This document outlines eating disorders including anorexia nervosa, bulimia nervosa, binge-eating disorder, and obesity. It discusses the diagnostic criteria, epidemiology, risk factors, medical complications, treatment including therapy and medications, and prognosis for each disorder. Diagnostic tools such as the Eating Disorder Inventory are also mentioned. The document is presented by Dr. Heba Essawy and provides an overview of eating disorders for information and education purposes.
Feeding and Eating disorders are one of the devastating disorders , Anorexia is a killer disease , very common in childhood and adolescent, mainly in girls more than boys. Bulimia is charecterize by binge eating followed by compulsive purging . Binge eating disorders and night eating syndrome are becoming very prevalent
Feeding disorders as avoidant restrictive food intake disorder , rumination disorders and pica are the types of feeding disorders in infant and childhood period
psychological rehabilitation, nutritional plan and medical therapy are the most effective lines of treatment foe eating Disorders
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
Feeding and Eating disorders are one of the devastating disorders , Anorexia is a killer disease , very common in childhood and adolescent, mainly in girls more than boys. Bulimia is charecterize by binge eating followed by compulsive purging . Binge eating disorders and night eating syndrome are becoming very prevalent
Feeding disorders as avoidant restrictive food intake disorder , rumination disorders and pica are the types of feeding disorders in infant and childhood period
psychological rehabilitation, nutritional plan and medical therapy are the most effective lines of treatment foe eating Disorders
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
Eating disorder is now known to reflect an interaction between an organism’s physiological variables include the balance of various neuropeptide and neurotransmitters, metabolic state, metabolic rate, condition of the gastrointestinal tract, amount of storage tissue, and sensory receptors for taste and smell.
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
Eating disorder is now known to reflect an interaction between an organism’s physiological variables include the balance of various neuropeptide and neurotransmitters, metabolic state, metabolic rate, condition of the gastrointestinal tract, amount of storage tissue, and sensory receptors for taste and smell.
Do Adolescents with Eating Disorders Ever Get Well?Dr David Herzog
Dr. David Herzog presents a slideshow regarding adolescents and their struggle with eating disorders. Do they ever get better and move past their eating disorders?
Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape.
Done by:
Alhanouf Alsarhan
Farah Alshammari
11 Feeding, Eating and Elimination DisordersThe diagnostic crite.docxjesusamckone
11 Feeding, Eating and Elimination Disorders
The diagnostic criteria for the Feeding and Eating Disorders in this chapter are categorized by recurrent disordered eating activities and attitudes that are mutually exclusive, with the exception of pica, which results in significant physical and/or psychosocial impairment (APA, 2013). Research demonstrates that eating disorders often originate in childhood or adolescence with the average age of onset between 8 and 21 years (Hudson, Hiripi, Pope, & Kessler, 2007). Approximately 20 million women and 10 million men in the United States suffer from a clinically significant eating disorder during their lifetime (Wade, Keski-Rahkonen, & Hudson, 2011). Despite this prevalence, only one in ten individuals with an eating disorder receives treatment (Noordenbox, 2002). It is estimated that over 90% of those diagnosed with an eating disorder are young females between the ages of 12 and 25 (SAMHSA, 2003), but adult males suffer significantly as well (EDC, 2007).
Data from the National Comorbidity Replication Survey (NCS-R) and the Adolescent Supplement (NCS-A) show that adults and children with eating disorders often have coexisting mental disorders such as depression, anxiety, and substance use; sadly, few seek treatment specific to their eating disorder. More distressing, this data demonstrates that eating disorders are often associated with functional impairment and suicidality (Hudson et al., 2007; Swanson, Crow, Le Grange, Swendsen & Merikangas, 2011).
The first three disorders were relocated to this category “Feeding and Eating Disorders” to highlight that although they are most often diagnosed in children, they can occur at any age, including adulthood. These disorders are distinguished by problems with the process of eating and retaining food, eating inappropriate food, or lack of interest in or avoidance of food. Among individuals with intellectual disabilities their presence appears to increase with the severity of the condition. Pica Disorder is the eating of nonfood items such as paint chips, string, hair, or newspaper. Although it may occur with other eating and mental disorders, symptoms must be severe enough to warrant an independent diagnosis. Rumination Disorder involves vomiting and re-eating food. Avoidant/Restrictive Food Intake Disorder was formerly feeding disorder of infancy or early childhood, but it has been expanded to capture a broader range of symptoms and age levels. This disruption in eating and feeding behavior is marked by continuous inability to meet appropriate sustenance and dietary needs. It is associated with a serious decrease in body weight, failure to grow, nutritional deterioration, reliance on enteral feeding and impairment in psychosocial functioning (APA, 2013). For any of these diagnoses, all three eating disorders should not develop solely during the course of another eating disorder and cannot be a culturally sanctioned practice or attributable to a medica.
