Anorexia and Bulimia

Anorexia Nervosa

• Definition: Anorexia nervosa is characterized by an intense fear of gaining weight, leading individuals to starve themselves.

Causes of Anorexia Nervosa

• Hereditary Factors:

  • Eating disorders often run in families.

  • If a woman has an eating disorder, her daughter is likely to develop one due to observing those behaviors.

• Psychological Factors:

  • Mental disorders such as depression can contribute.

  • Drug addiction and alcoholism may be linked to anorexia.

Symptoms of Anorexia Nervosa

• Physical Symptoms:

  • Dizziness

  • Fainting

  • Fast weight loss

• Psychological Symptoms:

  • Intense fear of gaining weight, akin to a phobia.

  • Mood swings, depression, and cognitive impairment.

• Behavioral Signs:

  • Consuming very small portions of food (e.g., one carrot or piece of lettuce).

  • Potentially includes some binge and purging behaviors, but not as consistently as seen in bulimia.

• Physiological Effects:

  • Amenorrhea (absence of menstruation) due to body fat levels being too low to regulate menstrual cycles.

  • Sleep disorders.

Physiological Impact on the Body

• General Effects:

  • Changes in brain chemistry leading to cognitive issues.

  • Hair becomes thin, brittle, and may fall out due to lack of nutrients.

  • Skin may bruise easily, appear dry and yellow.

  • Development of fine body hair (lanugo) as a response to starvation.

  • Prone to feeling cold easily, due to diminished body fat.

  • Low birth weight in babies of pregnant individuals with anorexia; higher risk of miscarriage.

  • Potential for bone loss and difficulties with growth and pregnancy.

Bulimia Nervosa

• Definition: Bulimia nervosa involves episodes of eating large amounts of food followed by purging (vomiting).

Characteristics of Bulimia Nervosa

• Binge Eating:

  • Consuming a large amount of high-calorie, soft foods that are easier to purge.

  • Usually occurs in isolation or secrecy.

• Purging Behaviors:

  • Feelings of guilt and anxiety after binge eating lead to purging.

  • Purging typically happens 20 minutes to half an hour after eating.

• Physical Appearance:

  • Often maintain a normal weight or are slightly overweight.

  • May wear loose clothing to hide their body shape.

• Methods of Weight Control:

  • Use of diuretics, diet pills, and excessive exercise.

• Physical Impact:

  • Abrasions on knuckles from inducing vomiting (self-induced).

  • Dental erosion or damage due to stomach acid from vomiting.

Social and Environmental Factors

• Risk Factors:

  • Occupational pressures in careers such as modeling and acting where weight standards are often set.

  • Athletes in sports where body image is prioritized.

  • Family history of eating disorders increases risk.

  • Influences of social media which often showcase unrealistic body standards.

Nursing Interventions for Eating Disorders

• Building Relationships:

  • Establish a trusting relationship with patients.

  • Positive reinforcement to improve self-esteem and body image.

• Monitoring Conditions:

  • Weigh patients backward to prevent fixation on weight scale numbers.

  • Implement bathroom supervision post-meals to prevent purging behaviors.

• Inpatient Treatment:

  • Structured eating schedules and regulated meal times, with emphasis on group therapy and interactions.

Neurocognitive Disorders

• Definition: Neurocognitive disorders disrupt thinking, memory, and problem-solving abilities.

• Examples:

  • Delirium, dementia, Alzheimer’s disease, Parkinson's disease, Huntington’s disease (not covered in detail for this course).

Delirium

• Characteristics:

  • Acute confusion, disorientation, and clouded consciousness.

  • May involve hallucinations or illusions.

• Driving Factors:

  • Intoxication, polypharmacy in elderly, infections such as UTIs can trigger delirium.

  • Typically resolved once underlying causes are treated.

Dementia

• Definition: A chronic condition characterized by progressive loss of cognitive functions due to brain damage.

• Symptoms:

  • Memory loss that affects daily life, personality changes, and inability to plan or organize.

• Severity Levels:

  • Mild: Problems with daily tasks; moderate: increased need for assistance; severe: complete dependency on others.

Alzheimer’s Disease

• Characteristics:

  • Progressive brain disorder leading to memory loss and cognitive decline.

  • Most common cause of dementia among older adults.

  • Significant caregiver burden associated with caring for patients with Alzheimer’s due to extensive hours needed for care.

• Diagnosis:

  • Definitive diagnosis typically occurs post-mortem during autopsy, assessing for abnormal protein deposits (amyloid beta and tau).

Treatment Options for Alzheimer’s

• Medications:

  • Cholinesterase inhibitors (e.g., Donepezil, Memantine) can slow disease progression but do not provide a cure.

  • Research focuses on possible interventions to prevent plaque formation in the brain.

Comparison Between Dementia and Delirium

• Dementia is chronic and gradual; delirium is acute and rapid in onset.

Conclusion

• Understanding eating disorders and neurocognitive disorders is crucial for effective patient care. Nursing interventions aim to provide support, promote recovery, and comfort through comprehensive treatment options.

• Continuous education and awareness of risk factors can aid in prevention and management of these disorders.