EATING DISORDER

-an irregular eating habits and severe distress or concern

about body weight or shape
-inadequate or excessive food intake which can ultimately
damage an individual’s well-being
-a medical illness that coexist with other conditions such
as anxiety disorders, substance abuse, or depression

CAUSES:
Biological factors
*irreg. hormone functions
*genetics
*nutritional deficiencies
Psychological factors
*negative body image
*poor self-esteem
Environmental factors
*dysfunctional family dynamic
*professions & careers that promote being thin &
weight loss (e.g. ballet & modeling)
*aesthetically oriented sports (lean body) (e.g. diving,
gymnastics, wrestling, rowing)
*family and childhood traumas (e.g. sexual abuse)
*cultural, peer pressure among friends & co-workers
*stressful transitions or life changes
TYPES
ANOREXIA NERVOSA

Diagnostic Criteria:
R- refusal to maintain BW (less than 85% of EBW, & BMI
less than 17.5 kg/m2)
I- intense fear of gaining wt. or becoming fat (even though
underweight)
D- disturbance in a way in which one’s body wt. or shape is
experienced, undue influence of body weight or shape on
evaluation, or denial of the seriousness of the current low
body weight
A- amenorrhea for 3 cycles
o BULIMIA NERVOSA
Diagnostic Criteria:
BINGE EATING
* eating a large amt. of food, rapidly &
discretely in a given time (2H)
* sense of lack of control over eating during
episode
COMPENSATORY BEHAVIOR TO PREVENT
WEIGHT GAIN
* self-induced vomiting, laxatives, diuretics,
enemas, fasting, excessive exercises
TWICE A WEEK EPISODE FOR 3 MONTHS
 SIGNS & SYMPTOMS
 A. N.
• Refuses to eat
• Plays with food & eats only
very small amounts
• Perceives body or body part
as being fat even though thin
• Dry skin, fine downy body
hair
• Absent menses
• Hypothermia, hpn,
bradycardia
B. N.
- binge eating followed by
purging (Binge-purge cycle)
- loss of tooth enamel, esp.
on posterior front teeth
- calluses on dorsum of
fingers or scars on dorsum
of hand
- reddened knuckles
- enlarged parotid gland
- increased peristalsis, rectal
bleeding, or constipation
CHARACTERISTICS :
1.Chronic dieting (despite being hazardously
underweight)
2.Constant weight fluctuations
3.Obsession with calories & fat contents of food
4.Engaging in ritualistic eating patterns (cutting
food into tiny pieces, eating alone, & or hiding
food)
5.Continued fixation with food, recipes, or cooking
(may cook intricate meals for others but refrain
from partaking)
6.Depression or Lethargic stage
7.Avoidance of social functions, family, & friends
8.Switching between periods of overeating & fasting
o Binge Eating Disorder (BED)

- frequently lose control over his or her eating

- episodes of binge-eating are not followed by com-
pensatory behaviors, such as purging, fasting, or
excessive exercise
- may be obese & at an increased risk of developing
other conditions (CardioV. Dse.)
- may experience intense feeling of guilt, distress, &
embarrassment related to their binge-eating, which
would influence the further progression of the
eating disorder
 APPROACHES TO CLIENTS WITH
EATING DISORDER

DO…
- SFF
- Monitor I/O, & bowel functions
- Monitor weight gain & lab. Results
- Encourage expression of feelings
- Set realistic expectations of self
- Encourage participation in activities
- Stay with client during meal time, & at least 1H post
meal (Bulimia)
- Accompany to bathroom (if self-induced vomiting is
expected)
Don’t…
- don’t indicate feelings of shock, disbelief or
disgust at eating disorders
- don’t confront & judge hostilities & anger, should
they occur
- don’t discuss & explain food, diet, or body (unless
these are linked with feelings)
- don’t compare client’s behavior & appearance
with other
- don’t allow long meal time (set 30 min. mealtime)
Treatment:
 Medical care & monitoring (addressing any health
issues that may have been a consequence of eating
disorder behaviors)

 Nutrition (weight restoration & stabilization, guidance

for normal eating, & the integration of an individualized
meal plan)

 Therapy (psychotherapy that can be helpful in addressing

the underlying causes of eating disorders) (it is the
fundamental piece of treatment—recovery opportunity
that addresses & heals traumatic life events & learn
coping skills & methods for expressing emotions)

 Medication (anxiolytics; tranquilizers) (to help resolve

mood & anxiety symptoms)
LEVELS OF PREVENTION
Primary Secondary Tertiary
Prevention Prevention Prevention
Definition An intervention imple- An intervention im- An intervention
mented before there is plemented after a implemented after
evidence of a disease disease has begun, a disease or injury
or injury but before it is symp- is established
(changing attitudes & tomatic (to treat/ heal)
norms)
Intent Reduce or eliminate Early identification Prevent sequelae
causative risk factors (through screening) (stop bad things
(risk reduction) and treatment from getting
worse)

Example Encourage exercise Check body mass index Help obese indivi-
and healthy eating to (BMI) at every duals lose weight
prevent individuals well check-up to to prevent prog-
from becoming over- identify individuals ression to more
weight who are overweight severe consequences
or obese
DOH Programs & Services that Focus on
Primary and Secondary Prevention

 National Tuberculosis Program- Direct Observed

Short Course Treatment
(NTP-DOTS)
 Integrated Management of Childhood Illness (IMCI)

 Control of Diarrheal Disease (CDD)

BASIS FOR CLASSIFYING THE CHILD’S ILLNESS
(COLOR-CODED TRIAGE SYSTEM)
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
TETANUS TOXOID VACCINATION