Similar to Eating disorder : symptoms, Diagnosis and treatment (20)
severe and enduring anorexia nervosa : clinical and neuropsychological aspectsHeba Essawy, MD
severe and enduring anorexia nervosa is a persistent dietary restriction , underweight and over evaluation-of weight , history of more than 3 years and exposure to at least two evidence based treatments delivered
Alexithymia and eating disorders : clinical and treatment implicationHeba Essawy, MD
alexithymia and emotion regulation difficulties have an impact on the course and maintenance of eating disorders
lack of insight and the externally- oriented thinking styles typical to alexithymia will interfere with treatment compliance and patients with eating disorders ability to benefit from interventions especially psychotherapy ones
always screen for alexithymia in the everyday clinical practice with psychiatric patients including those suffering from eatings
A Comprehensive Exploration of Alexithymia, Autism spectrum Disorders and Eat...Heba Essawy, MD
Alexithymia , autism and eating disorders are sophisticated conditions that have garnered significant attention in recent years
these conditions have dramatic effects on mental and emotional well-being
one of the specific psychological variables that contribute to the etiology of eating disoders and autism is emotion regulation ability
Alexithymia is sub-clinical phenomenon not identifying a personality disorder per se, but a personality trait with a dimensional nature
construct of alexithymia , difficulty in identifying feelings, difficulty differentiation between typical bodily processes ( Hunger cues exhaustions
externally oriented thinking where the clients are paying more attention to external things arond than to internal experiences
difficulty of describing emotions
Autism eating experience and sensory processing constructs , exteroception, interoceptive
Uncovering the correlation between PTSD and Eating DisordersHeba Essawy, MD
traumatic experience and PTSD and eating disorders commonly co-occur , which can complicate recovery due to how the two psychiatric disorders can fuel one another .
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
3. Risk Factors for EDs
Perfectionism for AN
Early Puberty
Failed attempts to lose weight
Athletics
Beginning a diet
Family history of eating disorder, substance abuse or
mood disorder
4.
5.
6. Diagnosis AN (DSM-5):
Restriction of energy intake relative to
requirements leading to a significantly low body
weight in the context of age, sex.
Intense fear of gaining weight or becoming fat,
or persistent behavior that interferes
with weight gain.
Disturbance in one's body weight or shape ,
persistent lack of recognition of the seriousness
of low body weight
Specify:
Restricting type
Purging type/Binge Eating.
7.
8. Subtypes AN (DSM-5):
Restricting Type: during last 3months, the person has
not engaged in recurrent episodes of binge eating or
purging behavior
Binge-Eating/Purging Type: during last 3 months, the
person engaged in
recurrent episodes of binge eating or purging behavior
9. Epidemiology:
Life time prevalence 0.5- 3.7%
Girls from 14- 18ys 0.5- 1%
AN and BN 30 - 50%
Death 3-8%
Age: 10-30years.
Risk : Sp. After stress
M:F ratio 1: 20
In professions modeling –
ballet dancers.
10. Medical Complication
Death (hypokalemia , starvation, sudden cardiac death)
Hypometabolic state (bradycardia, hypotension, hypothermia)
Dehydration
Arrhythmia, heart failure.
Bone loss
Peripheral edema
Delayed sexual maturity
Hair loss, brittle hair, Lanugo.
On recovery: Re-feeding syndrome
13. Eating Disorder Inventory (EDI)
The EDI is a 64 item, self-report for the
assessment of psychological and behavioral traits
common in anorexia nervosa (AN) and bulimia.
EDI consists of eight sub-scales measuring: 1)
Drive for Thinness, 2) Bulimia, 3) Body
Dissatisfaction, 4) Ineffectiveness, 5)
Perfectionism, 6) Interpersonal Distrust, 7)
Interoceptive Awareness ,8) Maturity Fears
14.
15. Anorexia Nervosa: Treatment
Determine inpatient vs. day treatment vs. outpatient
Multidisciplinary teams are ESSENTIAL!
