Transcript The Cultural Identity of Eating Disorders among Adolescent

The Cultural Identity of
Eating Disorders among
Adolescent Girls
K1004821
Georgia Petherick
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Anorexia - extensive determined efforts to avoid
weight gain and lose weight by food avoidance and
excessive exercise (Dhakras, 2005).
In Bulimia, a person will have eating ‘binges’ where
they have a high intake of high-calorie food followed
by vomiting or the use of laxatives to mitigate the
effects of the ingested food (Blows, 2011).
70 million individuals worldwide (NICE, 2004).
Over 50% of 9 and 10 year old girls feel better about
themselves if they are on a diet.
81% have reported to be scared of getting fat (The
Renfrew Centre Foundation for Eating Disorders,
2002).
Introduction
Steady decline in female wellbeing since the early
1970s, which is also consistent among socioeconomic
and ethnic groups (Lakasing and Sargent, 2012).
 Effects of celebrity culture have clearly created
damage to women’s health, as the market is
manipulating younger generations to conform to a
‘body type’ (Lakasing and Sargent, 2012).
 Great number of women who will never seek medical
help contributing to the morbidity and mortality
among the undiagnosed (Perry, 2000).
 Women often turn to nurses in difficult situations
(Lakasing and Sargent, 2012), nurses should be
aware of the risk factors and health behaviour within
this group.
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Rationale
Behaviours and Beliefs of Eating Disordered
Adolescent Girls
2. Implications to Health
3. NICE guidelines of management
4. Interventions
- Cognitive Behaviour Therapy
- Screening for Eating Disorders
- Health Education
5. Nursing Implications
6. Conclusion
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Outline of Presentation
Behaviours and Beliefs of Eating
Disordered Adolescent Girls
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Morris (2002) contends that adolescent girls with eating
disorders feel socially isolated from society, and use pro
anorexic and bulimic sites to gain a sense of belonging.
Often these websites are used to;
Share crash dieting techniques
Advise on how best to induce vomiting or use laxatives
Suggest ways on how to suppress hunger pains
Give tips on how to hide weight loss from parents and
doctors
Compete with each other to lose weight or fast together in
displays of solidarity
Post pictures of themselves and their body measurements
to solicit acceptance and affirmation (Fox et al, 2005).
Aim - Fisher et al. (1991) conducted a study in order
to determine whether adolescent females with
abnormal eating attitudes display lower levels of selfesteem and higher levels of anxiety than their peers,
and whether these adolescents participate in healthrisk behaviours.
 Method – questionnaires given to (n= 268) females
aged 16
 Result - 18% of the students had a score suggestive
of an eating disorder. The study revealed that those
with more unhappiness with their weight were more
likely to have lower self-esteem and higher anxiety,
and to participate more in health-risk behaviours,
including cigarette smoking, alcohol use, drug use,
and sexual activity with more total partners
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Implications to Health
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Outpatient basis with psychological
treatment
Evidence-Based self help
programme/Anti-depressants
Inpatient treatment - re-feeding with
careful physical monitoring in combination
with psychosocial interventions
Cognitive Behaviour Therapy
Family interventions
NICE Guidelines
INTERVENTIONS
Cognitive Behaviour Therapy
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Aim - Hay et al (2009) conducted a review to
evaluate the efficacy of Cognitive Behaviour
Therapy in Bulimia nervosa and other
psychotherapies in the treatment of eating
disorders.
It involved reviewing 48 studies, with (n= 3054)
participants that had bulimia and other eating
disorders that had not been specified.
The results supported the efficacy of CBT in the
treatment of people with bulimia nervosa and
also related eating disorder syndromes. Self-help
approaches that used highly structured CBT
treatment manuals were promising too.
NICE (2004) states target groups for screening should include;
-Adolescents with low BMIs
-Patients consulting with weight concerns who are not overweight
-Women with menstrual disturbances
-Patients with gastrointestinal symptoms
-Patients with physical signs of starvation or repeated vomiting
-Children with poor growth.
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Scoff questionnaire (Morgan et al, 1999) and the Eating Attitudes
Test (EAT-26) (Garner et al, 1983) are the main two screening
tools for eating disorders.
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Limited amount of school nurses
Screening for Eating Disorders
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The UK appears to be the only country that
has developed national guidelines on
measuring children's height and weight in
school settings (Ikeda et al., 2006).
However, this is only to gather local data on
childhood obesity.
Currently three main programmes in the
prevention of eating disorders: Promoting
healthy eating, Promoting body acceptance
and Promoting self-esteem (Miller &
Coverdale, 2010).
Health Education
One of the most serious effects of anorexia is
hormonal changes, which can have severe health
consequences such as fertility problems in later life
(UMMC, 2011). Thus causing more people requiring
fertility treatments.
 Almost 90% of women with anorexia experience
osteopenia, and 40% have osteoporosis (UMMC,
2011). In future, this will cause higher admission
rates in orthopaedic and trauma units.
 Adolescents with eating behaviours associated with
anorexia are at high risk for anxiety and depression in
young adulthood (UMMC, 2011). This therefore
implicates all mental health facilities around the UK.
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Nursing Implications
School nurses are a very pertinent role, as they are
one of the few health professionals who will deliver
prevention programmes to young people in a variety
of settings, and screening (UMMC, 2011). Following
this presentation, it has been found there is a great
need to employ more school nurses.
 The research has shown that a cause of eating
disorders is the huge emphasis there is on school
children today to not become fat, and this has caused
a ripple in adolescents to become eating disordered.
It has also shown the need for screening adolescents
without signs of disordered eating, due to the
secretive nature of this cultural group, and improving
future practice by lowering admission rates.
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Conclusion
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Bardone-Cone, A. M. and Cass, K. M. (2007) ‘What does
viewing a pro-anorexia website do? An experimental
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548.
Coombs, A. (2011) ‘Treating eating disorders in the
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Fisher, M., Schneider, M., Pegler, C. and Napolitano, B.
(1991) ‘Eating attitudes, health-risk behaviours, selfesteem, and anxiety among adolescent females in a
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