anorexia nervosa and bulimia nervosa, such as mood disorders, anxiety disorders, and substance abuse/dependence.

Biologic Factors

Factors related to genetics, neurochemical changes, and disruptions in the hypothalamus that may contribute to the development of eating disorders.

Developmental Factors

Factors related to adolescence, such as the struggle for autonomy and the establishment of a unique identity, that may contribute to the development of eating disorders.

Maintenance

Refers to families that do not support members' efforts to gain independence, leading to feelings of little or no control over their lives.

Control through severe dieting

Teens with disordered eating may use severe dieting as a way to gain control over their weight and exert control over one aspect of their lives.

Risk factors for developing eating disorders

Identifying potential risk factors, such as body dissatisfaction, can help target prevention programs to those at highest risk.

Body image disturbance

Occurs when there is an extreme discrepancy between one's own body image and how others perceive them, leading to extreme dissatisfaction with one's body image.

Family influences

Growing up in families with problems and abuse can increase the risk of developing eating disorders as disordered eating becomes a distraction from negative emotions.

Sociocultural factors

The media's portrayal of thinness as attractive, along with cultural beliefs equating thinness with beauty and success, can contribute to the development of eating disorders.

Cultural considerations

Eating disorders are more prevalent in industrialized societies where thinness is idealized, but can also increase in non-Western cultures as the Western ideal spreads.

Anorexia nervosa

An eating disorder characterized by a negative body image, control over weight, social isolation, and a high risk of medical complications or suicide.

Treatment and prognosis for anorexia nervosa

Treatment settings depend on the severity of the illness, and weight restoration, nutritional rehabilitation, and psychotherapy are key components of treatment.

Bulimia nervosa

An eating disorder characterized by episodes of binge eating followed by purging behaviors, often initiated after restrictive eating.

Onset and clinical course of bulimia nervosa

Bulimia nervosa typically begins in late adolescence or early adulthood, and clients go to great lengths to hide their eating behaviors from others.

Bulimia

A eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging or excessive exercise.

Untreated

Refers to clients with bulimia who have not received any form of treatment for their disorder.

Cognitive-Behavioral Therapy (CBT)

A type of therapy that is considered the most effective treatment for bulimia, focusing on changing the client's thoughts and behaviors related to food, weight, body image, and self-concept.

Psychopharmacology

The use of medications, primarily antidepressants, to treat bulimia. These medications have been found to be more effective than placebos in reducing binge eating and improving mood, but the positive results are often short-term.

Self-Concept

Refers to the way individuals perceive and evaluate themselves. In clients with eating disorders, low self-esteem and a focus on controlling food intake and weight are prominent.

Nutritional Rehabilitation

The process of establishing normal eating patterns and ensuring adequate nutrition in clients with eating disorders, often through inpatient treatment for severely malnourished clients with anorexia or for clients with bulimia whose behaviors are out of control.

Connections between emotions and eating behaviors

Clients begin to see the relationship between their emotions, situations, and their eating behaviors.

Managing emotions

The nurse helps clients develop techniques such as relaxation and distraction to manage emotions, particularly anxiety, without resorting to food.

Body image acceptance

The nurse assists clients in accepting a more normal body image, which may involve weighing more than desired for the sake of health and staying out of the hospital.

Viewing oneself beyond weight and body image

The nurse helps clients identify personal strengths, talents, and positive aspects of character that are unrelated to body shape or size.

Client and family education

The nurse provides education to clients and their families about basic nutritional needs, the harmful effects of restrictive eating and purging, setting realistic goals for eating, and accepting a healthy body image.

Evaluation of treatment progress

The nurse uses assessment tools to evaluate improvement in clients with eating disorders, such as the Eating Attitudes Test, and considers treatment successful if the client maintains a body weight within 5% to 10% of normal with no medical complications.

Community-based care

Treatment for eating disorders typically occurs in community settings, including inpatient, outpatient, and day treatment programs, as well as self-help groups.

Mental health promotion

Nurses can educate parents, children, and young people about strategies to prevent eating disorders, including developing realistic ideas about body size and shape, resisting peer pressure to diet, improving self-esteem, and learning coping strategies for emotions and life issues.

Self-awareness issues

Nurses need to be aware of their own reactions and emotions when working with clients with eating disorders, avoiding personalizing the client's behavior and maintaining empathy and nonjudgmental attitudes.

Points to consider when working with clients with eating disorders

Nurses should be empathetic, avoid sounding parental when teaching about nutrition, and refrain from labeling clients as "good" or "bad" based on their eating behaviors.