1. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 0

2. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 1 Chapter 25 Eating Regulation Responses and Eating Disorders

3. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 2 Figure 25-2 The overlapping relationships among eating disorders.

4. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 3 Figure 25-3 Major factors influencing food intake.

5. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 4 Figure 25-4 The Stuart Stress Adaptation Model as related to eating regulation responses.

6. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 5 Primary Nursing Diagnoses Related to Eating Regulation Reponses Anxiety Disturbed body image Imbalanced nutrition: less than body requirements Imbalanced nutrition: more than body requirements Powerlessness Chronic low self-esteem Situational low self-esteem Risk for self-mutilation

7. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 6 Primary Medical Diagnoses Related to Eating Regulation Reponses Anorexia nervosa Bulimia nervosa Binge eating disorder

8. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 7 Key Features of Anorexia Nervosa (without bingeing or purging) Rare vomiting or diuretic/laxative abuse More severe weight loss Slightly youngera More introverted Hunger denied Eating behavior may be considered normal and source of esteem Sexually inactive Obsessional and perfectionist features predominate Death from starvation (or suicide, in chronically ill) Amenorrhea Fewer behavioral problems (these increase with level of severity)

9. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 8 Key Features of Bulimia Nervosa Frequent vomiting or diuretic/laxative abuse Less weight loss Slightly older More extroverted Hunger experienced Eating behavior considered foreign and source of distress More sexually active Avoidant, dependent, or borderline features as well as obsessional features Death from hypokalemia or suicide Menses irregular or absent Drug and alcohol abuse, self-mutilation, and other behavior problems

10. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 9 Evidence-Based Treatments for Bulimia Nervosa Disorder: Bulimia nervosa (BN) Treatment: Several different classes of antidepressant drugs produce significant, short-term reductions in binge eating and purging. Manual-based cognitive-behavioral therapy (CBT) is most effective in eliminating the core features of BN; roughly half the patients receiving CBT reduce binge eating and purging; long-term maintenance of improvement was good.

11. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 10 Cognitive Distortions in Maladaptive Eating Regulation Responses Magnification—Overestimation of the significance of undesirable events Superstitious thinking—Believing in the cause-effect relationship of noncontingent events Dichotomous or all-or-none thinking—Thinking in extreme or absolute terms such as that events can only be black or white, right or wrong, good or bad

12. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 11 Cognitive Distortions in Maladaptive Eating Regulation Responses (Cont.) Overgeneralization—Extracting a rule on the basis of one event and applying it to other dissimilar situations Selective abstraction—Basing a conclusion on isolated details while ignoring contradictory and more important evidence Personalization and self-reference—Egocentric interpretations of impersonal events or overinterpretation of events related to the self

13. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 12 Figure 25-5 The perception of body shape and size.