Eating disorders

1. By
Mr. Vincent Ejakait

4. Anorexia Nervosa

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 This is a 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
steadfast inability or refusal to acknowledge the
seriousness of the problem or even that one
exists

6. Anorexia Nervosa

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 Clients with anorexia nervosa have:
A body weight that is 85% less than expected for
their age and height
Experienced amenorrhea for at least three
consecutive cycles
A preoccupation with food and food-related
activities

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 Fear of gaining weight or becoming fat
even when severely underweight (Main
Sign)
 Body image disturbance
 Amenorrhea
 Depressive symptoms such as depressed
mood, social withdrawal, irritability, and
insomnia
 Preoccupation with thoughts of food
 Feelings of ineffectiveness
 Inflexible thinking
 Strong need to control the environment

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 Limited spontaneity and overly restrained
emotional expression
 Complaints of constipation and abdominal
pain
 Cold intolerance
 Lethargy
 Emaciation
 Hypotension, hypothermia and
bradycardia
 Hypertrophy of salivary glands

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Is an eating disorder characterized
by:
Recurrent episodes (at least twice a week for
3 months) of binge eating (consuming a large
amount of food, far greater than most people
eat at a time, in a discrete period of usually 2
hours or less)

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Is an eating disorder characterized
by:
Binge eating followed by inappropriate
compensatory behaviors to avoid weight gain
such as:
 Purging (compensatory behavior designed to
eliminate food by means of self-induced
vomiting, misuse of laxatives, enemas, and
diuretics)
 Fasting
 Excessively exercising

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 Recurrent episodes of binge eating
 Compensatory behavior such as self-induced
vomiting, misuse of laxatives, diuretics, enema or
other medications, or excessive exercise
 Self-evaluation overly influenced by body shape and
weight
 Usually within normal weight range, possible
underweight or overweight
 Restriction of total calorie consumption between
binges, selecting low-calorie foods while avoiding
foods perceived to be fattening are likely to trigger a
binge

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 Depressive and anxiety symptoms
 Loss of dental enamel
 Chipped, ragged, or moth eaten
appearance of the teeth
 Increased dental caries
 Menstrual irregularities
 Dependence on laxatives
 Esophageal tears

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 Fluid and electrolyte abnormalities
 Metabolic alkalosis (from vomiting) or
metabolic acidosis (from diarrhea)
 Mildly elevated serum amylase levels

16.  Binge eating disorder is defined as recurring
episodes of eating significantly more food
in a short period of time than most people
would eat under similar circumstances,
with episodes marked by feelings of lack of
control.

17. Recurrent episodes of binge eating. An episode of
binge eating is characterized by:
 1. Eating in a discrete period of time (e.g.
within any 2 hr)
amount of food that is definitely larger than what
most individuals would eat in a similar period of
time under similar circumstances;
 2. A sense of lack of control over eating during
the episodes (e.g. a feeling that one cannot stop
eating or control what or how much one is
eating).

18. Binge eating episodes are associated with three or
more of the following:
 1. Eating much more rapidly than normal.
 2. Eating until feeling uncomfortably full.
 3. Eating large amounts of food when not feeling
physically hungry.
 4. Eating alone because of feeling embarrassed by
how much one is eating.
 5. Feeling disgusted with oneself, depressed, or
very guilty afterwards.

20.  Persistent eating of nonnutritive, nonfood
substances over the period of at least 1
month.
 If the eating behaviour occurs in the context
of another mental disorder or medical
condition e.g pregnancy.

21.  Repeated regurgitation of food over the
period of at least one month. Regurgitated
food may be re-chewed, re-swallowed, or
spit out.
 Not attributable to an associated
gastrointestinal or other medical condition
(e.g. reflux).

22.  A feeding or eating disturbance
characterized by:
 lack of apparent interest in eating food;
 avoidance based on the sensory
characteristics of food

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 Body image disturbance
 Self-esteem disturbance
 Ineffective individual coping

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• Promote improved nutrition – assume a
calm, matter-of-fact attitude and positive
expectation of the client, meeting
minimal nutritional goals is non-
negotiable.
– Tube or IV feedings
– Weigh daily, record intake and output, observe
client during meals and bathroom activities
– Avoid discussing food, recipes, restaurants and
eating
– Provide a pleasant meal time environment and
adopt realistic expectations of how much the
client will eat

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 Promote improved nutrition
Frequent, small meals are more acceptable
Set time limit of about one-half hour to forestall
mealtime “marathon” (protracted meals during
which the client eats little)
Collaborate with a dietitian
Acknowledge and recognize efforts of clients who
meet weight gain goals but avoid praise or
flattery
Behavior modification therapy can help

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• Promote effective individual coping
– The best way is to involve the clients in their own
treatment planning
– Give clients the opportunity to practice problem
solving. Demonstrate positive belief in client’s
abilities to regain healthy functioning and a
willingness to tolerate “mistakes”
– Set firm, clear limits to provide the secure
environment needed to learn more effective
coping behaviors
– Explore client’s feelings about their families, their
roles in the family and their autonomy within the
family system

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 Promoting effective coping with anxiety –
help them recognize events that create
anxiety and to avoid binging and purging in
response to anxiety
 Promoting improved fluid volume
 Promoting effective individual coping

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 Promoting effective individual coping
It is important for clients to identify situations or
patterns of events that precede episodes of
binging and purging.
They need to learn effective ways of expressing
feelings and assertive techniques to diminish
guilt interactions in the future
 Promoting effective family coping