Eating Eating Anorexia Anorexia Anorexia bulimia disorder disorder Eating disorder Eating Eating Prepared by : Hanadi ahmad Faygah al shibily Nouf bashawi Aghnar marwah disorder disorder What is eating disorder? Supervised by: Dr. amal shehataa Anorexia Anorexia Anorexia bulimia bulimia

bulimia Anorexia Eating disorder Out line: Introduction of eating disorder Definition of anorexia nervosa and bulimia nervosa Epidemiology of anorexia nervosa and bulimia nervosa Symptoms of anorexia nervosa and bulimia nervosa Warning sings of anorexia nervosa and bulimia nervosa Treatment of anorexia nervosa and bulimia nervosa risk factors of eating disorder Etiology of eating disorder Biopsychosocial intervention for patients with eating disorder Nursing care plan bulimia Anorexia

Eating disorder Objective : After studying this presentation, student will able to: Define the anorexia nervosa and bulimia nervosa. Distinguish the Symptoms and Warning sings of anorexia nervosa and bulimia nervosa. Identify treatment of anorexia nervosa and bulimia nervosa. Describe risk factors and Etiology of eating disorder. Explain Biopsychosocial intervention for patients with eating disorder. Formulate nursing care plan of patient with eating disorder. Stop bulimia Stop anorexia Stop bulimia Stop anorexia Stop bulimia Stop anorexia

Eating disorder Introduction: There are many diseases, disorders, and problem conditions involving food, weight and eating, but in everyday conversation, the term "eating disorders" has come to mean anorexia nervosa and bulimia disorder, which are defined on this presentation

Eating disorder Anorexia Nervosa: Epidemiology: Age of onset: is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. Epidemiology: Age of onset: Typically between 14 and 16 years. Gender differences: Females are 10 times more likely than males. Familial predisposition: First degree relative of people with anorexia nervosa have higher rate of this disorder.

symptoms of Anorexia Nervosa Resistance to maintaining body weight at or above a minimally normal weight for age and height Intense fear of weight gain or being “fat” even though underweight. Disturbance in the experience of body weight or shape, denial of the seriousness of low body weight. Loss of menstrual periods in girls and women post-puberty.

Warning Signs of Anorexia Nervosa: Warning Signs of Anorexia Nervosa: Dramatic weight loss. Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.). Frequent comments about feeling “fat” or overweight despite weight loss. Anxiety about gaining weight or being “fat.” Denial of hunger. Development of food rituals (e.g. eating foods in certain orders, excessive chewing, Warning Signs of Anorexia Nervosa: Consistent excuses to avoid mealtimes or situations involving food. Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury--the need to “burn off” calories taken in. Withdrawal from usual friends and activities. In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Treatment: Treatment: hospitalization of the anorexic patient will be necessary to restore weight . Cognitive-behavioral therapy is sometimes used to change abnormal thoughts and behaviors. Group therapy is often advised so people can share their experiences with others. Family therapy is important particularly if the individual is living at home and is a young adolescent Treatment: A physician or advanced-practice nurse is needed to prescribe medications that may be useful in treating the disorder. nutritionist may be necessary to advise the patient about proper diet and eating regimens. pharmacologic intervention : SSRIs need to used with cautions in initiation phase because some of SSRIs cause weight loss olanzapine , used for sever anorexia .

Eating disorder bulimia Nervosa: Epidemiology: is a serious, potentially life-threatening eating disorder characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting. Epidemiology: Age of onset: Typically between 18 and 24 years. Gender differences: Females are 10 times more likely than males. Familial predisposition: First degree relative of women with anorexia nervosa have higher rate of this disorder and women with other psychiatric disorders.

symptoms of bulimia Nervosa Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior. Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise. Extreme concern with body weight and shape.

Warning Signs of Bulimia Nervosa: Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of containers indicating the consumption of large amounts of food. Evidence of purging behaviors, including frequent trips to the bathroom after meals. Excessive, rigid exercise regimen Unusual swelling of the cheeks or jaw area.

