Anorexia Nervosa Essay Example for Free

Anorexia Nervosa Essay I. Introduction Anorexia nervosa has received a great deal of attention in the popular media in recent years. This disorder is listed under the category of disorders of childhood or adolescence in DSM-III. Anorexia consists of extreme weight loss due to a reduction in eating. It occurs most frequently in female adolescents; only about 1 in 10 people with anorexia are male. The disorder is believed to be rate, but one study found an incidence of 1 case out of 200 adolescent girls. Anorexia begins when the adolescent starts to diet. The person often has major problems in self-esteem and concerns about physical appearance. Weight reduction may be one way for the person to feel in control of her or his behavior, and to improve self-esteem ( Lager, 2003).   However, for anorexics, dieting gets out of hand. They develop an unreasonable fear of eating, and often suppress hunger by engaging in repetitive activity such as frequent exercising. When anorexics must eat because others (e.g., parent) demand it, they often will induce vomiting after meals to get rid of the food ingested. Even though the anorexic begins to waste away and develops such physical problems as cessation of menstruation (for girls), constipation, and imbalances in body chemistry, she or he is often unconcerned about the life-threatening aspect of the behavior (Darby, 2001). Anorexics continue to perceive themselves as heavier that they really are, and some continue to avoid eating until they die from starvation. Death may occur in up to 15 percent of anorexics. This paper intent to: (1) understand what anorexia nervosa really means and its effects; (2) know the measures for managing anorexia; (3) be aware of the use of pharmacologic agents to stimulate appetite in the terminally ill and; (4) be familiar of the factors influencing nutritional status in varied situations. II. Background Anorexia Nervosa is a psychiatric disorder characterized by an aversion to food and a resulting extreme loss of weight. It is most common in teenage girls and young women. The victims, although not necessarily overweight, become obsessed with a fear of obesity and deliberately subject themselves to a starvation diet (see â€Å"Anorexia Nervosa Overview.† eMedicineHeath. Emergency Care + Consumer Health). The resulting malnutrition typically leads to constipation, vomiting, low body temperature, low blood pressure, and amenorrhea (cessation of menstruation). Victims can lose up to 25 percent of their body weight and, if untreated, may die. Treatment for anorexia consists of hospitalization along with psychotherapy and counseling. Victims are either fed intravenously or are placed on a high-calorie, high-protein diet supplemented by large doses of vitamins. A. What are an anorexia nervosa and its effects? At the other end of the spectrum from obesity is anorexia nervosa, an eating disorder associated with self-imposed starvation. The already underweight person continues to restrict food intake, often to the point where death is a genuine concern. One of the most distinguishing traits of people who have anorexia nervosa is that they do not see themselves as thin (Halmi, 2004). When they look in a mirror, they actually perceive themselves to be overweight or gaining weight. In the latter case they may go out and jog 5 miles or stay up all night jumping jacks. The resulting weight loss and attendant physical stress often lead to an absence of menstruation among females, and the person may look pallid and gaunt. III. Discussion Anorexia is a puzzling disorder. Why would an otherwise healthy young person starve to death? Although some explanations of anorexia have focused on biological causes (a possible malfunction of the hypothalamus which could lead to a lack of desire for food), current views focus on problems in the family which may lead to anorexic behavior. The parents of anorexic adolescents are often very controlling and attempt to order their children’s lives to a greater extent than do parents of non-anorexics. Furthermore, the families are often filled with conflict between family members. Anorexic behavior may be an extreme, distorted attempt by the adolescent to control at least one aspect of her or his own behavior. Treatment of anorexia usually involves several different emphases. If the weight loss is life threatening, medical intervention (e.g., intravenous feeding) is necessary. The reinstitution of eating behavior and achieved using behavioral approaches; however, these gains are often short-lived. Most treatment programs report success rates as high as 86 percent. However, anorexia still results in death for some individuals. A. Measures for managing Anorexia Anorexia is a common problem in the seriously ill. The profound changes in the patient’s appearance and his or her concomitant lack of interest in the socially important rituals of mealtime are particularly disturbing to families. The approach to the problem varies depending on the patient’s stage of illness, level of disability associated with the illness, and desires. Although causes of anorexia may be controlled for a period of time; progressive anorexia is an expected and natural part of the dying process. Anorexia may be related to or exacerbated by situational variables (eg, the ability to have meals with the family versus eating alone in the â€Å"sick room†), progression of the disease, treatment for the disease, or psychological distress. The patient and family should be instructed in strategies to manage the variables associated with anorexia. B. Measures for Managing Anorexia There are many ways in how to manage the patient who suffers from anorexia nervosa and it is divided into two measures, the medical interventions and patient and family tips. a) Medical Interventions The medical group initiates measures to ensure adequate dietary intake without adding stress to the patient at mealtimes and assess the impact of medications (eg,chemotherapy, antiretroviral) or other therapies (radiation therapy, dialysis)that are being used to treat the underlying illness. It administers and monitors effects of prescribed treatment for nausea, vomiting, and delayed gastric emptying and encourages patient to eat when effects of medications have subsided and assess and modify environment to eliminate unpleasant odors and other factors that cause nausea, vomiting, and anorexia. Remove items that may reduce appetite (soiled tissues, bedpans, emesis basins, clutter). This medical group assesses and manages anxiety and depression to the extent possible (see â€Å"Anorexia Nervosa: Treatment.