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No TIME Specific CONTENT Teacher and Av aids Evaluation

objectives student
activity

1. 5min Introduce the Anorexia (an-o-REK-see-uh) Lecture cum Black The student
topic nervosa — often simply called discussion board know the
anorexia — is an eating method introduction of
disorder characterized by an the topic
abnormally low body weight,
an intense fear of gaining
weight and a distorted
perception of weight. People
with anorexia place a high
value on controlling their
weight and shape, using
extreme efforts that tend to
significantly interfere with
their lives.

To prevent weight gain or to

continue losing weight,
people with anorexia usually
severely restrict the amount Lecture cum
Define the topic discussion The student
2 3 min of food they eat. They may
control calorie intake by method defining the
OHP
vomiting after eating or by anorexia
misusing laxatives, diet aids, nervosa
diuretics or enemas. They may
also try to lose weight by
exercising excessively. No
matter how much weight is
lost, the person continues to
fear weight gain.

Anorexia isn't really about

food. It's an extremely
unhealthy and sometimes life-
threatening way to try to cope
with emotional problems.
When you have anorexia, you
often equate thinness with
self-worth.

Anorexia, like other eating

disorders, can take over your
life and can be very difficult to
overcome. But with
 treatment, you can gain a
better sense of who you are,
return to healthier eating
habits and reverse some of
anorexia's serious
complications

Symptoms

The physical signs and

symptoms of anorexia
nervosa are related to
starvation. Anorexia also
List out the
includes emotional and
symptoms of
behavioral issues involving an Lecture cum
anorexia
unrealistic perception of body discussion
nervosa
3. 5min weight and an extremely method Chart Student list out
strong fear of gaining weight the symptoms of
or becoming fat. anorexia
nervosa
It may be difficult to notice
signs and symptoms because
what is considered a low body
weight is different for each
person, and some individuals
may not appear extremely
thin. Also, people with
anorexia often disguise their
thinness, eating habits or
physical problems.

Physical symptoms

Physical signs and symptoms

of anorexia may include:

Extreme weight loss or not

making expected
developmental weight gains

Thin appearance

Abnormal blood counts

Fatigue

Insomnia
Dizziness or fainting

Bluish discoloration of the

fingers

Hair that thins, breaks or falls

out

Soft, downy hair covering the

body

Absence of menstruation

Constipation and abdominal

pain

Dry or yellowish skin

Intolerance of cold

Irregular heart rhythms

Low blood pressure

Dehydration

Swelling of arms or legs

Eroded teeth and calluses on

the knuckles from induced
vomiting

Some people who have

anorexia binge and purge,
similar to individuals who
have bulimia. But people with
anorexia generally struggle
with an abnormally low body
weight, while individuals with
bulimia typically are normal to
above normal weight.

Emotional and behavioral

symptoms

Behavioral symptoms of
anorexia may include
attempts to lose weight by:

Severely restricting food

intake through dieting or
fasting

Exercising excessively

Bingeing and self-induced

vomiting to get rid of food,
which may include the use of
laxatives, enemas, diet aids or
herbal products

Emotional and behavioral

signs and symptoms may
include:

Preoccupation with food,

which sometimes includes
cooking elaborate meals for
others but not eating them

Frequently skipping meals or

refusing to eat

Denial of hunger or making

excuses for not eating

Eating only a few certain

"safe" foods, usually those
low in fat and calories

Adopting rigid meal or eating

rituals, such as spitting food
out after chewing

Not wanting to eat in public

Lying about how much food

has been eaten

Fear of gaining weight that

may include repeated
weighing or measuring the
body

Frequent checking in the

mirror for perceived flaws

Complaining about being fat

or having parts of the body
that are fat
 Covering up in layers of
clothing

Flat mood (lack of emotion)

Social withdrawal

Irritability

Insomnia

Reduced interest in sex

Causes

The exact cause of anorexia is

Explaining the unknown. As with many
causes and risk diseases, it's probably a
factors of combination of biological,
anorexia psychological and
nervosa environmental factors.
Lecture cum The student
Biological. Although it's not discussion explaining the
4. 5min yet clear which genes are method causes and risk
involved, there may be factors of
Black
genetic changes that make anorexia
board
some people at higher risk of nervosa
developing anorexia. Some
people may have a genetic
tendency toward
perfectionism, sensitivity and
perseverance — all traits
associated with anorexia.

Psychological. Some people

with anorexia may have
obsessive-compulsive
personality traits that make it
easier to stick to strict diets
and forgo food despite being
hungry. They may have an
extreme drive for
perfectionism, which causes
them to think they're never
thin enough. And they may
have high levels of anxiety
and engage in restrictive
eating to reduce it.
Environmental. Modern
Western culture emphasizes
thinness. Success and worth
are often equated with being
thin. Peer pressure may help
fuel the desire to be thin,
particularly among young
girls.

