Eating disorders are serious medical illnesses, and the way we talk about them w
Eating disorders are serious medical illnesses, and the way we talk about them with others matters.[1] See Figure 13.1[2] with facts nurses can use to help shape the conversation around eating disorders.
Common Eating Disorders
Common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder.[3]
Anorexia Nervosa
Anorexia nervosa is a condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods. They have an intense fear of gaining weight or becoming fat, even if they are significantly underweight. People with anorexia nervosa often have distorted body image and view themselves as overweight.[4] See Figure 13.2[5] for an illustration of how a person with anorexia nervosa may perceive themselves.
There are two subtypes of anorexia nervosa: restricting type and a binge eating/purging type. People with the restrictive subtype of anorexia nervosa severely limit the amount and type of food they consume or engage in excessive exercise. People with the binge-purge subtype have binge eating and/or purging episodes. Binge eating episodes refer to eating large amounts of food in a short period of time with a feeling of a loss of control. Purging episodes refer to eating large amounts of food in a short time followed by self-induced vomiting or the misuse of laxatives, diuretics, or enemas to eliminate what was consumed.[6],[7]
Anorexia nervosa can be fatal due to medical complications associated with starvation. It has an extremely high mortality (death) rate compared with other mental health disorders. Young people between the ages of 15 and 24 with anorexia have 10 times the risk of dying compared to their same-aged peers. Males represent 25% of individuals with anorexia nervosa and are at a higher risk of dying because they are often diagnosed later than females.[8],[9]
Signs and symptoms of anorexia nervosa include the following[10]:
- Severely restricted eating
- Extreme thinness (also referred to as emaciation)
- A relentless pursuit of thinness and unwillingness to maintain a healthy weight
- Intense fear of gaining weight
- Distorted body image where a person’s self-esteem is heavily influenced by their perception of their of body weight and shape
- Denial of the seriousness of low body weight
Other signs may develop over time, including these issues[11]:
- Thinning of the bones (i.e., osteopenia or osteoporosis)
- Anemia
- Muscle wasting and weakness
- Brittle hair and nails
- Dry and yellowish skin
- Growth of fine hair all over the body (lanugo)
- Severe constipation
- Low blood pressure
- Slowed breathing and pulse
- Drop in internal body temperature, causing the person to feel cold all the time
- Lethargy, sluggishness, or feeling tired all the time
- Infertility
- Damage to the structure and function of the heart
- Brain damage
- Multiorgan failure
See the following box for criteria used to diagnose anorexia nervosa according to the Diagnostic and Statistical Manual o