Pamela S. Chally, PhD, RN Dean/Professor

University of North Florida College of Health

4567 St. Johns Bluff Rd. S Jacksonville, Florida 32224

pchally@unf.edu

Shocking Facts About Eating Disorders

An estimated 8,000,000 people suffer from eating disorders in the United States. An estimated 3-6% of the serious cases will die - - a far higher death rate than for any other mental illness. Although most anorexics or bulimics start in their teens, victims range from five years to seventy years old. The number of males and people of color suffering from eating disorders is increasing.

WARNING SIGNS!! of Anorexia-self imposed starvation

Deliberate self starvation

Intense fear of gaining weight

Plans and cooks elaborate meals

Refusal to eat, except for tiny portions

Denial of hunger

Compulsive exercise

WARNING SIGNS!! of Anorexia-self imposed starvation

Distorted body image

Cold intolerance

Absent menstruation (primary & secondary)

Hair loss and/or fine, downy hair on body

Wears loose, baggy clothing

Dizziness and headaches

WARNING SIGNS!! of Bulimia-repeated cycle of out-of-control eating followed by

purging

Binge eating, usually in secret

Preoccupation with food

Vomiting after bingeing

Frequent use of the bathroom after meals

Abuse of laxatives, including diuretics, diet pills, or emetics

WARNING SIGNS!! of Bulimia-repeated cycle of out-of-control eating followed by

purging

Weight fluctuations

Swollen salivary glands

Broken blood vessels in eyes and/or mini bruises on face

Bruised or callused knuckles

Feeling guilty about eating

Feeling out of control

Dental caries

Biological

Psychological

Family

Sociocultural

Abnormalattitudetoward

weight and shape

Extreme Behavior

Overeatingor

Extreme dieting

Physiologicaland

PsychologicalResponses

PREDISPOSINGFACTORS

STRESSORS BINGE AND/ORPURGE CYCLE

PRECIPITATINGFACTORS

PERPETUATINGFACTORS

Medical Complications of Eating Disorders

Short Term:

Osteoporosis

Slow heart beat

Dehydration

Cold intolerance

Tooth and gum erosion

Inflammation or ulcers of the stomach or esophagus

Amenorrhea or menstrual irregularities

Low blood pressure (anorexia)

High blood pressure (compulsive overeating)

Medical Complications of Eating Disorders

Long Term:

Infertility

Renal disease

Liver damage

Electrolyte imbalance

Seizures

Cardiac arrhythmias

Death

PsychologicalComplications of EatingDisorders Low self-esteem Body image disturbance Inability to concentrate Depression Obsessive-compulsive disorders Bi-polar disorders Attention deficit disorders

Unrealistic representation of the perfect body continues

Unhealthy relationships

Social isolation

Treatment costs

Work absences

Lost of potential of 5-10% of the female population

Female, middle or upper social class

Family history of eating disorder, depression, or obsessive compulsive disorder

Overly compliant

Desires to be in control

Overachiever, perfectionist

Compulsive

Denies feelings

Low self esteem

Is or has been dieting

Has trouble with close relationships

Participates in body conscious sports or activities

Recent family crisis

Jane is a 13-year-old whose grades have been excellent andwhom the teachers describe as a “model student.”

Recently some of Jane’s friends have expressed concern tothe school nurse practitioner that Jane has begun to “jog” atlunch time and seldom eats with them.

Jane has told her friends that she has gained weight over thewinter months and that she is “jogging” because she wants to qualify for the track team this spring.

Case Study: Anorexia Nervosa

The Anorexic Client

Nursing Care Plan

Nursing Diagnosis:

Imbalanced nutrition: less than body requirements related to self-starvation.

Goal 1: Will consume nourishment adequate for weight gain

Goal 2: Will follow behavior-modification plan (if implemented)

Goal 3: Will reduce energy expenditure

The Anorexic Client

Nursing Care PlanNursing Diagnosis:

Disturbed body image related to altered perception

Goal 1: Will express self in acceptable ways

Goal 2: Will receive adequate support

Goal 3: Will receive assistance in altering distorted self-image

The Anorexic Client

Nursing Care PlanNursing Diagnosis:

Ineffective coping related to unrealistic perceptionsGoal 1: Will conform to therapeutic program

Nursing Diagnosis:

Readiness for enhanced family coping related to ambivalent family relationship

Goal 1:

Will recognize disturbed pattern of family interaction (if applicable)

Regular physical monitoring by a medical doctor who understands

eating disorders

Individual therapy

Group therapy

Family therapy

Marital therapy

Support groups

Nutritional counseling

Special outpatient therapy programs

Hospitalization for physical stabilization and concentrated focus on behavioral and emotional growth