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Eating disorder . ppt , pritesh
- 1. EATING DISORDERS PRESENTED BY :- PATEL PRITESH D M.Sc.Nursing in Mental Health
- 3. WHAT IS AN EATING DISORDER? • Eating disorders are mental illnesses that cause serious disturbances in a person’s everyday diet. It can manifest as eating extremely small amounts of food or severely overeating. The condition may begin as just eating too little or too much but obsession with eating and food over takes over the life of a person leading to severe changes.
- 4. TYPES OF EATING DISORDERS • Anorexia Nervosa • Bulimia Nervosa • Binge Eating Disorder • Not Otherwise Specified (NOS)
- 5. EPIDEMIOLOGY • Up to 4% of adolescent & young adults • Most common age of onset bet. 14 & 18 yrs • 0.5% to 1 % of adolescent girls • 20% more common in females • Professions requiring thinness • Depression 65%;social phobia 34% OCD 26%
- 6. ANOREXIA NERVOSA • Anorexia nervosa — often simply called anorexia — is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight . People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives. • Anorexia nervosa is a psychiatric disorder characterized by a voluntary refusal to eat.
- 7. Causes • Biological/genetic causes :-Although it's not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance — all traits associated with anorexia.
- 8. CON… • Psychological. Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which causes them to think they're never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it. • A disturbance of body image a struggle for cantrol and sense of identity .
- 9. CON …. • Environmental. Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls. • Life changing or stressful events
- 10. Con… • Causes within the family :-disturbance in family relationship over protection ,family member having an unusal interest in food and physical appearance .
- 11. RISK FACTORS:- • Accepting society’s attitudes about thinness. • Being perfectionist. • Experiencing childhood anxiety. • Feeling increased concern or attention to weight and shape. • Having family history of addictions or eating disorder. • Having negative self-image.
- 12. signs and symptoms • Physical signs and symptoms of anorexia may include: • Extreme weight loss Thin appearance • Abnormal blood counts • Fatigue • Insomnia • Dizziness or fainting • Bluish discoloration of the fingers • Hair that thins, breaks or falls out
- 13. CON… • Soft, downy hair covering the body • Absence of menstruation • Constipation and abdominal pain • Dry or yellowish skin • Intolerance of cold • Low blood pressure • Dehydration • Swelling of arms or legs
- 14. CON .. • Emotional and behavioral symptoms • Severely restricting food intake through dieting or fasting • Exercising excessively • Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products.
- 15. CON … • Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them • Frequently skipping meals or refusing to eat • Denial of hunger or making excuses for not eating • Eating only a few certain "safe" foods, usually those low in fat and calories • Adopting rigid meal or eating rituals, such as spitting food out after chewing
- 16. CON … • Social withdrawal • Irritability • Insomnia • Reduced interest in sex
- 17. DIAGNOSING • The patients refusal to maintain a body weight normal for age and height . • Intense fear of becoming fat even though underweight . • A distorted self –image that result in self – confidence . • Denial of the seriousness of emaciation .
- 18. EXAMINATION AND TESTS:- • 1. Complete physical examination including laboratory tests to rule out the endocrine, metabolic and central nerves system abnormality or other disorders. • 2. Complete blood testing, • Hb level • Platelet count • Cholesterol level Calcium. ECG reading irregular. • Thyroid function Test ...Urinalysis
- 19. TREATMENT:- • The goats of treatment are to first restore normal body Weight and eating habits and then to address psychological issue. • A Hospital stay may be needed if
- 20. Con ...
- 21. Con… • The person has lost a lot of Weight (Below 30% of ideal body Wright). • Weight loss continues despite treatment. • Medical complications such as heart rate problems, changes mental status and low potassium levels. • The person has severe depression or thinks about committing suicide.
- 22. Con… • Short term management aimed to ensure weight gain and correct nutritional deficiencies. • Long term treatment aimed to maintaining a normal weight achieved through a short term management
- 23. Con… • Other treatments may include. • Antidepressant drug therapy. • Behavioral therapy. • Psychotherapy. • Supportive care. • Cognitive behavioral therapy (CBT)
- 24. NURSING MANAGEMENT: • Monitor the weight of client. • Correction of nutritional deficiency by providing nutritious diet. Eating must be supervised by the nurse and provide balanced, • In the early stage of Anorexia Nervosa the treatment is for patient to remain in bed in single room while the Nurse maintains close observation.
- 25. Con… • Eating must be supervised by the nurse and provide balanced diet of at least 3000 calories should be provided in 24hrs. • The goal should to be achieving weight gain of 0.5 to 1 Kg. per week. • Monitor the serum electrolysis levels. • Control vomiting by making bathroom inaccessible for at least 2 hrs. After food.
- 26. • Maintain a strict intake and output chart . • Monitor status of skin and oral mucous membranes. • Avoid discussion that focus on food and weight • Eating must be supervised by the nurse and a balanced diet of at least 3000 calaries .should be provided in 24 hours
- 28. BULIMIA NERVOSA
- 29. Definition • Bulimia nervosa, commonly called bulimia, is a serious, potentially life- threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food with a loss of control over the eating — and then purge, trying to get rid of the extra calories in an unhealthy way.
- 30. causes • Low self-esteem • Trauma • History of teenage abuse • Stressful environment • Unhealthy relationships • Genetic
- 31. risk factors include: • Being female • Depression and anxiety disorders • Substance use disorders • Traumatic events • Stress • Frequent dieting.
- 32. Bulimia Symptoms • Physical symptoms of bulimia can includ • Dental problems • Sore throat • Swollen glands in your neck and face • Heartburn, indigestion, bloating • Irregular periods • Weakness, exhaustion, bloodshot eyes
- 33. Con…. • Gaining and losing weight often. • Dizziness or fainting • Feeling cold all the time • Sleep problems • Dry skin, and dry and brittle nails
- 34. Con… • Behavioral symptoms of bulimia may include. Eating uncontrollably, followed by purging. • Hoarding or stealing food • Food rituals, like eating only a certain food, chewing more than necessary, or not allowing foods to touch • Skipping meals or eating only small portions during meals. • Feeling out of control.
- 35. Diagnosis • Talk to you about your eating habits, weight-loss methods and physical symptoms. • Do a physical exam • Request blood and urine tests. • Request a test that can identify problems with your heart . • Perform a paychological evaluation , including a discussion of your attitude toward your body and weight .
- 36. Treatment • Medical treatments • Medications.Theantidepressant fluoxetine (P rozac) is FDA-approved for the treatment of bulimia. Doctors sometimes recommend other antidepressants or types of medicines. • Hospitalization. This doesn't happen often. But with serious cases of bulimia, you might be treated in a hospital for a short time.
- 37. Con … • Psychotherapy • Cognitivebehavioral therapy (CBT). In this type of therapy, you learn normal eating habits . • Support groups :- this is the least expensive approach and may be helpful for patient who have mild conditions with no health conseqences.
- 38. Con … • Interpersonal psychotherapy (IPT). This focuses on problems in your relationships with other people in your life. The way you interact with others can affect your emotional state and mental health.
- 39. Nursing management :- • Neursing diagnosis :-altered nutrition less than body requirement related to refusal to eat / drink . • N/D :- Fluid volume deficit related to poor intake or refusal to take food / fluids . • N/D:- Body image disturbance related to ego development and dysfunctional family system .
- 40. Con… • Establish control with patient that specific amount and type of food she must eat at each meal . • Set the time limit for each meal . • Encourage patient to recognize and verbalize her feeling about her eating behavior.