The current assignment focuses on the mental health issue of eating disorder and the impact the same can have on the lifestyle, health, and surroundings of people. Sometimes the effect is much more pronounced and effects the family members of the one affected also. Eating disorder or binge eating often arises as an outcome of certain mental health issues. Binge eating is mainly taken up by individuals when one is in a melancholic or depressive state of mind. It is also a sign of the restless mind where an individual tries to recover from their mental frustrations through indulging in food. The eating disorder is mainly characterized by irregular eating patterns often accompanied by large gaps which are primarily triggered by concern regarding individual body and weight. Eating disorders are expressed equally within the male as well as in the female. Apart from binge eating, the other types of the eating disorder include anorexia nervosa and bulimia nervosa.
The eating disorders can arise at any stage of life. However, they are mainly are predominant during the teenage years and often co-exist with the mental sickness issues which include depression, abuse of substance and anxiety. Most of the eating disorders stem from a shame regarding body shape and image. The process of clinical reasoning is used by medical professionals to aid in informed decision making. Clinical expertise, previous knowledge and using evidence-based practice play an important part in clinical reasoning to make the best use of patient’s information in making a judgment (Banning 2008, Lee, Lee, et al. 2016). Clinical reasoning is also helpful to care for patients having unhealthy altered eating habits that progress to eating disorders. Eating disorders are most commonly categorized into three, Binge eating disorder (BED), Anorexia nervosa (AN) and Bulimia Nervosa (BN) and (Kupfer, Kuhl, et al. 2013, Maguen, Hebenstreit, et al. 2018).
Considering the patient’s situation is helpful when planning care for a patient having an eating disorder. It is prevalent in younger age groups, especially in female population aged 15 -19-year-old (Smink, van Hoeken et al. 2012, Hoek 2016). Various factors including genetic, neurobiological, psychological commonly body image dissatisfaction, personality disorders, western cultural influence and childhood sex abuse contributes to eating disorders occurrences (Rikani, Choudhry, et al. 2013). Patient history including family past occurences of eating disorders and having a past or present diagnosis of mental illnesses including obsessive-compulsive depression, disorder in mind, anxiety, etc. can also have a significant impact on patient’s presentation of eating disorder (Cederlöf, Thornton et al. 2015).
Assessing a patient diagnosed with an eating disorder for the current issue, status on mental health, developmental occurences, societal, medical history and current medical problems, eating patterns and compensatory behaviors are essential for planning the care and treatment plans (Wolfe and Gimby 2003). Current presentation like very low or high individual weight in terms of age, physical health and sex, fearful of being overweight, being unable to sense and control inappropriate eating habits. There is also consuming significant quantity of food within a while, having settling behaviors to avoid weight gain are observed during eating disorders (Harrington, Jimerson et al. 2015).
Malnutrition in anorexia nervosa can present as symptoms like brittle hair and nails, hyperkeratosis, hypotension, amenorrhea, osteoporosis at young age. It can also progress to more complications such as arrhythmia, bradycardia, edema etc. Due to electrolyte imbalances and heart muscle wasting while in bulimia nervosa the clinical signs due to self-induced vomiting include oral disease, calluses on fingers, parotid gland increase or scars, weight fluctuations, electrolyte imbalances leading to edema, etc. (Harrington, Jimerson et al. 2015, Mehler and Brown 2015). Psychological conditions including disorder in mind, anxiety, abuse of substance, personality, self-harm, committing suicide thoughts or depression are commonly comorbid with eating disorders; it is unclear whether these are caused by or are a risk factor of an eating disorder (Herpertz-Dahlmann, Keski-Rahkonen and Mustelin 2016).
For a patient diagnosed with this problem, it is important to consider the vast possibilities of various medical and psychological co-morbidities, and hence a very comprehensive patient assessment is essential to link the association of multiple diseases and to formulate a treatment plan. Conventional diagnostic procedures for eating disorders include SCOFF questionnaire, regular weight, height and body mass index measurements, urinalysis to determine hydration status, ph. Level, kidney damage, routine blood pressure measurements, electrocardiography, complete blood count, etc. (Harrington, Jimerson, et al. 2015). Deriving a pattern from the diagnosis and associated comorbidities a care plan can be formulated by the treatment team. Attention is given to the severe medical conditions first that may be life-threatening, for example, cardiac complications associated with the eating disorder may require emergent hospitalization, after stabilizing those conditions focus can be moved to improve the lifestyle and providing patient with psychological and medical support to maintain that lifestyle.
Assessment of eating disorder
The occurrence of binge eating disorder within an individual could be analyzed through comprehensive clinical assessment. As mentioned by Mehler & Andersen (2017), the eating disorders are associated with the significant amount of health morbidities as well as could also result in psychological distress. Some of the typical processes which could be conducted by the attending physician to monitor the presence of eating disorder in an individual are through routine laboratory tests, review of presenting symptoms, recording vital health details of the patient and comparing them on each visit and conducting a psychometric assessment test. Some of the routine laboratory tests performed to monitor the overall eating pattern of an individual are-liver function test, monitoring serum calcium, magnesium and phosphorus, monitoring TSH, blood glucose. As commented by Clement et al. (2015), the liver function tests are beneficial in determining any anomalies or abnormalities in the metabolic process and digestion.
