Rebecca Sposato MS, RN

Eating Disorders A collection of psychiatric conditions that manifest psychological illness through abnormal eating habits and body image

Includes anorexia nervosa, bulimia nervosa, binge eating, orthorexia nervosa, pica and selective eating disorder

(www.nationaleating disorder.org, 2011)

http://vimeo.com/user638254/videos/sort:date

StatisticsEating disorders are grossly under diagnosed due

to the surrounding secretive and resistant habits90% of cases are female: U.S. prevalence 10

million women and 1 million men40% of new diagnoses occur in females 15-19

years oldOnly 1/3 of people with anorexia nervosa and 6%

of people with bulimia receive mental health services

(www.nationaleating disorder.org, 2011)

Eating Disorders Comorbid DiagnosesBorderline Personality DisorderObsessive Compulsive Disorder and

Obsessive Personality DisorderDepressionAnxietyBody Dysmorphic DisorderNarcissistic Personality DisorderAddiction and Substance abuseVictim of Abuse or trauma

Methods of Eating DisordersPersons with eating disorders may utilize

different methods as their illness evolvesCalorie reductionExcessive exerciseInduced vomiting (mechanical or chemical)Misuse of laxatives, dieting pills, enemas,

diuretics Insulin misuse

What does 300 calories look like?

Anorexia NervosaSeek to maintain a BMI <18, most often with

calorie reductionRitualistic /analytical eating habitsPreoccupation with weight/size and anxiety

with weight gainLifetime prevalence of 1% in women, 90% of

cases are female Anorexia nervosa has a mortality rate of 20%,

giving it the highest mortality rate of all psychiatric disorders10% die within 10 years of diagnosis35% fully recover

(www.state.sc.us/dmh/anorexia/statistics.htm, 2011)

Body Mass index

Bulimia NervosaEngage in compulsory consumption of high

calorie foods during binge episodes often followed by purgingCyclic pattern of calorie restraint, excessive intake

and purgingBinge on high calorie, high sugar and high fat foodsBinge-purge twice/week x 3 months per DSM 4Episodes occur in private, beyond volitional control

Usually have a BMI >18Episodes are often triggered by stressful events

and changes (www.womenshealth.gov/faq/bulimia-nervosa.cfm#a, 2011)

Pro-Ana, Pro-Mia and Pro-EdA n eating disorder community who

collectively deny the pathology of their habits, defend their condition as a lifestyle choice and maintain extreme thinness as a form of beauty

Thinspiration pictures

http://www.bukisa.com/articles/381852_45-pro-ana-tips-and-tricks

AssessmentWhat would you include in your assessment?

Questions?Measurements?Labs?Diagnostics?

Medical TreatmentsStandard:

History: height/weight, eating/dieting habits , body image, menstrual habits, stressors/coping

Labs: CBC, chem panel, thyroid levels, estrogen, albumin/prealbumin, urinanalysis, ABG

Diagnostics: VS, EKG

>20% below BMI: chest x-ray, 24hr creatinine clearance, bone density scan, echocardiogram (mitral valve prolapse) EEG, brain imaging

(www.nationaleatingdisorders.org/uploads/file/Screening%20for%20Eating%20Disorders%20by%20Primary%20Care%20Physicians-2.pdf, 2011)

Recovery TeamMedical MD, psychiatrist Clinical psychologist/therapist, expressive therapist

Social worker, case managerNurse Dietician Teachers/School Liaison

Recovery EnvironmentsHospital Inpatient: Acute physical problemsMental Health Inpatient Facility: unstable

psychiatric problems, suicidalResidential Facility: structured living

environmentIntensive Outpatient: several hours on most

weekdaysOutpatient: weekly sessionsTelehealth: technology and telephone

resources (www.eatingdisorderrecovery.com. 2011)

Recovery InterventionsTube Feeding – with consentTreat the compounding psychiatric

conditionIndividual counseling, psychotherapyGroup TherapyFamily TherapySupport GroupsArt/Expression Therapy,

Culinary/Nutrition Sessions (www.eatingdisorderrecovery.com. 2011)

ReferencesEating Disorder Recovery (2011). Retrieved

from www.eatingdisorderrecovery.com.

National Eating Disorders Association (2011). Retrieved from www.nationaleating disorder.org

Women’s Health Information Center (2011) Retrieved from www.womenshealth.gov