Laine Eating Disorders

Front 1

what are the 3 broad categories of eating disorders?

Back 1

1. anorexia nervosa (AN)
2. Bulimia Nervosa (BN)
3. Eating disorder not otherwise specified (EDNOS)

Front 2

how are eating disorders often described in OT?

Back 2

biologically based serious mental illness that restricts participation in life activities

Front 3

what are some factors impacting the cause of eating disorders?

Back 3

-compulsive behaviors
-loss of control over one's behaviors
-repetitive dysfunctional behavior despite adverse consequences or obvious negative physical impact
-no single factor but a combo of biological, behavioral, psychological, emotional, interpersonal, and social factors

Front 4

what are common behavioral patterns and thinking?

Back 4

Inflexible thinking often with cognitive distortions (black and white thinking) (use CBT to reframe dysfunctional thinking)
Low self esteem (calibrate self image)
Feelings of inadequacy
Sometimes depression and anxiety
Perfectionistic attitude
Limited self efficacy
May have a history of difficult family relationships
May have a history of physical or sexual abuse
Unrealistic or diminished self image and self concept

Front 5

what has one of the highest mortality rates of any mental illness?

Back 5

anorexia

Front 6

what percent of people with anorexia die as a result?

Back 6

10%

Front 7

what % of people with anorexia have other psychiatric diagnosis?

Back 7

54-94%

Front 8

what are the physical signs of weakness?

Back 8

Heart- feel weak, electrolyte shortage orthostatic pressure changes, weak pulse
Digestion-GI tract slows, constipation, bloating
Hormones-disrupts sex hormone production; delays puberty, infertility; periods may stop
Brain-cognitive damage with possible changes in serotonin levels due to obsessive thinking; low concentration
Hair-thin, dry, brittle from protein deficiencies
Skin- dry, easily bruised, fine layer of hair may grow as insulation (lanugo)
Bones-risk for fractures, growth arrested
Muscles-atrophy, boney appearance
Kidneys-can lead to organ failure
Endocrine metabolic- hypothermia, feel cold, tired
Nails-turn brittle
Hemotologic- bruise easily
Obvious signs of malnutrition
Liver dysfunction

Front 9

what do the later signs of anorexia look like?

Back 9

-brain shuts down at brain stem level and patient refuses or has difficulty swallowing, shallow breathing, organs shutting down

Front 10

what types of BN are there?

Back 10

purging and non purging type

Front 11

what does the criteria for diagnosis of bulimia include?

Back 11

-recurrent periods of eating an abnormally large amount of food in a discrete period and feeling unable to stop or control the amount eated

Front 12

what does the purging type of BN focus on?

Back 12

inappropriate reoccuring behavior to prevent gaining weight and may include:
-self induced vomitting
-laxative abuse
-diuretics
-enemas
-medications
-binge-purge cycles

Front 13

what are health consequences of BN?

Back 13

-electrolyte imbalance
-gastric rupture
-esophageal inflammation
-severe tooth decay
-chronic irregular BM
-peptic ulcers
-pancreatitis

Front 14

where do laxatives work?

Back 14

end of the bowel where diarrhea affects loss of water and electrolytes

Front 15

what are symptoms of laxative withdrawl?

Back 15

-constipation
-fluid retention
-bloating
-temorary weight gain
-these symptoms usually diminish after 3-4 days with regular exercise and hydration, however, for persons with an eating disorder this is often misinterpreted as permanently feeling fat

Front 16

what are GI tract cosequences from BN?

Back 16

damage from continual vomiting destroys the esophagus, teeth, ect

Front 17

what are skin cosequences from BN?

Back 17

loses elasticity

Front 18

what are reproductive cosequences from BN?

Back 18

scanty periods

Front 19

what are muscle cosequences from BN?

Back 19

muscle weakness

Front 20

what are psychological cosequences from BN?

Back 20

eating behavior not connected to hunger but more to compulsivity, low self esteem, negative body image, cognitive distortions about self and others

Front 21

what is OT's role in eating disorders?

Back 21

occupational profile of patters of eating and how this affects engagment in occupations
(how are routines and habits impacted)
(use of time with the pre-occupation on restricting food and preventing weight gain)
-eval of thought processes
-assessing life style choices
-providing psychoeducation about eating disorders
-exploration of healthier coping skills

Front 22

what are goals for OT?

Back 22

-recognize dysfunctional patterns of eating behaviors
-educate on health patters of eating
-cognitvely reframe dysfunctional thinking
-learn and use coping skills
-promote healthy communication and interaction skills with others; allow for self expression and problem/solution identification
-understand need for control and learn ways to deal with this issue

Front 23

what are some issues to discuss regarding eating disorders?

Back 23

feminist perspective on body image; influences of the media on body image
-ethnic differences
-eating habits of various socioeconomic classes and how weigh control is viewed

Front 24

what are common problems of eating disorders?

Back 24

-Eating
maladaptive eating habits and impaired meal preparation
-Communicating
impaired communication and assertiveness skills
-coping with emotions
impaired stress management skills
-participating in everyday activities
maladaptive self care, productivity and leisure habits, and impaired independent living skills
-impaired volition
disabiling psychological factors influencing motvation to change and participate in occupations/roles
--over-valuation of weigh/shape
--mood intolerance
--core low self-esteem
--perfectionism
--interpersonal problems

Front 25

what are intervetion ideas?

Back 25

self-help and support groups

Front 26

what are general principles of intervention?

Back 26

-physical harm reduction
-cognitive reconstruction
-psychosocial functional enablement

Front 27

what are specific OT interventions?

Back 27

menu planning and meal prep
lifestyle redesign and independent living skills
communication ans assertion training
stress management
projective art
crafts
relapse prevention
body image improvement