18 EATINGDISORDERS 453
will power to stop. The nurse must remember that the
client’s eating behavior has gotten out of control. Eat-
ing disorders are a mental illness just like schizo-
phrenia or bipolar affective disorder.
Points to Consider When Working
With Clients With Eating Disorders
- Be empathetic and nonjudgmental, although
this is not easy. Remember the client’s per-
spective and fears about weight and eating. - Avoid sounding parental when teaching
about nutrition or why laxative use is harm-
ful. Presenting information factually without
chiding the client will obtain more positive
results. - Do not label clients as “good” when they avoid
purging or eat an entire meal. Otherwise
clients will believe they are “bad” on days
when they purge or fail to eat enough food.
➤ KEY POINTS
- Anorexia nervosa is a life-threatening eating
disorder characterized by body weight less
than 85% of normal, an intense fear of being
fat, a severely distorted body image, and re-
fusal to eat or binge eating and purging. - Bulimia nervosa is an eating disorder that
involves recurrent episodes of binge eating
and compensatory behaviors such as
purging, use of laxatives and diuretics, or
excessive exercise.- Ninety percent of clients with eating dis-
orders are female. Anorexia begins at ages
14 through 18, and bulimia at age 18 or 19. - Many neurochemical changes are present in
eating disorders, but it is uncertain whether
these changes cause or are a result of the
eating disorder. - Persons with eating disorders feel un-
attractive and ineffective and may be
poorly equipped to deal with the challenges
of maturity. - Societal attitudes regarding thinness,
beauty, desirability, and physical fitness
may influence the development of eating
disorders. - Severely malnourished clients with anorexia
nervosa may require intensive medical treat-
ment to restore homeostasis before psychiatric
treatment can begin.
- Ninety percent of clients with eating dis-
I NTERNET R ESOURCES
Resource Internet Address
◗About Face (changing attitudes about body image) http://www.about-face.org
◗Academy for Eating Disorders http://www.aedweb.org
◗American Anorexia Bulimia Association http://www.anred.com
◗Body Positive http://www.bodypositive.com
◗Eating Disorder Referral and Information Center http://www.edreferral.com
◗National Association of Anorexia Nervosa &
Associated Eating Disorders http://www.anad.org
◗National Eating Disorders Association http://www.nationaleatingdisorders.org/
p.asp?webpage_ID-337Critical Thinking Questions
1.You notice a friend or family member has been
losing weight, has strange eating rituals, and
constantly talks about dieting. You suspect an
eating disorder. How would you approach this
person?
2.A client has the right to refuse treatment. How
would the nurse address this right when work-
ing with a client with anorexia who doesn’t
want treatment?