Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They might start with an obsession with food, body weight, or body shape. In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated.

1. Presented by
Mr.Kalyan kumar Msc (N)

2. Introduction
 Eating is part of everyday life. It is necessary for
survival and part of many happy occasions. People
go out for dinner, invite friends and family for meals in
their homes, and celebrate special events such as
marriages, holidays and birthdays with food.

3. Overview of eating disorders
 More than 90 % of cases of anorexia nervosa and
bulimia nervosa occur in females. 30 % to 35 % of
normal-weight people with bulimia have a history of
anorexia nervosa and low body weight and about
50 % of people with anorexia nervosa exhibit
bulimic Behaviour.

4. Anorexia nervosa
 It 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.

5. Etiology
 A specific cause for eating disorders is unknown.
Initially dieting may be the stimulus that leads to their
development. Biologic vulnerability, developmental
Problems and family and social influences can turn
dieting into an eating disorder.
 Disturbance in hypothalamus
 Many neurochemical changes accompany eating
disorders, but it is difficult to tell whether they cause or
result from eating disorders.

6. Clinical features
 Body image disturbance
 Compensatory behaviour such as self-induced vomiting,
misuse of laxatives
 Sensitivity to cold
 Delayed gastric emptying
 Constipation
 Low blood pressure

7.  Bradycardia
 Hypothermia
 Amenorrhea
 Electrolyte disturbances (Hypokalemia)

8. Diagnostic findings
 History collection
 Physical examination
 Complete blood count
 Liver profile
 Electrolytes
 Blood glucose levels
 ECG

9. Complications
 Increased susceptibility to infection
 Hypoalbuminemia
 Chronic inflammatory bowel disease
 Esophageal erosion, ulcers, bleeding, dental caries
(due to frequent vomiting)
 Cardiovascular issues
 Amenorrhea

10. Medical management
 Medical management focuses on weight restoration,
nutritional rehabilitation and correction of
electrolyte imbalances.
Pharmacotherapy
❖Neuroleptics
❖Appetite stimulants
❖Anti depressants

11.  Psychological therapies
❖Individual psychotherapy
❖Behavioral therapy
❖ cognitive behavior therapy
❖Family therapy

12. Nursing interventions
 Maintain strict intake and output chart
 Monitor status of skin and oral mucous membranes
 Short term management is focused on ensuring weight
gain and correcting nutritional deficiencies.
 Eating must be supervised by the nurse and a balanced
diet of at least 3000 calories should be provided in 24
hours
 Monitor electrolyte levels.

13.  Weight should be checked regularly
 Control vomiting by making the bathroom
inaccessible for at least 2 hours after food.
 In extreme cases when patient refuses to eat and
comply with the treatment, gavage feedings may
need to be instituted.
 Encourage family to participate in education
regarding connection between family process and the
patients disorder.

14. BULIMIA NERVOSA
 Bulimia nervosa is characterized by episodes of binge
eating followed by feelings of guilt, humiliation and self-
condemnation.
 Clients with bulimia nervosa report dissatisfaction with
their bodies, as well as they belief that, they are fat,
unattractive and undesirable.

15. Etiology
 Family history of mood or anxiety disorders (e.g,
obsessive-compulsive disorder) places a person at risk
for an eating disorder.
 Altered serotonin levels in brain
 Society's emphasis on appearance and thinness
 Sexual abuse
 Struggle for control or self-identity
 Learned maladaptive behavior

16. Clinical features
 Heartburn
 Persistent sore throat
 Callused or scarring on back of hands and knuckles.
 Tooth staining or discoloration
 Loss of dental enamel
 Increased dental caries
 Normal or slightly overweight appearance.

17.  Epigastric or abdominal pain
 Amenorrhea
 Fluid and electrolyte imbalance
 Poor impulse control
 Low tolerance for frustration
 Excessive exercise regimen
 Withdrawal from friends .

18. Diagnostic findings
 History collection
 Physical examination
 Psychological evaluation and beck depression inventory
 Blood investigations (Electrolytes, blood glucose)
 ECG
 Medical evaluation to rule out Gastrointestinal disorder.

19.  Psychotherapy
 SSRIs
 Cognitive behavioral therapy
 Most clients with bulimia are treated on an out
patient basis. Hospital admission is indicated if
binging and purging behaviours are out of control
and the client’s medical status is compromised.
Medical management

20. Complications
 Dehydration or electrolyte imbalances
 Chronic, irregular bowel movements
 Constipation
 Increased risk of suicide
 Gastric rupture during periods of binge eating
 Dental caries and gum infections.

21. Nursing care
 Encourage patient to recognize and verbalize her
feelings about her eating behavior
 Provide assertiveness training
 Explain risks of emetic, laxative and diuretic abuse
 Set a time limit for each meal.

22. KEY POINTS
 Anorexia nervosa is a life-threatening eating disorder
characterized by body weight less than 85% of normal,
an intense fear of being fat and refusal to eat or binge
eating and purging.
 Bulimia nervosa is an eating disorder that involves
recurrent episodes of binge eating and compensatory
behaviour such as purging, use of laxatives and diuretics
or excessive exercise.
 Severely malnourished clients with anorexia
nervosa may require intensive medical treatment to
restore homeostasis before psychiatric treatment can
begin.

23.  Family therapy is effective for clients with anorexia;
cognitive-behavioural therapy is most effective for
clients with bulimia nervosa.
 Focus on healthy eating.

24. SUMMARY
CONCLUSION