Eating Disoder PPT 3

DO I HAVE AN
EATING
DISORDER?
What is Eating Disorder?
 Is a disorder characterized by alteration or

disturbance in eating pattern and body image
interfering relationship and occupational
functioning.
 More than 90% of case of anorexia nervosa

and bulimia occurs in WOMEN. However,
there is also an increasing number of case in
MEN.
ETIOLOGY
 BIOLOGY FACTOR
 Genetic vulnerability result from a personality type
Hypothalamus dysfunction
 Lateral hypothalamus dysfunction
Anorexia- decreased eating and decreased responses to
sensory stimuli that are important to eating
 Ventromedial Dysfunction
Bulimia- leads to excessive eating, weight gain and
decreased responsiveness to the satiety
 Neurochemical changes
 a. Decrease level of norepinephrine-
decreased appetite (seen in anorexia)
 b. Increase level of serotonin- decreased
satiety (seen in bulimia)
 c. Low level of monoamine oxidase
 Developmental Factor
 Failure to develop Autonomy
 Role modeling
 Failure to establish unique identity
 Family Influence
 Response to family conflict and problems
 Childhood adversities
 -Sexual Abuse -Rejection
 -Over Protectiveness -Parental Maltreatment
 -Excessive paternal control
 -Failure to develop satisfying relationship with peers
 SOCIOCULTURAL FACTORS
 Advertisements, magazines, and movies that
feature thin models reinforce the cultural
belief that slimliness is attractive
 Peer Pressure
Types of Anorexia
 ANOREXIA NERVOSA
-Is a life threatening eating disorder
characterized by body weight 85% or less
than expected for their age and height.
 BULIMIA NERVOSA
-is an eating disorder characterized by recurrent
episodes of binge eating at least twice a week
for 3 months.
SIGN AND SYMPTOMS
 A-Amenorrhea for at least 3 consecutive cycles

 N-No Organic factor accounts for weight loss O-
Obviously thin but feels fat
 R-Refusal to maintain body weight
 E-Emotional expression us restrained
 X- Xymptoms (Symptoms) such as depression
and social withdrawal
 I-Intense fear of gaining weight and insomnia
 A-Always think of food and food related activities
SUBTYPE OF ANOREXIA
 RESTRICTING SUBTYPE
-weight loss through fasting, dieting, and
excessive exercise
 BINGE-PURGING SUBTYPE
-weight loss through induce vomiting, use of
laxatives, diuretics and enema
MEDICAL COMPLICATION RELATED TO
WEIGHT LOSS
 CARDIAC-HYPOTENSION,BRADYCARDIA,CARDIAC ARRYTHMIAS
 DERMATOLOGIC- DRY, CRACKING SKIN,LANUGO, ACROCYNOSIS
(BLUE HANDS AND FEET)
 HEMATOLOGIC-LEUCOPENIA,ANEMIA,THROMBOCYTOPENIA
 METABOLIC-HYPOGLYCEMIA,HYPOTHYROIDISM
 MUSCULUSKELETAL- LOSS OF FAT,OSTEOPOROSIS, PATHOLOGIC
FRACTURES
 GASTROINTESTINAL- CONSTIPATION,ABDOMINAL PAIN,AND
DIARRHEA
 REPRODUCTIVE- AMENORRHEA
 NEURO PSYCHIATRIC- DEPRESSION,INSOMNIA OTHER
 MEDICAL COMPLICATION- ELECTROLYTE IMBALANCES,ELEVATED
BUN, HYPERTROPHY OF SALIVARY GLAND
SIGN AND SYMPTOMS
 B-BINGE EATING
 U-UNDER STRICT DIETING OR VIGOROUS
EXERCISE
 L-LACK OF CONTROL OVER EATING
 I-INDUCED VOMITING
 M-MOTH-EATEN APPEARANCE TEETH
 I-INCREASE AND PERSISTENT CONCERN OF BODY
 A-ABUSE OF DIURETUCS AND LAXATIVES
MEDICAL COMPLICATION RELATED
TO PURGING
 DENTAL- PREIMYOLYSIS (EROSION OF
DENTAL ENAMEL)
 GASTRO INTESTINAL-
ESOPHAGITIS,PAROTID GLAND
 ENLARGEMENT METABOLIC-
HYPOKALEMIA,HYPOMAGNESEMIA
 NEURO PSYCHIATRIC- SEIZURES, FATIGUE,
WEAKNESS
ANOREXIA BULIMIA
HISTORY • Perfectionist w/ • Pleasing others and avoiding
above average contacts
intelligence • Has hx of impulsive behavior such
• Achievement as substance abuse shoplifting
oriented • Hx of anxiety, depression, and
• Dependable personality disorder
• Seeking approval
ANOREXIA BULIMIA
GENERAL APPEARANCE • Appears slow, lethargic • With normal or near
AND BEHAVIOR and fatigued normal body weight
• Emaciated • General appearance is
• Slow to respond to not unusual
questions • Appears open and
willing to talk
ANOREXIA BULIMIA
MOOD AND EFFECT S- SAD • Initially pleasant and cheerful