Primary care provider
Psychiatrist
Individual therapist
Family therapist
Nutritionist
1st
: weight restoration
2nd
: psychological
3rd
: maintinance (long-term)
16. Medical Admission Criteria
<75% ideal body weight
Hypothermia T<36
Bradycardia HR<50 while awake, <45 asleep
Orthostasis-drop in sbp >10, increase in
HR>35
Dehydration
Severe hypokalemia (<2-3 mmol/L) or other
electrolyte abnormality
Acute medical complication
Severe depression/suicidality– Psychiatric
admit
Refractory to outpatient treatment
17. Anorexia Nervosa: Therapy
Best evidence is for family-based treatment
(Maudsley approach)
Who: younger patients who live at home, intact family
Philosophy: no-blame, family did not cause anorexia; family
is the best resource to help her get better
Elevate family’s anxiety about the gravity of the illness.
Empower parents to do whatever they need to do to get the
anorexic to eat. Align siblings with the patient for support.
Externalize the anorexia.
“Family Meal”
Once weight-restored: explore the family dynamics and
psychological issues.
18. Anorexia Nervosa: Medications
No approved medication treatments for Anorexia Nervosa
Prozac (or other SSRI) for co-morbid depression or anxiety
Low-dose Atypical Antipsychotics off-label for near-
psychotic thinking that is characteristic of anorexia,
Zyprexa may help with weight gain
- problem: informed consent for risks of weight gain
19. ANOREXIA NERVOSA
Prognosis:
40% → recover.
30% → continue with milder course.
30% → chronic cases.
Risk of death
Suicide
Cardiac arrest
Malnutrition
> 3 years of illness: prognosis is poor
20.
21.
22.
23. Diagnostic Criteria for Bulemia Nervosa DSM-5
A. Recurrent episodes of binge eating:
(1) Eating large amount in a discrete period of time
(2) lack of control over eating
B. Recurrent compensatory behavior in order to
prevent weight gain.
C. Binge eating and inappropriate compensatory
behaviors is at least once a week for 3 months.
28. Medical Complication
Electrolyte abnormalities
Dental – loss of enamel, chipped teeth, cavities
Parotid enlargement
Conjunctival hemorrhages
Calluses on dorsal side of hand (Russel’s sign)
Esophagitis
hematemesis
Latxative-dependent: cathartic colon, melena, rectal
prolapse
29.
30. Bulemia: Treatment
Multidisciplinary team
Primary care provider
Psychiatrist
Family therapist
Nutritionist
Evidence based : CBT + Antidepressant (SSRI)
31.
32. Bulemia: Treatment (Therapy)
Family therapy is a good option if patient is young
and still lives at home (But not as much evidence as
for Anorexia)
Interpersonal therapy (IPT) (short-term treatment
focused on life transitions)
Psychodynamic Psychotherapy (good for long-term
results in people with chronic depressive and
personality symptoms)
Nutrition plan, exercise, physical activity
33. Bulemia: Medicaions
High-dose Fluoxetine/Prozac (SSRI) – very good
evidence!
Sertraline/Zoloft (SSRI) – some good evidence
Buproprion/Wellbutrin (other antidepressant) –
contraindicated! (risk of seizures if history of
purging)
Topiramate/Topomax (mood stabalizer,
promotes weight loss) – some good evidence, but
use with caution esp if low-weight
34. Bulemia: Prognosis
33% remit every year
But another 33% relapse into full criteria
Adolescent-onset better prognosis than adult-onset
Death-rate = 1%
36. Binge Eating Disorder- Diagnosis
Also needs 3 of the following:
Eating much more rapidly than normal
Getting uncomfortably full
Large amounts of food when not physically
hungry
Eating alone because embarrassed about how
much one is eating
Feeling disgusted with oneself, depressed, or
guilty when over-eating
37. DSM-5 Diagnostic Criteria for Binge Eating
Disorder
Eating, in a discrete period of time , large amount
Lack of control over eating during the episode
Binge eating occurs, on average, at least once a week
for three month
39. Binge Eating Disorder:
Treatment (Medication)
SSRI
high dose reduces binge behavior short-term
but doesn’t help weight loss
Topomax, Zonisamide (anticonvulsants, mild
mood stabalizer)
Helps binge reduction
Helps weight loss
Caution for adverse effects, high discontinuation rates
40. Binge Eating Disorder:
Treatment (Therapy)
Therapies either prioritize…
Weight loss
Binge-reduction
Neither (ie. relationships, depression etc)
Group psychotherapy
There is little evidence that obese individuals who
binge should receive different therapy than obese
individuals who do not binge