Eating Disorders Nursing 202 Introduction The hypothalamus contains

Eating Disorders Nursing 202

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.

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

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

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

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.

• • • Assessment Predisposing Factors Nursing Diagnosis Planning and Implementation Outcome Treatment Modalities

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

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

Treatment Modalities • Individual Therapy • Family Therapy • Psychopharmacology

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: • Fluoxetine (Prozac) • Imipramine (Tofranil) • Desipramine (Norpramine) • Amitriptyline (Elavil) • Nortriptyline (Aventyl) • Phenelzine (Nardil)

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

• Questions