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.

1. EATING DISORDER
Sayani Samanta
M.Sc. Nursing 2nd year

2. Introduction
• The hypothalamus contains the appetite regulation centre within
the brain
• This complex neural system regulates the body’s ability to
recognize when it is hungry and when it has been sated.

3. Cont..
• Halmi stated, 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.
Environmental conditions include features of the food such as taste,
texture, novelty, accessibility, and nutritional composition, and other
external conditions such as ambient temperature, presence of other
people, and stress.

4. ICD 10 Classification:
• F50-F59: Behavioural syndromes associated with physiological disturbances and
physical factors
• F50 Eating disorders
• F50.0 Anorexia nervosa
• F50.1 Atypical anorexia nervosa
• F50.2 Bulimia nervosa
• F50.3 Atypical bulimia nervosa
• F50.4 Overeating associated with other psychological disturbances
• F50.5 Vomiting associated with other psychological disturbances
• F50.8 Other eating disorder
• F50.9 Eating disorder, unspecified
DSM 5 Classification:
• 329 Feeding and Eating Disorders
• F50.1 Anorexia Nervosa
• F50.01 Restricting type
• F50.02 Binge eating/ purging type
• F50.2 Bulimia Nervosa
• F50.8 Binge eating Disorder
• F50.8 Other specified Feeding or Eating Disorder
• F50.9 Unspecified Feeding or Eating Disorder

6. Anorexia Nervosa
• Anorexia nervosa is a syndrome characterized by three
essential criteria-
1) The first is a self-induced starvation to a significant degree
a behaviour.
2) The second is a relentless drive for thinness or a morbid
fear of fatness-a psychopathology.
3) The third criterion is the presence of medical signs and
symptoms resulting from starvation-a physiological
symptomatology.

7. ETIOLOGY

8. Diagnostic and clinical features
• Restriction of energy intake relative to requirements,
leading to a significantly low body weight in the context
of age, sex, developmental trajectory, and physical
health. Significantly low weight is defined as a weight
that is less than minimally normal or, for children or
adolescents, less than that minimally expected.

9. Cont..
• Intense fear of gaining weight or of becoming fat, or persistent
behavior that interferes with weight gain, even though at a
significantly low weight.
• Disturbance in the way in which one's body weight or shape is
experienced, undue influence of body weight or shape on self-
evaluation, or persistent lack of recognition of the seriousness of
the current low body weight.

10. Subtypes
• Food restricting type

11. •Purging type

12. Pathology and laboratory examination
• Endocrine Changes

13. Treatment
Hospitalization
Cognitive Behaviour Therapy
Dynamic Psychotherapy
Family therapy
Pharmacotherapy

15. Etiology
• Biological factors
• Social factors
• Psychological factors

16. Diagnosis and clinical features
• Recurrent episodes of binge eating. An episode of binge eating is
characterized by both of the following:
• Eating, in a discrete period of time (e.g., within any 2-hour time
period), an amount of food that is definitely larger than what most
individuals would eat in a similar period of time under similar
circumstances.
• A sense of lack of control over eating during episode (e.g., a feeling
that one cannot stop eating or control what or how much one is
eating).

17. Cont..
• Recurrent inappropriate compensatory behaviours in order to prevent
weight gain, such as self-induced vomiting; misuse of laxatives, diuretics,
or other medications; fasting; or excessive exercise.
• The binge eating and inappropriate compensatory behaviours both
occur, on average, at least once a week for 3 months.
• Self-evaluation is unduly influenced by body shape and weight.
• The disturbance does not occur exclusively during episodes of anorexia
nervosa.

18. Pathology and laboratory examinations
• Bulimia nervosa can result in electrolyte abnormalities
and various degrees of starvation, although it may not
be as obvious as in low-weight patients with anorexia
nervosa.
• In general, thyroid function remains intact in bulimia
nervosa, but patients may show nonsuppression on a
dexamethasone-suppression test.

19. Cont..
• Dehydration and electrolyte disturbances are likely to
occur in patients with bulimia nervosa who purge
regularly. These patients commonly exhibit
hypomagnesemia and hyperamylasemia.
• Although not a core diagnostic feature, many patients
with bulimia nervosa have menstrual disturbances.
• Hypotension and bradycardia occur in some patients.

20. Treatment
Cognitive
Behavioral
Therapy
Dynamic
psychother
apy
Other
modalities
Pharmacot
herapy

21. Binge eating Disorder

22. Psychogenic vomiting

23. Other specified feeding or eating
disorder
Night eating
Syndrome
Purging
disorder
Obesity and
metabolic
disorder

24. Etiology
• Satiety
• Genetic factors
• Developmental factors
• Physical activity factors
• Brain damage factors
• Health factors
• Other clinical factors
• Psychotropic drugs
• Psychological factors

25. Treatment
Diet
Exercise
Lifestyle
modification
Common
drugs

26. Metabolic Syndrome

27. Nursing Diagnosis
• Imbalanced nutrition less than body requirements related to refusal
to eat, self induced vomiting, abuse of laxatives as evidenced by loss
of weight, poor muscle tone or skin turger, bradycardia,
hypotention, cardiac arrhythmias, pale dry mucus membrane.
• Deficient fluid volume related to refusal to drink, self induced
vomiting, abuse of diuretics as evidenced by loss of weight, poor
muscle tone or skin targer, bradycardia, hypotention, cardiac
arrhythmias, pale dry mucus membrane.

28. Journal
Title: Use of yoga in outpatient eating disorder treatment: a
pilot study
Author: Allison Hall, Nana Ama Ofei-Tenkorang, Jason T. Machan, and Catherine M.
Gordon, Journal of eating disorders, Dcember 9, 2016
• Yoga practice combined with outpatient eating disorder
treatment were shown to decrease anxiety, depression, and
body image disturbance without negatively impacting
weight. These preliminary results suggest yoga to be a
promising adjunct treatment strategy, along with standard
multidisciplinary care.