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Eating Disorders
- 1. Eating Disorders Anorexia Nervosa & Bulimia Nervosa Power Point Presentation for Nursing Students By Katrina Tyne (2005)
- 24. The End Thank you for your time
Notas do Editor
- Anorexia and bulimia are complex disorders, and no specific factors have been identified as the cause. Research findings indicate a variety of possible causes, which include but are not restricted to Familial Sociocultural Biological Trauma
- Kenny (1991) suggested that a person with anorexia: comes from a family, which discourages him or her from making outside contact Is expected to succeed and achieve Is oppressed by domineering parents Palazzoli (1974) has looked at familial factors in more detail and has found these factors to be involved: A rejection of communicated messages Poor conflict resolution A covert alliance of family members Munichin (1978) also found these factors: Enmeshment over-protectiveness Rigidity Lack of conflict resolution
- Concerns have been raised about the media and how it may have contributed to the image of a slim to under-weight figure being socially acceptable. It is believed that adolescents view under-weight rock stars, models and actresses as being more happy, popular, wealthy and acceptable. More research is required before one can say that the media is a definite influence. Relationship between eating disorders and cultural/religious values Social acceptance and social norms regarding body size, food Australasian studies have indicated a trend towards thinness (Nowak et al. 1996). In some cultures not only is it acceptable, but a symbol of wealth to be overweight. New Zealand is a young country and its culture is still developing and is no doubt under the influence of other cultures. More research is required to highlight the sociocultural factors relevant to New Zealand
- There are many factors that play a role in the development of anorexia nervosa and it is important that clinicians screen the person with anorexia and their family for the following conditions: Inflammatory bowel disease Malignancies/cancer Thyroid disease Diabetes mellitus Chronic infections Genetic influence such as a familial history of Obesity/overweight Eating disorder Dieting Depression Bipolar Ellen et al. (2003) discuss the recent awareness of familial transmission as a result of current research findings. There appears to be emerging evidence that children who have close relatives with an eating disorder are more at risk of developing an eating disorder themselves.
- Refusal to maintain body weight at or above minimally normal weight for age and height. Intense fear of gaining weight or becoming fat, even though underweight. BMI <17.5 In post-menarcheal females, amenorrhea (3 consecutive months) 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. Restrictive Type = Restricting diet Binge/Purge Type = Laxatives, self-induced vomiting
- Recurrent episodes of binge eating characterised by eating in a discrete period of time, an amount that is definitely larger than most people would eat during a similar period of time and under similar circumstances. And a sense of lack of control over eating during the episode (e.g., feeling that one cannot stop eating or control what or how much one is eating). This occurs at least 2 times per week for the duration of 3 months. Recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting or excessive exercise. This occurs at least 2 times per week for the duration of 3 months. Self-evaluation is unduly influenced by body shape and weight. So low self-esteem when weight increases. Purging Type = Regularly engaging in self-induced vomiting or the misuse of laxatives. Non purging = inappropriate compensatory behaviours such as exercise or fasting
- Treat co-morbid illness. Mortality rate higher for those with co-morbid illness. Check suicidality.
- Weight restoration – this is especially important if BMI is low and any changes occurring in vital signs. If you ever come across anyone who is malnourished, say with a BMI of 16 or less, you will notice a deterioration in there cognitive functioning and their Anorectic thoughts are stronger. Weight restoration is complexed, if it happens too quickly it can cause death (Re-feeding Syndrome), other complications include pain can be due to mouth ulcers, dental erosion, irritated osophegus, reduced bowel motility, constipation, bloating. Normalisation ED behaviours – So what kinds of ED behaviours are we/family likely to see?? Isolates self at meal times, exercising, preparing family meals and dishing up meals, doing the grocery shopping
- BP and pulse lying and standing. Ask about dizziness or feeling faint. Note the rhythm and rate and strength of pulse, take pulse for full 60 seconds. Not uncommon to have very low diastolic and postural drop and also common to have a weak thready pulse, bradycardia and arrhythmias. Body temp, Why do we check this??? advise them to wear warm clothes, heater in bedroom. Hydration, tongue, skin, cap refill
- Brainstorm signs of BN with class…
- Nurses who participated in a study ‘caring for adolescent females with anorexia nervosa: registered nurses’ perspective’ did not have any formal mental health training. Living with frustration overwhelmed the nurses, they reached a point where they’d just had enough. The warring, frustration, being hurt and lack of success eroded their resilience so much they couldn’t cope with the situation any more and ‘turned off’. They distanced themselves from their patients and spent less time with them, they did this to protect themselves. Maintenance of optimal relationships between people with eating disorders and nursing staff is difficult. People with eating disorders are unique and challenging.
- What is a healthy BMI? (20-25) for adults, refer to chart for youth