eating disorders ppt , anorexia nervosa , bulimia nervosa .

1. EATING DISORDERS
PRESENTED BY :-
PATEL PRITESH D
M.Sc.Nursing in Mental Health

2. EATING DISORDERS

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.