The health professional catering to the eating disorder concerns needs to review the clinical symptoms expressed in the patient. Some of these could be health related or merely psychological manifestations. The range of symptoms expressed in the patient are-fatigue, frequent urination, heartburn, irritability, loss of menses, sleep disturbances, depression, constipation, diarrhea, brittle hair, and nails. As supported by, self-monitoring of weight on a regular basis can also help in regulation the obsessive eating disorder. Additionally, the healthcare professionals could develop a range of questions to inquire regarding the eating patterns of an individual.
Treatment and nursing interventions
Some nursing interventions and treatment methods could be suggested for treatment of anorexia or eating disorder in people. The treatment or the intervention plans have been designed concerning the overall health assessment of the patient. As mentioned by Mehler & Andersen (2017), it is essential to consider the health co-morbidities before a specific intervention plan could be met out to a patient. The healthcare or nursing professionals could play a very effective role in monitoring the eating patterns of an individual. As mentioned by Ágh et al. (2015), adequate nutrition and electrolyte balance needs to be maintained as the lack of nutrient can lead to the development of some health issues or disorders. Setting the time limits for each meal along with strictly monitoring activities such as vomiting before and after eating can lead to a reduction in anxiety level related to eating. Additionally, monitoring the weight of the patients frequently can help in preventing the incidents of binge eating. Integration of an individualized meal plan can also help in restoration and stabilize normal eating (Chesney, Goodwin & Fazel, 2014). Some psychotherapeutic approaches have been suggested for controlling the rate of binge eating in an individual. Some of these are implemented through cognitive behavioral therapy which helps an individual to change their perception regarding food and themselves.
The interpersonal psychotherapy focuses upon the interpersonal difficulties in a person’s life which should be treated to bring the required changes in eating patterns. The incorporation of a dialectical behavioral therapy helps people to figure out the emotional distress faced by them. As commented by McElroy et al. (2015), lip-smacking food is often seen as a way out from the melancholic and depressive mode of life. Thus, the process of the mental based depression reduction therapy can also help in the reducing the dependence upon food, which acts a source of stress buster.
Effect on family and community
An eating disorder is a severe problem in the modern world. It is a psychological disorder which is characterized by disturbed or abnormal eating habit. For example, nervosa is an eating disorder, where people stop eating because of the fear of weight addition and hence, suffer from severe food restriction. The perceptions of a perfect figure and resulting eating disorder have a profound implications on the individual, their family and the community the individual is living in (Rohde, Stice & Marti, 2014).
Today, the mass media advertises the concept of beauty regarding youthful face and slender figure of women, which leads to the idealization of a thin body by not gaining weight. However, the ideal value is almost impossible to achieve, but women get panicked about their weight and stop eating. Individuals can experience physical consequences, like malnutrition, together with other chronic diseases, for example, high blood pressure, diabetes, heart disease, dental issues, heart attack, inflamed esophagus, weak bones, and sometimes even death (Blodgett Salafia et al., 2015). The physical impact of the eating disorder shows the implications gradually on the body system. The effects are long-term, which cast their impact in the adulthood. If an individual suffers from this disorder and its resultant health effects, then it is an another cost to the family of the person affected and the whole community. The society is then burdened to provide long-term treatment to these individuals. Yu, Damhorst & Russell (2011) state that in the future, when these young people grow up with many chronic diseases, the community has to provide proper medical treatment at large, regarding hospital facilities, drug counseling, and many more. The working capacity of that individual will also be affected due to ill health, which in turn will change the work culture as well as the productivity of the community.
The individuals with severe eating disorder suffer from isolation and substance abuse. These can have repercussions for their families. The academic performance, social interaction, participation in school and college programs, all get affected due to health issues of the individuals (Moessner & Bauer, 2017). The parents want to cope up with such problems, also get isolated from the society, which is again a major problem for the community. As the problem of an eating disorder is more mental and less physical, it brings extreme pressure on the individual and their families although from different perspectives. The behavior coming from this disorder puts an emotional toll on the affected individual and his family and friends. They start lagging behind in confidence, which gets reflected in their regular activities of daily life and the family faces financial consequences (Gale et al., 2014). The medical cost for such nervous problem is quite high, and the families and the society gets affected by the cost of treatment.
It can be said that the self-perception of an individual, influenced by the media, can result in a disastrous effect on the individual regarding somatic and mental health and the families and the community get affected through high medical cost and social isolation.
The current assignment focuses on the aspect of eating disorder in individuals. The eating disorder stems from psychological stress, negative self-image and failure to lose weight. There is broad scale opinion that weight is genetically controlled and once someone is fat they can hardly do anything about it. Therefore, failure leads to more disappointment and as a result of which an individual has often been seen to stop making an effort altogether. The higher the frustration, the more is the level of indulgence in binge eating. The binge eating can result in a tremendous amount of health complications such as gastrointestinal disorders along with obesity, which can trigger further complications. One of the most critical methods in the control of eating disorders is through implementing useful counseling sessions. As mentioned by Ágh et al. (2015), the counseling sessions help in changing the view possessed by an individual regarding self and eating habits. As suggested by Clement et al. (2015), acceptance of self in the true form can help in reducing the fidgety behavior regarding food. However, effective nursing intervention methods are crucial in the assessment of the obesity patterns of an individual. Some of the intervention approaches could be delivered in the form of psychotherapy sessions. The psychotherapeutic approaches can further help in removing the individual biases regarding self and food.
Banning, M. (2008). “Clinical reasoning and its application to nursing: Concepts and research studies.” Nurse Education in Practice 8(3): 177-183.