ANOREXIA NERVOSA/BULIMIA NERVOSA
307.1 Anoxexia nervosa
307.51 Bulimia nervosa
307.50 Eating disorders NOS
Binge-eating disorder (proposed, requiring further study)
Anorexia nervosa is an illness of starvation, brought on by severe disturbance of body image and a
morbid fear of obesity.
Bulimia nervosa is an eating disorder (binge-purge syndrome) characterized by extreme overeating,
followed by self-induced vomiting. It may include abuse of laxatives and diuretics.
Binge-eating is defined as recurrent episodes of overeating associated with subjective and behavioral
indicators of impaired control over and significant distress about the eating behavior but without the use of
inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise).
The individual reflects a developmental arrest in the very early childhood years. The tasks of trust,
autonomy, and separation-individuation are unfulfilled, and the individual remains in the dependent
position. Ego development is retarded. Symptoms are often associated with a perceived loss of control in
some aspect of life and may center on fears of sexual maturity
intimacy. Although these disorders affect
women primarily, approximately 5% to 10% of those afflicted are men. Additionally, eating disorders are
often associated with depression, anxiety, phobias, and cognitive problems.
These disorders may be caused by neuroendocrine abnormalities within the hypothalamus. Symptoms
are linked to various chemical disturbances normally regulated by the hypothalamus. Furthermore, a
physiological defect may make it difficult for the individual to interpret sensations of hunger and fullness.
Issues of control become the overriding factors in the family of the client with an eating disorder.
These families often consist of a passive father, a domineering mother, and an overly dependent child.
There is a high value placed on perfectionism in this family, and the child believes she or he must please
others and satisfy these standards.
CLIENT ASSESSMENT DATA BASE
Disturbed sleep patterns (e.g., early morning insomnia; fatigue)
Feeling “hyper” and
avid exerciser, participation in high-energy sports
Employment in positions
professions that require control of weight (athletics, such as gymnasts, swimmers,
jockeys, wrestlers; modeling, flight attendants)
Feeling cold even when room is warm
Low BP; tachycardia, dysrhythmias