Warning Signs of Bulimia Nervosa: Discoloration or staining of the teeth. Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions. Withdrawal from usual friends and activities. In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Treatment: Treatment: Treatment usually takes place in an out patient setting , except when patient is suicidal or when past outpatient treatment has failed . Cognitive-behavioral therapy is sometimes used to change abnormal thoughts and behaviors. Group therapy is often advised so people can share their experiences with others. Family therapy is important particularly if the individual is living at home and is a young adolescent. A physician or advanced-practice nurse is needed to prescribe medications that may be useful in treating the disorder Treatment: nutritionist may be necessary to advise the patient about proper diet and eating regimens. pharmacologic intervention: the combination of CBT and medication has had the best result . SSRIs , should not taken in the morning because of their side effect of insomnia fluoxetine , has been the most studied for bulimia nervosa in clinical trials .

Risk factors of eating disorder: Psychological Factors. Social Factors. Biological Factors. Interpersonal Factors.

Risk factors of eating disorder: Psychological Factors: Low self-esteem. Feelings of inadequacy or lack of control in life. Depression, anxiety, anger, or loneliness. Lack of assertiveness. Sexual abuse. body dissatisfaction.

Risk factors of eating disorder: Social Factors: Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body" . Narrow definitions of beauty that include only women and men of specific body weights and shapes. Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths. Distorted body image. Fashion industry. Elite athletes.

Risk factors of eating disorder: Interpersonal Factors: Troubled family and personal relationships. Difficulty expressing emotions and feelings. History of physical or sexual abuse.

Risk factors of eating disorder: Biological Factors Over- weight. Dieting. Over exercising.

Etiology of eating disorder: Biologic Increase genetic vulnerability Dieting starving over exercising decrease awareness of hunger decrease serotonin activity Social idealization of thinness – media pursuit of thinness enmeshment with family overprotective family Psychological separation – individuation struggle sexuality conflicts decrease awareness of emotional cue - feminist view role pressure negative body image – body dissatisfaction

Biopsychosocial intervention for patients with eating disorder psychological social biologic establish trust use daily self-monitoring to help identify emotions correct cognitive distortions encourage movement- dance therapies assist with realistic goal setting provide education to clarify misconceptions be supportive but fair with family include family in therapies and teaching Suggest resource for information and support assist teachers with discharge plan and re-entry into classroom Assess and monitor somatic symptoms weight daily supervise bathroom if purging establish normal sleep routine administer medication for depression monitor exercise

Nursing care plan Nursing diagnosis 1 : Imbalance nutrition less than body requirement relater to purges by vomiting and sleep pattern disturbed by exercise evidence by unable to increase food intake and weight more than 20% below ideal weight . Goals : maintain daily intake of 1200 cal . eliminates exercising . Ceases purging for 1 week .

Nursing care plan Nursing intervention : allow patient to verbalize feeling such as anxiety related to food and weight gain . monitor meals and snacks , record amount eaten . monitor 1st hour after meals for purging .

Verbalizes feeling related to changing body shape and weight Nursing care plan Nursing diagnosis 2 : Disturbance body image related to inaccurate perceptions of physical appearance secondary to anorexia nervosa evidence by verbalizes that she is too fat , and hides body in large , buggy clothing . Goals : Verbalizes feeling related to changing body shape and weight

Nursing care plan Nursing intervention : assist patient in identifying positive physical characteristics . clarify patient's views about an ideal body weight . provide education related to normal growth of women's bodies and role of fat in protection of body .

Summary Definition of anorexia nervosa and bulimia nervosa Symptoms of anorexia nervosa and bulimia nervosa Warning sings of anorexia nervosa and bulimia nervosa Treatment of anorexia nervosa and bulimia nervosa Risk factors of eating disorder Etiology of eating disorder Biopsychosocial intervention for patients with eating disorder Nurse car plan of patient with eating disorder

contemporary practice (third edition) Reference www.nami.org/helpline/anorexia.htm psychiatric nursing contemporary practice (third edition)