† Mental Health. MayoClinic.com). It also assesses for constipation and/or intestinal obstruction and prevents and manages constipation on an ongoing basis, even when the patient’s intake is minimal. Furthermore, it provides frequent mouth care, particularly following nourishment, ensure that dentures are properly taken care, and administer and monitor effects of topical systematic for oropharyngeal pain. b)  Ã‚  Ã‚  Ã‚   Patient and Family Teaching Tips The family reduces the focus on â€Å"balanced† meals; offer the same food as often as the patient desires it and increase the nutritional value of meals. For example, add dry milk powder to milk, and use this fortified milk to prepare cream soups, milkshakes, and gravies. Allow and encourage the patient to eat when hungry, regardless of usual meal times. Eliminate or reduce noxious cooking odors, pet odors, or other odors that may precipitate nausea, vomiting, or anorexia and keep patient’s environment clean, uncluttered and comfortable (Halmi, 2004). Make mealtime a shared experience away from the â€Å"sick† room whenever possible. Reduce stress at mealtimes. Avoid confrontations about the amount of food consumed. Reduce or eliminate routine weighing of the patient. Encourage patient to eat in a sitting position; elevate the head of the patient’s bed. The family plan meals (food selection and portion size) that the patient desires. Provide small frequent meals if they are easier for patient to eat. Encourage adequate fluid intake, dietary fiber, and use of bowel program to prevent constipation (Wrede-Seamn, 1999). C. Use of pharmacologic agents to stimulate appetite in the terminally ill A number of pharmacologic agents are commonly used to stimulate appetite in anorectic patients. Commonly used medications for appetite stimulation include dexamethasone (Decadron), cyproheptadine (Periactin), megestrol acetate (Megace), and dronabinol (Marinol). Dexamethasone initially increases appetite and may provide short-term weight gain in some patients. However, therapy may need to be discontinued in the patient with a longer life expectancy, as after 3 to 4 weeks corticosteroids interfere with the synthesis of muscle protein. Cyproheptadine may be used when corticosteroids are contraindicated, such as when the patient is diabetic. It promotes mild appetite increase but no appreciable weight gain. Megestrol acetate produces temporary weight gain of primarily fatty tissue, with little effect on protein balance. Because of the time required to see any effect from this agent, therapy should not be initiated if life expectancy is less than 30 days. Finally, dronabinol is not as effective as the other agents for appetite stimulation in most patients. Although the use of these agents may cause temporary weight gain, their use is not associated with an increase in lean body mass in the terminally ill. Therapy should be tapered or discontinued after 4 to 8 weeks if there is no response (Wrede-Seamn, 1999). D. Factors Influencing Nutritional Status in varied Situations. One sensitive indicator of the body’s gain or loss of protein is its nitrogen balance. An adult is said to be nitrogen equilibrium when the nitrogen intake (from food) equals the nitrogen output (in urine, feces, and perspiration); it is a sign of health. A positive nitrogen balance exists when nitrogen intake exceeds nitrogen output and indicates tissue growth, such as occurs during pregnancy, childhood, recovery from surgery, and rebuilding of wasted tissue. Negative nitrogen balance indicates that tissue is breaking down faster than it is being replaced. In the absence of an adequate intake of protein, the body converts protein to glucose for energy. This can occur with fever, starvation, surgery, burns, and debilitating diseases. Each gram of nitrogen loss in excess of intake represents the depletion of 6.25 g of protein or 25 g of muscle tissue. Therefore, a negative nitrogen balance of 10g/day for 10 days could mean the wasting of 2.5 kg (5.5 lb) of muscle tissue as it i s converted to glucose for energy. When conditions that result in negative nitrogen balance are coupled with anorexia (loss of appetite), they can lead to malnutrition. IV. Conclusion In conclusion, the prevailing belief among clinical psychologists has been that anorexia arises out of an unstable self-concept. Thus, the commitment to diet and weight control is seen as an attempt to establish a firm sense of identity (Bhanji, 1999). In addition, there is the possibility that this illness, which in about 85 percent of cases occurs in adolescent females, indicates a rejection of traditional feminine roles. Even career patterns play a role. In certain occupations where there is a premium on being thin—for example, ballet dancing—the incidence of clinical anorexia may be great as 50 percent. Further, it has been suggested that malfunctioning neurons in the hypothalamus may alter the metabolism and feeding patterns of people with anorexia nervosa (Leibowitz 2003).   At present, however, the empirical support for underlying neurological disturbances is scant (Logue, 1999).

