LEARNING OUTCOMES

• Compare and contrast the symptoms of anorexia nervosa

and bulimia nervosa.

• Discuss various etiologic theories of eating disorders.

• Identify effective treatment for clients with eating

disorders.

• Apply the nursing process to the care of clients with

eating disorders.
 ANOREXIA NERVOSA BULIMIA NERVOSA
A life threatening eating disorder Characterized by:
characterized by: ✓ recurrent episodes of binge eating
✓ restriction of nutritional intake followed by inappropriate
necessary to maintain a minimally compensatory behaviors to avoid
normal body weight weight gain (purging, fasting,
✓ intense fear of gaining weight or excessively exercising)
becoming fat
✓ significantly disturbed perception of
the shape or size of the body
✓ steadfast inability or refusal to
acknowledge the seriousness of the
problem

The body weight is less than the The weight is usually in the normal
minimum expected weight. range.
Anorexia nervosa mainly refers to
starving on purpose, to create a
skeletal like body.
Patients are very thin or
emaciated most of the time.
Patients prefer to starve or eat
less.
May result in conditions like
amenorrhea, osteoporosis,
infertility.
Bulimia nervosa refers to binge
eating followed by purging,
resulting in an average or
overweight body due to the
residual amount of calorie.
Patients usually have an average
weight ideal for their height and
age or in some cases, an obese
body.
Patients eat heavy meals followed
by purging.
May result in damage to
esophagus and teeth.
ANOREXIA NERVOSA
Onset Begins between the ages of 14 and 18
years.
Clinical Course In the early stages, clients often deny
having negative body image or
anxiety.
As the illness progresses, depression
and lability in mood become
apparent.
Medical Weight restoration, nutritional
Management rehabilitation, rehydration and
correction of electrolyte imbalances.
Psychopharmacology Amitriptyline (Elavil)
Antihistamine
Cyproheptadine (Periactin)
Olanzapine (Zyprexa)
Fluoxetine (Prozac)
Psychotherapy Family therapy
Individual therapy
Enhanced cognitive-
behavioural therapy (CBT-E)
BULIMIA NERVOSA
Onset Begins in late adolescence or early
adulthood; 18 or 19 years is the
typical age of onset.
Clinical Course They are aware that their eating
behaviour is pathologic and hide it
from others.
Psychopharmacology Antidepressants
Psychotherapy Cognitive-behavioural therapy (CBT)
Other Related Disorders

Night eating syndrome

- characterized by morning anorexia, evening

hyperphagia, and nighttime awakenings to
consume snacks.

Pica

- persistent ingestion of non-food substance

Rumination

- repeated regurgitation of food that is then

rechewed, reswallowed, or spit out.
NURSING DIAGNOSIS

➢ Imbalanced nutrition: less than body

requirements
➢ Ineffective coping
➢ Disturbed body image
➢ Chronic low self-esteeem
NURSING INTERVENTIONS

➢ establishing nutritional eating patterns

➢ helping the client identify emotions and
develop non-food-related coping
strategies
➢ helping the client deal with body image
issues
➢ providing client and family education
POINTS TO REMEMBER!!!

• Be empathetic and non-judgemental.

• Avoid sounding parental when teaching
about nutrition or why laxative use is
harmful.
• Do not label clients as “good” when they
avoid purging or eat an entire meal.
Otherwise, clients will believe they are “bad”
on days when they purge or fail to eat
enough food.