EATING DISORDERS

Presented by:Nery F. Ona

Presented to: Ms. Ruby De

Guzman
 EATING DISORDERS
For many, eating symbolizes parental nurturing – the love
and care that are the prototype of and a basis for all
future intimate relationships

For some, however, eating creates anxiety because of its

association with unsatisfactory and unpleasant parent-
child interactions.

Clearly, food and eating have greater individual and

cultural meaning and importance than merely an activity
undertaken to sustain life.
 RISK FACTORS FOR EATING DISORDERS
DISORDER BIOLOGIC DEVELOPMENTAL FAMILY RISK SOCIO-
RISK RISK FACTORS FACTORS CULTURAL
FACTORS RISK
FACTORS
Anorexia Obesity; dieting Issues of developing Family lacks Cultural ideal of
Nervosa at an early age autonomy and emotional being thin;
having control over support; media focus on
self and parental beauty,
environment; maltreatment; thinness,
developing a unique cannot deal with fitness,
identity; conflict preoccupation
dissatisfaction with with achieving
body image the ideal body

Bulimia Obesity; early Self-perceptions of Chaotic family Same with

Nervosa dieting; being overweight, with loose above, weight-
possible fat, unattractive, and boundaries; related teasing
serotonin and undesirable; parental
norepinephrine dissatisfaction with maltreatment
disturbances; body image including
chromosome 1 possible
susceptibility physical or
sexual abuse
ANOREXIA NERVOSA
 ANOREXIA NERVOSA
This is a life-threatening eating disorder
characterized by:

– the client’s refusal or, inability to maintain a

minimally normal body weight
– intense fear of gaining weight or becoming fat
– significantly disturbed perception of the shape
or size of the body
 ANOREXIA NERVOSA
Clients with anorexia nervosa have:
– A body weight that is 85% less than
expected for their age and height
– Experienced amenorrhea for at least three
consecutive cycles
– A preoccupation with food and food-related
activities
 SIGNS AND SYMPTOMS OF
ANOREXIA NERVOSA
Fear of gaining weight or becoming fat even when
severely underweight (Main Sign)

Body image disturbance

Amenorrhea

Depressive symptoms such as depressed mood,

social withdrawal, irritability, and insomnia
 SIGNS AND SYMPTOMS OF
ANOREXIA NERVOSA
Preoccupation with thoughts of food

Feelings of ineffectiveness

Inflexible thinking

Strong need to control the environment

 SIGNS AND SYMPTOMS OF
ANOREXIA NERVOSA
Complaints of constipation and abdominal
pain

Cold intolerance

Lethargy
 SIGNS AND SYMPTOMS OF
ANOREXIA NERVOSA

Hypotension, hypothermia and bradycardia

Hypertrophy of salivary glands

 SIGNS AND SYMPTOMS OF
ANOREXIA NERVOSA
Elevated BUN

Electrolyte imbalances

Leukopenia and mild anemia

Elevated liver function studies

NURSING INTERVENTIONS FOR
ANOREXIA NERVOSA
Promote improved nutrition – assume a calm, matter-of-
fact attitude and positive expectation of the client,
meeting minimal nutritional goals is non-negotiable.
– Tube or IV feedings
– Weigh daily, record intake and output, observe client
during meals and bathroom activities
– Avoid discussing food, recipes, restaurants and
eating
– Provide a pleasant meal time environment and adopt
realistic expectations of how much the client will eat
NURSING INTERVENTIONS FOR
ANOREXIA NERVOSA
Promote improved nutrition
– Frequent, small meals are more acceptable
– Set time limit of about one-half hour to forestall
mealtime “marathon” (protracted meals during
which the client eats little)
– Collaborate with a dietitian
– Acknowledge and recognize efforts of clients who
meet weight gain goals but avoid praise or flattery
– Behavior modification therapy can help
NURSING INTERVENTIONS FOR
ANOREXIA NERVOSA
Promote effective individual coping
– The best way is to involve the clients in their own
treatment planning
– Give clients the opportunity to practice problem solving.
Demonstrate positive belief in client’s abilities to regain
healthy functioning and a willingness to tolerate
“mistakes”
– Set firm, clear limits to provide the secure environment
needed to learn more effective coping behaviors
– Explore client’s feelings about their families, their roles in
the family and their autonomy within the family system
BULIMIA NERVOSA
 BULIMIA NERVOSA

Is an eating disorder characterized by:

– Recurrent episodes (at least twice a
week for 3 months) of binge eating
(consuming a large amount of food, far
greater than most people eat at a time,
in a discrete period of usually 2 hours or
less)
 BULIMIA NERVOSA
Is an eating disorder characterized by:
– Binge eating followed by inappropriate
compensatory behaviors to avoid weight gain
such as:
• Purging (compensatory behavior designed to
eliminate food by means of self-induced vomiting,
misuse of laxatives, enemas, and diuretics)
• Fasting
• Excessively exercising
 SIGNS AND SYMPTOMS OF
BULIMIA NERVOSA
Recurrent episodes of binge eating

Compensatory behavior such as self-induced vomiting,

misuse of laxatives, diuretics, enema or other medications,
or excessive exercise

Self-evaluation overly influenced by body shape and weight

Usually within normal weight range, possible underweight

or overweight
 SIGNS AND SYMPTOMS OF
BULIMIA NERVOSA
Restriction of total calorie consumption between
binges, selecting low-calorie foods while avoiding
foods perceived to be fattening are likely to trigger
a binge

Depressive and anxiety symptoms

Possible substance use involving alcohol or

stimulants
Loss of dental enamel
 SIGNS AND SYMPTOMS OF
BULIMIA NERVOSA
Chipped, ragged, or moth eaten appearance of the teeth

Increased dental caries

Menstrual irregularities

Dependence on laxatives

Esophageal tears
 SIGNS AND SYMPTOMS OF
BULIMIA NERVOSA
Fluid and electrolyte abnormalities

Metabolic alkalosis (from vomiting) or

metabolic acidosis (from diarrhea)
COMMON NURSING DIAGNOSES
RELATED TO EATING DISORDERS
Body image disturbance

Self-esteem disturbance

Ineffective individual coping

NURSING INTERVENTIONS FOR
BULIMIA NERVOSA
Promoting effective coping with anxiety – help
them recognize events that create anxiety
and to avoid binging and purging in response
to anxiety

Promoting improved fluid volume

Promoting effective individual coping

NURSING INTERVENTIONS FOR
BULIMIA NERVOSA
Promoting effective individual coping
– It is important for clients to identify situations
or patterns of events that precede episodes of
binging and purging.

– They need to learn effective ways of

expressing feelings and assertive techniques
to diminish guilt interactions in the future
Promoting effective family coping
THE END