Relationship to Nutrition
The life threatening condition that may occur with eating disorder patients is called Refeeding Syndrome. What deficiency is secondary to sudden increase of carbohydrate metabolism?
Thiamin ( Vitamin B9) Deficiency
(Dudek, 2020)
What are the common clinical manifestations of Bulimia Nervosa?
Frequent binge episodes followed by extreme measures to prevent weight gain, lack of control of eating patterns, constant weight fluctuations, chronic dehydration, esophageal inflammation, frequent urgency to use the restroom after a meal, broken blood vessels in the eyes
(Dudek, 2020)
For weight maintenance in patients with Anorexia Nervosa, the need for 50 to 60 calories per kilogram amount higher than the general population. Why is this high caloric range necessary?
Due to metabolic changes and new onset of exercise
(Dudek, 2020)
In patients with Bulimia Nervosa, weight fluctuations are common. Patients usually have a normal body mass index, if not the body mass index is higher. Attempting to "diet" while recovering from an eating disorder can prove to not be successful. What are some outcomes to plan for?
Stabilize weight via reducing binge and purge episodes, develop normal views of hunger, fullness, and satiety; normalize the idea that eating patterns are healthy and ordered. (no fasting or punishment for eating)
(Dudek, 2020)
T/F: Anorexia is the same as Anorexia Nervosa.
False: Anorexia Nervosa is a psychological disorder which involves body image and influence, however the term anorexia is not being able to or willing to eat.
(Dudek, 2020)
What are common clinical manifestations of Anorexia Nervosa?
Extreme (un)intentional weight loss, thin appearance, fatigue, insomnia, syncope, amenorrhea, jaundice, alopecia, osteoporosis, abnormal blood count, intolerance of cold, localized edema (face, ankles), cyanosis of fingers
(Dudek, 2020)
T/F: After being diagnosed with an eating disorder, it is easy for the patient to follow a diet plan from their doctor.
False: there are psychological components to eating disorders and it takes time to create an effective meal plan that the patient will adhere to.
(Dudek, 2020)
A patient has a history of eating a large amount of food and within 2 hours feels they lack control or feel an immense amount of guilt. They ask the health care provider how they can control the urge to purge. What can the provider teach them?
The patient can have 4-6 small, regularly scheduled and planned meals throughout the day.
(Dudek, 2020)
T/F A patient's highest lifetime weight does not indicate how their body mass index or weight will be during the course of their life.
This is false, research has shown a correlation between a patient's highest weight earlier in life and weight management later in life
(Kaufmann, 2022)
While the etiology of eating disorders is idiopathic, the genetic heritability is around 50 to 80%, especially for Anorexia and Bulimia Nervosa. What are some common catalysts for eating disorders?
extreme dieting, childhood/ history of disordered eating, history of gastrointestinal conditions, extreme worry or concern about weight and size, poor self esteem
(Dudek, 2020)
How should patients with Bulimia space out their meals throughout the day compared to a normal meal plan?
They should do 4-6 small, frequent meals in order to avoid binging out of hunger.
(Dudek, 2020)
During treatment of a patient with Anorexia Nervosa, the main planning outcome should be to correct the disordered eating pattern. What are some strategies to promote compliance to treatment and overall trust in the patient?
involve the patient in outcome identification, customize the goals to be SMART, meal plan should cater to preferences and cultural beliefs of the patient, reward number of calories eaten instead of weight gained, encourage the use of food diary and physical activity, ensure they are eating a variety of kinds of food; the client should enjoy what they are eating while still being nutritious.
(Dudek, 2020)
T/F: Anorexia Nervosa and Bulimia Nervosa do NOT put the patient at risk for malnutrition.
False: both eating disorders can lead to malnutrition. This is because the patient is not receiving the nutrients they need from their daily intake.
(Rigaud, 2000)
T/F: Eating Disorder Treatment is universal and every patient recovers from these disorder the same way.
False, treatment is different for everyone and the care plans should be individualized. However, patients will have similarities to others with the same disorder; support groups should be encouraged
(Dudek, 2020)
What is the average amount of calories consumed in one "binging" episode?
5,000 - 15,000 calories
(U.S. Department of Health, n.d.)
What would you teach a patient with an eating disorder that abuses laxatives?
Medical problems associated with laxative abuse include electrolyte and acid/base changes that can involve the renal and cardiovascular systems and may become life threatening.
(Roerig JL, Steffen KJ, Mitchell JE, Zunker C., 2010)
Are weight fluctuations common in Bulimia patients?
Yes; People with BN are usually within their normal weight range, although some may be overweight; weight fluctuations are common.
(Dudek, 2020)
There is a common belief that purging involves emesis only or commonly known as pulling the trigger. However, the term purge is an umbrella term for all the ways to prevent weight gain from an episode of binge eating. Some more purging activities would be?
Fasting, excessive exercise after meals, diet pill abuse, laxative abuse, and diuretic abuse (this can include diet/detox teas that promote colon cleanses)
(Dudek, 2020)
Which of the following is a good breakfast option for patients recovering from an eating disorder?
A: oatmeal, fresh fruit, avocado toast, and a glass of low-fat milk.
B: water and an apple
A: oatmeal, fresh fruit, and avocado toast, and a glass of low-fat milk.
Rationale: you want a balanced meal, including grains/starch, fruits, fats/oils, and dairy.
(Dudek, 2020)
What can you, as the nurse, teach the concerned mother of an eating disorder patient about helping her child recover?
The nurse can teach the family to eat meals together, eat healthy foods, avoid snacking throughout the day, and be supportive of her child's new eating pattern.
(U.S. Department of Health, n.d.)