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Eating: A natural physiologic process?
A culturally determined process? A means for controlling, manipulating
or reacting to the events and process of our lives? A response to certain
emotions? Eating is controlled by many factors, including appetite, food
availability, family, peer, and cultural practices, and attempts at voluntary
control.
Eating disorders involve serious disturbances in eating behavior, such
as extreme and unhealthy reduction of food intake or severe overeating,
as well as feelings of distress or extreme concern about body size, shape
or weight. Eating disorders are complex, chronic illnesses largely misunderstood
and misdiagnosed. Eating disorders are not due to a failure of will or
behavior; rather, they are real, treatable medical illnesses in which
certain maladaptive patterns of eating take on a life of their own.
The main categories of eating disorders are anorexia nervosa and bulimia
nervosa (APA, 2000). A third type, binge-eating disorder, has been identified
but has not yet been approved as a formal psychiatric diagnosis in the
Diagnostic and Statistical Manual of the American Psychiatric Association.
Eating disorders frequently develop during adolescence or early adulthood,
but some reports indicate their onset can occur during childhood or later
in adulthood (Becker et al., 1999).
Eating disorders are on the rise in the United States and worldwide.
Clear etiology is not well understood; all socioeconomic, ethnic and cultural
groups are at risk. Dieting to a body weight leaner than needed for health
is highly promoted by current fashion trends; social and cultural trends
are for women and girls to mimic the extreme thinness of celebrities;
sales campaigns for special foods and "standards" in some activities
and professions may also contribute.
More than ninety percent of those with eating disorders are women. Further,
the number of American women affected by these illnesses has doubled to
at least five million in the past three decades (USDHHS, 2000). Anorexia
and bulimia mainly affect females between ages 14 and 40, but men and
women of any age, social class, or ethnicity may be affected (Dixon-Works
et. al., 2003).
Among young women, eating disorders are one of the key health issues.
Studies in the last decade show that eating disorders and disordered eating
behaviors are related to other health risk behaviors including tobacco
use, alcohol use, marijuana use, delinquency, unprotected sexual activity,
and suicide attempts. Currently, 1-4% of all young women in the United
States are affected by eating disorders. Anorexia nervosa, for example,
ranks as the third most common chronic illness among adolescent females
in the United States (NIMH, 2002).
Eating disorders have numerous physical, psychological and social ramifications,
from significant weight preoccupation, inappropriate eating behavior,
and body image distortion. Many people with eating disorders experience
depression, anxiety, substance abuse, and childhood sexual abuse, and
may be at risk for osteoporosis, kidney disorders and heart problems.
Moreover, death rates are among the highest for any mental illness.
Nutritional status directly impacts overall health and because the incidence
of medical complications of eating disorders is high, nurses in almost
every clinical specialty are likely to care for patients with eating disorders.
So whether you are caring for these patients in psychiatric settings,
in coronary care settings, gynecological settings or medical surgical
settings, in-patient or outpatient, it is likely that patients with eating
disorders will require your expertise. And because the risk of death due
to eating disorders is the highest of all psychiatric disorders, nurses
must increase their awareness of this health problem, learn to identify
symptoms and offer interventions that could be life saving. This course
will provide an overview of select categories, warning signs, and treatment
options for eating disorders.
© 2004 NYSNA All rights reserved.
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