Determine if medial/psychiatric condition warrants hospitalization (appropriate testing important)
Severe hypothermia, bradycardia, hypotension, hypokalemia, cardiac abnormalities
Weight loss more than 30% over 6 months
Suicidal of self-mutilating behaviors
Severe depression or psychosis
Emotional problems
Chaotic family relationships
o Treatment: Anorexia Nervosa
, RefeedingSyndrome: emergency status causing cardiac collapse and possible death
Generally treat on an outpatient basis unless a medical emergency occurs
Patient will usually fight the tx because they fear gaining weight and losing control
Can be manipulative and will lie to avoid exposure that they are not eating
Family MUST be a part of the recovery process for support
CBT, group therapy, family therapy and medication for depression
Bulimia Nervosa
o Diagnosis is made from:
Assessment and the history of behaviors
Recurrent episodes of binge eating followed by self-induced vomiting, misuse of laxatives or
diuretics
Behaviors are designed to prevent weight gain – not necessarily to lose weight
Patient will often be at normal or near normal weight so diagnosis is usually made off of patient
history and behaviors
o Characteristics: Bulimia Nervosa
Being a “people pleaser”
Low self-esteem
Depression, isolation and loneliness
Preoccupation with food; hoarding, hiding or stealing food
o Physical Complications:
Upset stomach
Burning throat (acid reflux)
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