A- ANXIOUS as though nothing is wrong
W- WORRIED • May express intense guilt,
shame and embarrassment
when discussing when
discussing bingeing and
purging
THOUGHTS • Have paranoid • Preoccupied with dieting, food

PROCESS AND ideas about their and food related behavior
CONTENT family
ANOREXIA BULIMIA
MENTAL PROCESS AND -Mild confusion, slow -alert and oriented

SELF CONCEPT mental process, difficulty
with concentration and -intact intellectual
attention functioning
-low self concept
-Low self concept
ROLES AND RELATIONS -Withdraw from peers and -Feels great shame about
pay little attention to their bingeing and purging
friendship behaviors
-Failure at school which is -Time spent buying and
in contrast to previously eating food and purging
successful academic interfere clients role
achievement performance
NURSING PROCESS
 1 BIOLOGIC DOAMIN
 (Nursing Diagnosis)
*Imbalance nutrition: less than body
requirement
*Disturbed sleep pattern
 (Planning)
*Client will establish adequate nutritional
eating pattern
 Nursing intervention
 Establish nutritional eating pattern
 Set specific time for meals
 Sit with the client during meals and snacks
 Observe client following meals and snacks (1-2 hours)
 Weight client daily (provide positive and negative
reinforcement)
 Offer liquid protein supplement if unable to complete
required calories
 Avoid beverages
 PSYCHOSOCIAL DOMAIN
 NURSING DIAGNOSIS
 Anxiety
 Disturbed body image
 Ineffective Coping
 PLANNING
 Client will demonstrate reduced anxiety
 Client will verbalize acceptance of body image with stable
body weight
 Client will demonstrate non-food related coping
mechanism
 NURSING INTERVENTION
 HELP CLIENT IDENTITY AND DEVELOP A
NON-FOOD RELATED COPING STRATEGIES
 HELP CLIENT DEAL WITH BODY IMAGE
ISSUES
 INTERPERSONAL THERAPY
 PROVIDE CLIENT AND FAMILY EDUCATION
EVALUATION
 DEMONSTRATE ALTERNATIVE METHODS

OF DEALING WITH STRESS
 DEMONSTRATE MORE SATISFYING
RELATIONSHIP
 DEVELOP POSITIVE SELF-CONCEPT
ANOREXIA BULIMIA
1. Medical Management 1. Medical Management
Focuses on weight Treat medical complication of
restoration, nutritional purging
rehabilitation, rehydration
and correction of electrolyte
imbalances
2. PSYCHOPHARMACOLOGY 2. PSYCHOPHARMACOLOGY
Flouxetine (Prozac) TCA-Desipramine
Olanzapine (Zyprexa) -Imipramine
Amitri ptyline ( Elavil) SSRI
PSYCHOTHERAPY COGNITIVE BEHAVIORAL
1. FAMILY THERAPY THERAPY
2. INDIVIDUAL THERAPY -Strategies designed to
change the clients thinking
(cognition) and action
(behavior)

Eating Disoder PPT 3

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Eating Disoder PPT 3

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DO I HAVE AN

 Is a disorder characterized by alteration or

 More than 90% of case of anorexia nervosa

 A-Amenorrhea for at least 3 consecutive cycles

MOOD AND EFFECT S- SAD • Initially pleasant and cheerful

THOUGHTS • Have paranoid • Preoccupied with dieting, food

MENTAL PROCESS AND -Mild confusion, slow -alert and oriented

 DEMONSTRATE ALTERNATIVE METHODS

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