Eating Disorders Chapter 11 Severe disruptions in normal eating patterns & a significant disturbance in the perception of body shape and weight Can often lead to death Categories Anorexia Nervosa: self-starvation, fear of gaining wt, disturbances in self-evaluation wt & amenorrhea Bulimia: repeated episodes of binge eating followed by self-induced vomiting Eating Disorders NOS: disorders of eating that do not meet criteria of anorexia or bulimia Prevalence & Comorbidity Culturally influenced with varying prevalence >50% have a concurrent psychiatric disorder Eating disorders Etiology Varied & complex Include a biological predisposition activated by psychological, environmental & cultural factors Models Neurobiological & Endocrine Neuroendocrine abnormalities are noted in both anorexia & bulimia Genetic Strong evidence of genetic vulnerability Psychological Play a role in setting off biological predisposition Theory Assessment Cachectic, lanugo, mottled cool skin, 85% < ideal body weight Assessment guidelines Diagnosis: Imbalanced nutrition: less than body requirements Outcomes Identification Planning Implementation Acute Care, Communication Guidelines, Health Teaching and Promotion, Milieu Therapy, Psychotherapy (CBT, Psychodynamic, Group & Family) Medication: Prozac-useful reducing occurrence relapse Recovery requires long term treatment Evaluation Application of nursing process: anorexia nervosa Assessment -May not appear physically or emotionally ill -May be slightly above or below ideal body wt -Assessment guidelines Diagnosis: Disturbed body image, Chronic low self esteem Outcomes Identification Planning Implementation -Acute Care, Communication Guidelines, Health Teaching and Promotion, Milieu Therapy, Psychotherapy (CBT is the most effective) -Medication: SSRI (Fluoxetine) produces most improvement Evaluation -Short & immediate goals are revised Application of nursing process: bulimia nervosa Variant of compulsive overeating Overeating a symptom of depression High rates of mood & personality disorders Majority recover Pharmacology SSRIs: Sertraline (Zoloft) reduced the frequency of binges & overall severity of the illness CBT is the most effective treatment Binge eating disorders