Chapter 14: Eating Disorders

Eating Disorders examines the multifaceted origins of these conditions, incorporating neurobiological factors such as serotonin and dopamine dysregulation, genetic predispositions, and sociocultural pressures that idealize thinness. The text meticulously breaks down anorexia nervosa, distinguishing between restricting and binge-eating/purging subtypes, and highlights severe physical complications including cachexia, lanugo, amenorrhea, and the potentially fatal refeeding syndrome that requires careful medical monitoring during weight restoration. The discussion extends to bulimia nervosa, characterized by a cycle of uncontrolled bingeing followed by compensatory behaviors like self-induced vomiting, laxative misuse, or excessive exercise, often presenting with physical signs such as parotid gland enlargement, dental erosion, and Russell’s sign. Additionally, the chapter defines binge-eating disorder as recurrent overeating without compensatory mechanisms, which is frequently linked to obesity and significant psychological distress. A major focus is placed on the application of the nursing process, from utilizing screening tools like the SCOFF questionnaire to prioritizing patient safety against high risks of suicide and self-harm. It outlines critical interventions including milieu therapy, precise weighing protocols, and supervised eating to interrupt disordered patterns. Finally, the summary covers interdisciplinary treatment strategies, including psychopharmacological options like SSRIs and lisdexamfetamine, as well as therapeutic modalities such as cognitive-behavioral therapy and the Maudsley family-based method, emphasizing the nurse's pivotal role in establishing a therapeutic alliance to support recovery and correct cognitive distortions regarding body image.