Eating disorder
Anorexia Nervosa
Bulimia nervosa
MR. VIHANG TAYDE
M.Sc. Nursing

INTRODUCTION
• Eating disorder is characteristic by
abnormal eating habits that may involve
either insufficient or excessive food
intake to the determent of an individual’s
physical and emotional health.

• Eating is a normal social activity but
sometime may individual following
eating habits and food pattern by
abnormal way which might be caused
some complications in their future life.

INCIDENCE:
• The incidence and prevalence of eating
disorders depends as always on the
definition used and the population being
considered. The peak incidence of
Anorexia Nervosa is around the age of
18. For the bulimia nervosa is slightly
higher.

affects all the
• Eating disorder
socioeconomic levels.
• Anorexia nervosa has the highest
mortality rate of any psychiatric disorder.
• The mortality rate for anorexia nervosa is
4% and bulimia nervosa is 3.9%.

ANOREXIA NERVOSA
• Anorexia is syndrome characterized by
three essential criteria.
• The first is to self-induced starvation, to
a significant degree.
• The second is relentless drive for thinner
or morbid fear of fatness.
• The third is presence of medical signs
and symptoms resulting from starvation.

• Anorexia Nervosa is often associated
with disturbance of body images, the
perception that one is distressingly large
despite obvious thinners.

DEFINITION :-
• Anorexia Nervosa is an eating disorder
occurs most often in adolescent girls. The
problem is found as refusal of food to
maintain normal body weight by reducing
food intake, especially fats and
carbohydrates.

Types of
1.) Anorexia Nervosa Binge / Purge Type
• The individual suffering from anorexia
nervosa binge / purge type will purge
when he or she eats.

• This is typically a result of the
overwhelming feelings of guilt a sufferer
would experience in relation to eating;
they compensate by vomiting, abusing
laxatives, or excessively exercising.

• 2. Restrictive Anorexia Nervosa –
• In this form of anorexia nervosa, the
individual will fiercely limit the quantity
of food consumed, characteristically
ingesting a minimal amount that is well
below their body’s caloric needs,
effectively slowly starving him or herself.

ETIOLOGY:-
• The main etiological factors are,
• Biological,
• Social and
• Psychological factors are complicated
in the cause of anorexia nervosa.

RISK FACTORS:-
about
• Accepting society’s attitudes
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.

SYMPTOMS:-

COMPLICATION
• CVS – Bradycardia, hypotension, ECG
abnormalities, myocarditis.
• SKIN - dry skin, hair lose, etc.

irregular
– Amenorrhea,
menses,
• ENDOCRINE
hypoglycemia,
imbalance of LH.
• FLUID AND ELECTROLYTE –
dehydration, vomiting, alkalosis.

• GI – constipation, esophagitis,
hypertrophy.
• HAMALOGICAL – anemia, leucopenia.

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, etc

• 3. ECG reading irregular.
• 4. Thyroid function Tests.
• 5. Urinalysis

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 ;

• 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.

• 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

–Other treatments may include.
• Antidepressant drug therapy.
• Behavioral therapy.
• Psychotherapy.
• Supportive care.
• Cognitive behavioral therapy (CBT)

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.

• Eating must be supervised by the nurse
and provide balanced diet of at least 3000
calories should be provided in 24 hrs.
• 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.

CONCLUSION:
• Anorexia Nervosa is an eating disorder occurs
most often in adolescent girls. The problem is
found as refusal of food to maintain normal
body weight by reducing food intake,
especially fats and carbohydrates.

• Anorexia is syndrome characterized by
three essential criteria.
• The first is to self-induced starvation, to a
significant degree.
• The second is relentless drive for thinner
or morbid fear of fatness.
• The third is presence of medical signs
and symptoms resulting from starvation.

SUMMARY:

BIBLIOGRAPHY:
• R. Shreevani., “A Guide To Mental
Health &Psychiatry Nursing”,
3rd Edition, 2010. Page No: 216 - 217

• Anbu.T; Text book of Psychiatric
Nursing; EMMESS., 1st Edition 2010;
Page No: 144 – 145
• https://www.eatingdisorderhope.com/info
rmation/anorexia

THANK
YOU….