Risk factors

Anorexia is more common in

girls and women. However,
boys and men have
increasingly developed eating
disorders, possibly related to
growing social pressures.

Anorexia is also more

common among teenagers.
Still, people of any age can
develop this eating disorder,
though it's rare in those over
40. Teens may be more at risk
because of all the changes
their bodies go through during
puberty. They may also face
increased peer pressure and
be more sensitive to criticism
or even casual comments
about weight or body shape.

Certain factors increase the

risk of anorexia, including:

Genetics. Changes in specific

genes may put certain people
at higher risk of anorexia.
Those with a first-degree
relative — a parent, sibling or
child — who had the disorder
have a much higher risk of
anorexia.

Dieting and starvation. Dieting

is a risk factor for developing
an eating disorder. There is
strong evidence that many of
the symptoms of anorexia are
actually symptoms of
starvation. Starvation affects
the brain and influences mood
changes, rigidity in thinking,
anxiety and reduction in
appetite. Starvation and
weight loss may change the
way the brain works in
vulnerable individuals, which
may perpetuate restrictive
eating behaviors and make it
difficult to return to normal
eating habits.

Transitions. Whether it's a

new school, home or job; a
relationship breakup; or the
death or illness of a loved one,
change can bring emotional
stress and increase the risk of
anorexia.

Complications

Anorexia can have numerous

complications. At its most
severe, it can be fatal. Death
may occur suddenly — even
when someone is not severely
underweight. This may result
from abnormal heart rhythms
(arrhythmias) or an imbalance
of electrolytes — minerals
such as sodium, potassium
and calcium that maintain the
balance of fluids in your body.

Other complications of
anorexia include:

Anemia

Heart problems, such as mitral

valve prolapse, abnormal
heart rhythms or heart failure

Bone loss (osteoporosis),

 increasing the risk of fractures

Loss of muscle

In females, absence of a
period

In males, decreased
testosterone

Gastrointestinal problems,
such as constipation, bloating
or nausea

Electrolyte abnormalities,
such as low blood potassium,
sodium and chloride

Kidney problems

If a person with anorexia

becomes severely
malnourished, every organ in
the body can be damaged,
including the brain, heart and
kidneys. This damage may not
be fully reversible, even when
the anorexia is under control.

In addition to the host of

physical complications, people
with anorexia also commonly
have other mental health
disorders as well. They may
include:

Depression, anxiety and other

mood disorders

Personality disorders

List out the Obsessive-compulsive Lecture cum The student able

complications of disorders discussion to list out the
anorexia method complications of
nervosa Alcohol and substance misuse anorexia
LCD
nervosa.
Self-injury, suicidal thoughts
5. 3min
or suicide attempts
Prevention

There's no guaranteed way to

prevent anorexia nervosa.
Primary care physicians
(pediatricians, family
physicians and internists) may
be in a good position to
identify early indicators of
anorexia and prevent the
development of full-blown
illness. For instance, they can
ask questions about eating
habits and satisfaction with
appearance during routine
medical appointments.

If you notice that a family

member or friend has low
self-esteem, severe dieting
habits and dissatisfaction with
appearance, consider talking
to him or her about these
issues. Although you may not
be able to prevent an eating
disorder from developing, you
can talk about healthier
behavior or treatment
options.

Diagnosis

If your doctor suspects that

you have anorexia nervosa, he
or she will typically do several
tests and exams to help
pinpoint a diagnosis, rule out
medical causes for the weight
loss, and check for any related
complications.

These exams and tests

generally include:

Physical exam. This may

include measuring your height
and weight; checking your
vital signs, such as heart rate,
blood pressure and
temperature; checking your
skin and nails for problems;
listening to your heart and
lungs; and examining your
abdomen.

Lab tests. These may include a

complete blood count (CBC)
and more-specialized blood
tests to check electrolytes and
protein as well as functioning
of your liver, kidney and
thyroid. A urinalysis also may
be done.

Psychological evaluation. A
doctor or mental health
professional will likely ask
about your thoughts, feelings
and eating habits. You may
also be asked to complete
psychological self-assessment
questionnaires.

Other studies. X-rays may be

taken to check your bone
density, check for stress
fractures or broken bones, or
check for pneumonia or heart
problems. Electrocardiograms
may be done to look for heart
irregularities.

Treatment

Treatment for anorexia is

generally done using a team
approach, which includes
doctors, mental health
professionals and dietitians,
all with experience in eating
disorders. Ongoing therapy
and nutrition education are
highly important to continued
 recovery.

Here's a look at what's

commonly involved in treating
people with anorexia.

Hospitalization and other

programs

If your life is in immediate

danger, you may need
treatment in a hospital
emergency room for such
issues as a heart rhythm
disturbance, dehydration,
electrolyte imbalances or a
psychiatric emergency.
Hospitalization may be
required for medical
complications, severe
psychiatric problems, severe
malnutrition or continued
refusal to eat.

