Eating Disorders
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| Anorexia Nervosa | 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
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| Clients with anorexia | Have a body weight that is less than the minimum expected weight, considering their age, height and overall physical health. Have a preoccupation with food and food-related activities and can have a variety of physical manifestations
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| Binge eating | Consuming a large amount of food in a discrete period of usually two hours or less
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| Purging | Compensatory behaviors designed to eliminate food by means of self-induced vomiting or misuse of laxatives, enemas, and diuretics.
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| Clients | Do not lose their appetites. They still experience hunger but ignore it and signs of physical weakness and fatigue. Often believe if they eat anything they won't be able to stop eating and will become fat
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| Bulimia Nervosa | Eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors to avoid weight gain, such as purging, fasting, or excessively exercising. Amount of food is much larger than a person would normally eat
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| Weight of clients with bulimia | Usually in the normal range
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| Recurrent vomiting | Destroys tooth enamel, incidence of dental carries and ragged or chipped teeth increases. Dentists are often the first health-care professionals to identify clients with bulimia
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| Night eating syndrome | morning anorexia, evening hyperphagia (consuming 50% of daily calories after the last evening meal), nighttime awakenings to consume snacks. Most are obese
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| Eating or feeding disorders in childhood | Include pica, rumination or repeated regurgitation of food that is then rechewed, reswallowed or spit out. Usually associated with parent-child conflict and family dysfunction
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| Developmental Factors | Two essential tasks of adolescence are the struggle to develop autonomy and establishment of a unique identity.
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| Enmeshment | lack of clear role boundaries
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| Body image | How a person perceives their body, a mental image
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| Body image disturbance | occurs when there is an extreme discrepancy between one's body image and the perceptions of others and extreme dissatisfaction with one's body image
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| Anorexia nervosa | Typically begins between 14 and 18 years of age. In early stage, they often deny they have a negative body image or anxiety regarding their appearance. Very pleased with their ability to control their weight and may express it.
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| Medical Management of Anorexia Nervosa | Focuses on weight restoration, nutritional rehabilitation, rehydration, and correction of electrolyte imbalances.
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| Psychopharmacology (Anorexia) | Amitriptyline and the antihistamine cyproheptadine in high doses (up to 28 mg/day) can promote weight gain. Olanzapine has been used with success because of antipsychotic effect
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| Bulimia | Usually begins in late adolescence or early adulthood; 18 or 19 years is typical age of onset. Binge eating begins during or after dieting
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| Clients with bulimia | Are aware that their eating behavior is pathologic; go to great lengths to hide it from others. May store food in cars, desks or secret locations around the house. May drive from one fast food restaurant to another ordering a normal amnt of food at ea one
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| Cognitive-Behavioral Therapy | Found to be the most effective treatment for bulimia
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| Psychopharmacology (Bulimia) | Despiramine, imipramine, amitriptyline, nortriptyline, phenelzine, and fluoxetine improved mood and reduced preoccupation with shape and weight; most positive results were short term. Fluoxetine is only drug approved by FDA for tx of bulimia
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| Nurse can use assessment tools | Such as Eating Attitudes Test to detect improvement for clients with eating disorders
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| Obesity | BMI of 30
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| Extreme Obesity | BMI of 40 or >
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| Underweight | BMI of <18.5
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| Normal | BMI of 18.5 to 24.9
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| Overweight | BMI of 25 to 29.9
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| Psychopharmacology (Obesity) | Topiramate
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