Eating and
Sleeping
Disorders
Chapter 37
Feeding And Eating Disorders
These disorders arise from altered body image
perceptions.
Lead to disturbances in eating behaviours and abnormal concern
about body weight and shape.
They occur mainly in teenage girls and young women.
Are influenced by, biological, psychological, and
sociocultural factors
Examples:
Anorexia nervosa
Anorexia bulimia
Feeding and Eating Disorders
Feeding and eating disorders in older persons in long-term care
facilities may include:
Fear of choking
Sick feeling
Depression
Dislike for texture or taste of food
Feeding and Eating Disorders
Anorexia Nervosa
Occurs when a client has an intense fear of weight gain and a distorted body image
Is often a life-threatening condition.
Three key features:
A refusal to maintain minimal body weight within 15% of an individual’s normal weight
An intense fear of gaining weight
A distorted body image of being “fat” or “ugly”
Feeding and
Eating
Disorders
Anorexia Nervosa
Has the highest mortality rate (6%) among all psychiatric
conditions.
Behavioural and environmental influences, and stressful
events all increase risk.
Feeding and Eating Disorders
Signs and symptoms of anorexia nervosa:
Obsession with food and weight
Thoughts of looking fat, in spite of being bone-thin
Depression
Brittle nails, hair, dry and yellow skin, feeling cold
Cessation of menstruation
Lanugo on body (fine hair like newborn)
Feeding and Eating Disorders
Signs and symptoms of anorexia nervosa:
Cutting food into tiny pieces
Refusal to eat in front of others
Abusing laxatives and diuretics
Effects on body includes damage to vital organs, irregular heart rhythms or
failure, and calcium loss from bones.
Feeding and Eating Disorders
Bulimia nervosa:
Occurs mainly in teenage girls and young women
Is characterized by episodes of binge eating followed by inappropriate methods of
weight control (e.g., purging):
The client eats large amounts of food (up to 20 000 calories at a time)
Then the body is purged (rid) of the food eaten to prevent weight gain.
Vomiting, laxatives, enemas, diuretics, fasting, and intense exercise are some methods
used to purge the body of food.
Feeding and Eating Disorders
Bulimia nervosa
Binge eating is not about hunger; it is usually a response to depression, stress, or
low self-esteem.
The cycle of overeating and purging becomes an obsession.
Foods binged on are usually ‘comfort foods’
Most people with bulimia nervosa are of normal weight
Women with bulimia are usually high achievers
Bingeing and purging are done in secret—the person often denies condition.
Feeding and Eating Disorders
Signs and symptoms of bulimia nervosa:
Eating uncontrollably
Purging, strict dieting, fasting
Vomiting or vomiting blood
Using bathroom frequently after meals
Preoccupation with weight
Depression or mood swings
Compulsive exercising
Feeding and Eating Disorders
Signs and symptoms of bulimia nervosa:
Excessive concern about shape and weight
Heartburn, swollen glands, heartburn, bloating, indigestion, constipation, irregular
menstrual periods, sore throat, poor dental health, bloodshot eyes
Feeding and Eating Disorders
Bulimia nervosa’s effects on the body:
Erosion of tooth enamel
Dental cavities; hot/cold sensitivities
Swelling and soreness in salivary glands
Stomach ulcer
Rupture of stomach and esophagus
Disruption in normal bowel function
Feeding and Eating Disorders
Bulimia nervosa’s effects on the body:
Electrolyte imbalance
Dehydration
Irregular heartbeat
Increased risk for suicidal behaviour
Decreased libido
Feeding and Eating Disorders
Pica
Defined as persistently eating substances without nutritional value for a period of
at least a month.
Examples include clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl
gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood,
plaster, light bulbs, needles, string, cigarette butts, wire, and burnt matches
Some nutritional deficiencies may cause pica.
Supporting Clients With Feeding and Eating
Disorders
Be patient.
Be compassionate.
Be encouraging.
Be nonjudgemental.
Be positive.
Prevent the client from eating nonfood substances.
Report any evidence of food refusal or vomiting to supervisor.
Sleep-Wake
Disorders
Sleep-Wake
Disorders
Sleep is essential for normal, healthy function.
Sleep-wake disorders are conditions in which repetitive
disturbed sleep patterns lead to distress and
impairment in a person’s daytime functioning.
Sleep-Wake Disorders
Classified into 10 conditions:
Insomnia (lack of sleep)—most common disorder
Breathing-related sleep disorders
Hypersomnolence disorder
Narcolepsy
Circadian-rhythm sleep–wake disorders
Nightmare disorder
NREM disorder
REM disorder
Willis-Ekbom disease
Substance/medication-induced sleep disorder
Sleep-Wake Disorders
Supporting clients with sleep-wake disorders:
Clients should avoid foods and medicines that alter their chemical balance (e.g.,
caffeine).
Observe if client has periods of not breathing, or wakes up with a headache every
morning.
Encourage client to seek medical attention.
Observe, report, and record:
How long the client is sleeping during each stage of sleep
Make note of client’s use of prescription and nonprescription drugs or alcohol
References
Sorrentino, S. (2022). Mosby’s
Canadian textbook for the
support worker (5th Cdn ed.).
Mosby: Toronto.
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