Some clinics specialize in

Explaining the treating people with eating
diagnosis and disorders. They may offer day
treatment of programs or residential Lecture cum
anorexia programs rather than full discussion
6. 5min method LCD The student able
nervosa hospitalization. Specialized
to list out the
eating disorder programs may
diagnosis and
offer more-intensive
treatment of
treatment over longer periods
anorexia
of time.
nervosa .
Medical care

Because of the host of

complications anorexia
causes, you may need
frequent monitoring of vital
signs, hydration level and
electrolytes, as well as related
physical conditions. In severe
cases, people with anorexia
may initially require feeding
through a tube that's placed
in their nose and goes to the
stomach (nasogastric tube).

Care is usually coordinated by

a primary care doctor or a
mental health professional,
with other professionals
involved.

Restoring a healthy weight

The first goal of treatment is

getting back to a healthy
weight. You can't recover
from anorexia without
returning to a healthy weight
and learning proper nutrition.
Those involved in his process
may include:

Your primary care doctor, who

can provide medical care and
supervise your calorie needs
and weight gain

A psychologist or other
mental health professional,
who can work with you to
develop behavioral strategies
to help you return to a
healthy weight

A dietitian, who can offer

guidance getting back to
regular patterns of eating,
including providing specific
meal plans and calorie
requirements that help you
meet your weight goals

Your family, who will likely be

involved in helping you
maintain normal eating habits

Psychotherapy

These types of therapy may

be beneficial for anorexia:

Family-based therapy. This is

the only evidence-based
treatment for teenagers with
anorexia. Because the
teenager with anorexia is
unable to make good choices
about eating and health while
in the grips of this serious
condition, this therapy
mobilizes parents to help their
child with re-feeding and
weight restoration until the
child can make good choices
about health.

Individual therapy. For adults,

cognitive behavioral therapy
— specifically enhanced
cognitive behavioral therapy
— has been shown to help.
The main goal is to normalize
eating patterns and behaviors
to support weight gain. The
second goal is to help change
distorted beliefs and thoughts
that maintain restrictive
eating

Medications

No medications are approved

to treat anorexia because
none has been found to work
very well. However,
antidepressants or other
psychiatric medications can
help treat other mental health
disorders you may also have,
such as depression or anxiety.

Treatment challenges in
anorexia

One of the biggest challenges

in treating anorexia is that
people may not want
treatment. Barriers to
treatment may include:

Thinking you don't need

treatment

Fearing weight gain

Not seeing anorexia as an

illness but rather a lifestyle
choice

People with anorexia can

recover. However, they're at
increased risk of relapse
during periods of high stress
or during triggering situations.
Ongoing therapy or periodic
appointments during times of
stress may help you stay
healthy.

Clinical trials

Explore Mayo Clinic studies

testing new treatments,
interventions and tests as a
means to prevent, detect,
treat or manage this
condition.

Lifestyle and home remedies

When you have anorexia, it

can be difficult to take care of
yourself properly. In addition
to professional treatment,
follow these steps:

Stick to your treatment plan.

Don't skip therapy sessions
and try not to stray from meal
plans, even if they make you
uncomfortable.

Talk to your doctor about

appropriate vitamin and
mineral supplements. If you're
not eating well, chances are
your body isn't getting all of
the nutrients it needs, such as
Vitamin D or iron. However,
getting most of your vitamins
and minerals from food is
typically recommended.

Don't isolate yourself from

caring family members and
friends who want to see you
get healthy. Understand that
they have your best interests
at heart.

Resist urges to weigh yourself

or check yourself in the mirror
frequently. These may do
nothing but fuel your drive to
maintain unhealthy habits.

Alternative medicine

Dietary supplements and

herbal products designed to
suppress the appetite or aid in
weight loss may be abused by
people with anorexia. Weight-
loss supplements or herbs can
have serious side effects and
dangerously interact with
other medications. These
products do not go through a
rigorous review process and
may have ingredients that are
not posted on the bottle.

Keep in mind that natural

doesn't always mean safe. If
you use dietary supplements
or herbs, discuss the potential
risks with your doctor.

Anxiety-reducing approaches
that complement anorexia
treatment may increase the
sense of well-being and
promote relaxation. Examples
of these approaches include
massage, yoga and
meditation.

Nursing considerations should

include the following goals:

Emphasizing proper nutrition

and resumption of normal
body weight

Promotion of self- esteem and

regaining trusting relationship
with others

Assisting client in
demonstrating realistic,
positive concept of self and
body image.

Behaviour modifications to
control binging, purging,
limiting of food intake, etc.

Ensuring safe environment

References:

Huelskoetter, M. & Beckmann,

M.(1991). Psychiatric Mental
Health Nursing: Giving
emotional care. C & E
Publishing Co.

Shives, L. R. (2008). Basic

Concepts of Psychiatric-
Mental Health Nursing 7th
Edition. Lippincott Williams &
Wilkins.