Eating/Sleeping Disorders
Leolin Castillo
NURS 4152 – Promoting Mental Wellness
University of Belize
Objectives
• At the end of the presentation students will:
1. Define the terms anorexia nervosa, bulima nervosa and
binge eating disorder.
2. Discuss the sub-types of anorexia nervosa and bulimia
nervosa.
3. Describe the etiologic agents of the eating disorders.
4. Explain the pathophysiology of the eating disorders.
5. Discuss the diagnostics tests of the eating disorders.
6. List the signs and symptoms of the eating disorders.
7. Explain the nursing management and treatment modalities
of the eating disorders.
Definition of Terms
• Anorexia nervosa is defined as a serious eating disorder, which
includes three basic components such as: refusal to maintain
healthy body weight, fear of gaining weight, and a distorted
body image. Anorexia can also be described by a compulsive
desire to lose weight by self-starving. An individual going
through this eating disorder is never satisfied with their body
weight.
Definition of Terms
• Bulimia nervosa is an eating disorder in which a person
gets involved in uncontrollable occurrences of overeating
(binging) usually followed by intentionally vomiting
(purging), misuse of laxatives, enemas, fasting, or
excessive exercise to control weight.
• Binge eating disorder is a severe, life-threatening and
treatable eating disorder characterized by recurrent episodes of
eating large quantities of food (often very quickly and to the
point of discomfort); a feeling of a loss of control during the
binge;
Types of Anorexia and Bulimia Nervosa
There are two types of Anorexia nervosa:
1. The restricting type of Anorexia, in which weight loss is
achieved by restricting calories (following drastic diets,
fasting, and excessive exercising).
2. The purging type of Anorexia, weight loss is achieved by
vomiting or using laxatives and diuretics.
Types of Anorexia and Bulimia Nervosa
There are also two subtypes of bulimia nervosa.
1. The Purging Type – describes individuals who regularly
compensate for the binge eating with self-induced
vomiting, laxative abuse, diuretics, or enemas.
2. The Non-Purging Type is used to describe individuals who
compensate through dietary fasting or excessive exercising.
Etiological agents of the three eating disorders.
Anorexia Nervosa
Bulimia Nervosa
The exact cause of
Anorexia nervosa is
unknown. Thought to
develop due to
physical, emotional and
social triggers.
The exact cause of bulimia nervosa is
currently unknown. Though it is thought
that multiple factors contribute to the
development of this eating disorder,
including genetic, environmental,
psychological, and cultural
influences. Some of the main causes for
bulimia include:
Stressful transitions or life changes.
History of abuse or trauma
Negative body image
Poor self-esteem
Professions or activities that focus on
appearance/performance
Binge Eating
Disorder
It can be triggered by
interpersonal
stressors, negative
feelings related to
body image, and
boredom.
Pathophysiology of Eating disorders
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
There is evidence that
specific areas of the brain,
particularly among Anorexic
patients, are involved in
complex pathophysiological
processes. The medial
central area of the
hypothalamus is probably a
key area influencing food
intake.
The pathophysiology of
Bulimia nervosa is unknown.
However, there is evidence
that suggests that individuals
may binge and purge when
they have low self-esteem,
when they are pressured to
conform to eating or to
adhere to a specific weight
and shape, and when they
are knowledgeable about
bingeing and purging.
Alterations in the left
orbitofrontal cortex, result
in increased insula volume.
Increased gray matter gyrus
rectus volume specifically
correlates with increased
weight gain and an
exaggerated response to
sucrose pleasantness ratings
in general. Reduced white
matter in the medial
temporal lobe, and the
parietal lobe, may also be
associated with binge-eating
disorder
Diagnostic tests of eating disorders
Anorexia Nervosa
Physical and
Psychological
examination.
Lab studies such as
LFT, KFT, CBC, and
Urinalysis
Bulimia Nervosa
Physical and
Psychological
examination.
Lab studies such as
LFT, KFT, CBC, and
Urinalysis
Binge Eating
Physical and
Psychological
examination.
Lab studies such as
LFT, KFT, CBC, and
Urinalysis
X-Ray and ECG
X-Ray and ECG
X-Ray and ECG
DIAGNOSTIC CRITERIA FOR EATING DISORDERS
Anorexia Nervosa
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Thin appearance
Insomnia
extreme tiredness
dizziness or fainting
spells
bluish nails
brittle hair and nails
Constipation
dry skin
irregular heart rhythm
Bulimia Nervosa
Binge Eating Disorder
• fear of gaining weight
• extreme use of weight
loss supplements
• forced vomiting
• extreme exercising
• regularly using laxatives,
diuretics, or enemas
eating unusually large
portions of food
eating until uncomfortably
full
insistence on eating alone
constantly dieting but not
losing weight
depression and anxiety
Treatment of Eating Disorders
1. Reinstitution of normal nutrition or reversal of the
severe state of malnutrition.
2. Resolution of disturbed patterns.
3. Individual psychotherapy
4. Family Therapy
5. Support therapy
6. Dialectical Behavioral Therapy
7. Antidepressants
8. Alternative therapies
Videos of Eating Disorders
• http://www.dailymail.co.uk/news/article-3090351/Mychances-slim-Actress-37-describes-battle-against-severeanorexia-left-emaciated-breathless-weighing-50lbs.html
• https://www.youtube.com/watch?v=DNDbnZ7M_lc
• http://www.webmd.com/mental-health/eatingdisorders/binge-eating-disorder/video/video-bingeeating