1. Eating Disorders
Nursing 202

2. Introduction
The hypothalamus contains the appetite regulation center within the brain.
It regulates the body’s ability to recognize when it is hungry, when it is not hungry, and when it has been sated.
Eating behaviors are influenced by
Society Culture
Historically, society and culture also have influenced what is considered desirable
in the female body.

3. Anorexia nervosa
Prevalence rate of anorexia nervosa among young women in the United States is approximately 0.5 to 1 percent. Occurs predominantly in females age 12 to 30 years.
Assessment
Predisposing Factors
Nursing Diagnosis
Planning and Implementation
Outcome
Treatment Modalities

4. Bulimia Nervosa is more prevalent than anorexia nervosa.
Estimates range from 1 to 3 percent of young women.
Onset of bulimia nervosa occurs in late adolescence or early adulthood.
Occurs primarily in societies that emphasize thinness
*Excessive vomiting and laxative or diuretic abuse may lead to problems with dehydration and electrolyte imbalances

5. Bulimia Nervosa Assessment Predisposing Factors Nursing Diagnosis
Planning and Implementation
Outcome
Treatment Modalities

6. Obesity
Obesity has been defined as a body mass index of 30 or greater.
Approximately 65% of adults are overweight, with 31 percent of these in the obese range.

7. Assessment
Predisposing Factors
Nursing Diagnosis
Planning and Implementation
Outcome
Treatment Modalities

8. Treatment Modalities Behavior Modification
Issues of control are central to the etiology of these disorders.
For the program to be successful, the client
must perceive that he or she is in control of
the treatment.
Successes have been observed when the client
Is allowed to contract for privileges based on weight gain
Has input into the care plan
Clearly sees what the treatment choices are

9. Treatment Modalities The client has control over
Eating
Amount of exercise pursued
Whether to induce vomiting
Staff and client agree about
Goals
System of rewards
The client has a choice whether to
Abide by the contract
Gain weight
Earn the desired privilege

10. Treatment Modalities Individual Therapy Family Therapy
Psychopharmacology

11. Psychopharmacology Medications that have been tried with some success:
For anorexia nervosa:
Fluoxetine (Prozac)
Clomipramine (Anafranil)
Cyproheptadine (Periactin)
Chlorpromazine (Thorazine)
Olanzapine (Zyprexa)
For bulimia nervosa:
Imipramine (Tofranil)
Desipramine (Norpramine)
Amitriptyline (Elavil)
Nortriptyline (Aventyl)
Phenelzine (Nardil)

12. Psychopharmacology For binge-eating disorder with obesity:
Topiramate (Topamax)
-For obesity:
Fluoxetine (Prozac)
Sibutramine (Meridia)
Various anorexiants (CNS stimulants)

13. Questions