mental health nursing ii nurs 2310 unit 9 eating disorders
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Mental Health Mental Health Nursing IINursing II
NURS 2310NURS 2310
Unit 9Unit 9
Eating DisordersEating Disorders
Anorexia Nervosa
DefinitionProlonged loss of appetite; self-starvation
with a disruption in metabolism due to inadequate calorie intake.
Incidence & Population Affected Increased in the past 30 years Affects approximately 1% of young
women– Occurs predominantly in females aged
twelve to thirty– Less than 10 percent of cases are males
Etiology & Characteristics Morbid fear of obesity Gross distortion of body image; sees self as
“fat” when obviously underweight Preoccupation/obsession with food
– hoarding or concealing food– preparing elaborate meals for others while
severely restricting self Refusal to eat; marked weight loss May include extensive exercising Physiological symptoms include amenorrhea,
hypothermia, bradycardia, hypotension, edema, lanugo, and metabolic changes
Diagnostic Criteria Refusal to maintain body weight at or
above a minimally normal weight for age and height
Intense fear of gaining weight or becoming fat, even though underweight
Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
Amenorrhea
Bulimia Nervosa
DefinitionExcessive, insatiable appetite;
episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time,
followed by inappropriate compensatory behaviors to rid the
body of the excess calories.
Incidence & Population Affected
More prevalent than anorexia nervosa Affects approximately 4% of young
women– Onset occurs in late adolescence or early
adulthood– Occurs mainly in populations with an
abundant availability of food, and in which the ideal of beauty is thinness
Etiology & Characteristics Persistent overconcern with personal
appearance Weight fluctuations common due to
alternating binges and fasts Excessive vomiting and laxative/diuretic
abuse may lead to problems with dehydration and electrolyte imbalances
Gastric acid in vomitus contributes to the erosion of tooth enamel
Individual may experience tears in the gastric or esophageal mucosa
Diagnostic Criteria Recurrent episodes of binge eating Recurrent inappropriate compensatory
behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
Self-evaluation is unduly influenced by body shape and weight
Obesity
DefinitionChronic disease defined by having a Body
Mass Index (BMI) of more than 30.
Incidence & Population Affected 61% of the U.S. population age 20 or
older are overweight; 27% are obese; 4.7% are morbidly obese
Affects black women more than white women, and white men more than black men
6 times more prevalent among lower socioeconomic classes
Etiology & Characteristics May have a genetic component Lifestyle factors; lack of physical
activity Leads to problems with hyperlipidemia,
hyperglycemia, diabetes mellitus, osteoarthritis due to trauma to weight-bearing joints, angina and respiratory insufficiency due to increased workload of the heart and lungs
Food is considered a social outlet Depression/low self-esteem May involve binge-eating disorder
Diagnostic Criteria(Binge-Eating Disorder)
Recurrent episodes of binge eating in which one does not feel in control of what/how much is being consumed
Binge-eating episodes are associated with– eating much more rapidly than normal– eating until feeling uncomfortably full– eating alone because of being
embarrassed by how much one is eating– feeling depressed or guilty after overeating
Marked distress regarding binge eating The binge eating occurs, on average, at least
2 days a week for 6 months
Nutritional Deficits
Electrolyte imbalances
Nutrient deficits
Malnutrition
Poor glucose control
Deficiency in vital fats
Vitamin deficiencies
Treatment Modalities
Education– Learning healthy eating patterns
Weight management– Nutrition education– Exercise program– Surgery
Individual therapy– Cognitive-behavioral therapy (CBT)– Coping with thoughts and feelings
Family therapy Psychopharmacology
– Antidepressants– Anxiolytics
Milieu Therapy*Focuses on behavior modification Changing maladaptive eating behaviors Empowering client to take control of treatment Contract for privileges based on weight gain or
weight maintenance Goals of therapy agreed upon by client and staff System of rewards and privileges can be earned
by client, who is given ultimate control– Client chooses whether or not to abide by the
contract– Client is made accountable for choices and
behaviors
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