Bulimia nervosa

Introduction
• Bulimia nervosa is an eating disorder in which
a person creates a destructive pattern of eating
in order to control their weight.
• People with bulimia tend to go on eating
binges, consuming large amounts of food in a
short period of time.

• Bulimia is an illness in which person
binges on food or has regular episodes of
significant over – eating and feels a loss
of control.
• The affected person then uses various
methods such as vomiting or Laxative
abuse to prevent Weight gain.

• People with bulimia tend to show signs of
depression, anxiety, or obsessive-compulsive
disorders.
• Bulimia may cause moodiness and irritability.
abuse
• Feelings of embarrassment and shame.
• They’re also at risk for substance
problems and suicidal behavior.

Major Types of Bulimia
• Bulimia Nervosa Purging type –
This type of bulimia nervosa accounts
for the majority of cases of those suffering
from this eating disorder.

• In this form, individuals will regularly
engage in self-induced vomiting or abuse
of laxatives, diuretics, or enemas after a
period of bingeing.

• Bulimia Nervosa Non-purging type –
In this form of bulimia nervosa, the
individual will use other inappropriate
methods of compensation for binge
episodes, such as excessive exercising or
fasting.

CAUSES:-
• There is no single cause of bulimia but
there are some factors which are
responsible for bulimia.

1. Culture:-
2. Families:-
If you are having mother or sister with
bulimia you are more likely to have bulimia.
3. Life changing or stressful events:-
Traumatic events as well as stressful things can
grad to bulimia.

4. Personality traits:-
• A person with bulimia may not like
herself. She hates the way she looks or
feels hopeless.
• She may be very moody have problems
expressing anger.

5. Biology:-
• Genes, Hormones or chemicals in brain
may be factors in developing bulimia.

SYMPTOMS:-
• Binges regularly. (Eats large amount of
food over short period) and purges of
time regularly.
• Diet and exercises often but maintains or
regains Wright.

• Becomes secret rater.
• Has swollen neck glands.
• Has scars on the back of hands from
forced vomiting

• Electrolyte imbalances, which can result
in cardiac arrhythmia, cardiac arrest,
• Chronic dehydration
• Inflammation of the esophagus

DIAGNOSIS
the upper
• Medical evaluation to rule out
gastro-intestinal disorder.
• MSE
• History.
• Lab test ( Hb% level, blood glucose, and
baseline ECG)

PSYCHOTHERAPY:-
1) Cognitive Behavioral Therapy
• Cognitive Behavioral Therapy should be
considered benchmark. First line
treatment of bulimia nervosa.
• Manual guided treatments that include
about 18 – 20 sessions over 5 to 6
months.

PHARMACOTHERAPY
• Antidepressant medications have been
shown to be helpful in treating bulimia.
This includes the selective serotoxin
reuptake inhibitors such as “fluoxetine”.

Nursing intervention
• Establish construct with patients that
specifies amount and type of food she
must eat at each meal.
• Set a time limit for each meal.

• Assess and monitor patients suicide
potential.
• Explain the risk of laxative, and diuretic
abuse.

CONCLUSION
• Bulimia nervosa is an eating disorder in which
a person creates a destructive pattern of eating
in order to control their weight.
• People with bulimia tend to go on eating
binges, consuming large amounts of food in a
short period of time.

• People with bulimia tend to show signs of
depression, anxiety, or obsessive-compulsive
disorders.
• Bulimia may cause moodiness and irritability.
• Feelings of embarrassment and shame.
• They’re also at risk for substance abuse
problems and suicidal behavior.

SUMMARY

Bibliography
1.R. Shreevani., “A Guide To Mental Health
&Psychiatry Nursing”,
3rd Edition, 2010. Page No: 217 - 218
2.Anbu.T; Text book of Psychiatric Nursing;
EMMESS., 1st Edition 2010; Page No:

3).https://www.eatingdisorderhope.com/informat
ion/bulimia
4).https://www.google.co.in/search?q=bulimia+n
ervosa&biw=1366&bih=625&source=lnms&tb
m=isch&sa=X&sqi=2&ved=0ahUKEwjJle-
FoYDSAhXHL48KHUfdCukQ_AUIBigB&dpr=
1

Thank you….