Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 0
Chapter 25
Eating Regulation
Responses and Eating
Disorders
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 1
Figure 25-2 The overlapping relationships among eating disorders.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 2
Figure 25-3 Major factors influencing food intake.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 3
Figure 25-4 The Stuart Stress Adaptation Model as related to eating regulation responses.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 4
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
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 5
Primary Medical Diagnoses Related to
Eating Regulation Reponses
• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 6
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)
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 7
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
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 8
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.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 9
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
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 10
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
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 11
Figure 25-5 The perception of body shape and size.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 12