Who Is Free To Choose :: essays research papers

Who Is Free To Choose?   Ã‚  Ã‚  Ã‚  Ã‚   The Internet started out as a tool for transmitting information to learn and study. Free expression on the Internet is one of the things that makes the Internet so great. People can get information on a subject from many different areas. This gives the chance for people to see an issue form other points of view. The Internet has developed into a vast medium of knowledge with many users contributing to its growth. With the growth of the Internet, many people have seen it as a source to express their ideas to the public. Some would even view the Internet as a virtual community, and say it is a democracy. People argue that with such freedom, the Internet should be censored to protect children form pornography, and others from sites that may concern 'objectionable'; material. There are people who live under the 1st Amendment and they use the Internet as an outlet to express their ideas and to incorporate ideas from others. Censorship of the Internet is wrong because it obstructs other pe ople from accessing what they want to see and it inhabits people's free speech. Censorship on the Internet has been a growing concern for the past three years. The wide range of information available has made it a tempting target for those who want to control what a person can see and read. The Random House Webster's School and Office Dictionary defines censorship as, 'An official who examines books, films etc., to suppress anything objectionable';. (CD ROM) The next question is who is going to decide for the millions of users on the Internet what is objectionable for them to see and read. The Internet has developed into a vast medium of knowledge with many users contributing to its growth. In this country, many activists for censorship on the Internet mainly have one thing on their minds. They want to protect children from pornography. Although I view this as big concern, there is a grater issue at hand. Since censorship involves all forms of expression, censoring the Internet woul d hurt many people. The Internet is an international community; we must view it as pertaining to other countries, not just the United States. Not all countries have the privilege of living in a democracy and under the Bill of Rights. As a result, the Internet has brought a new sense of freedom to most people who oppressed by tyrannical governments, or those that disagree with a government but are not allowed to express it.

Jane Addams – Biography

The argument Addams makes that â€Å"educational matters are more democratic in their political than in their social aspect† (197), I believe she is referring to the long struggle between the teachers and the Chicago School Board. The Chicago School Board was politically corrupt. Many of the teachers and custodial engineers were friends of politicians who secured their positions in exchange for certain kickbacks. The school board maintained control over the school administration for many years. During which they restricted the types of children that were able to attend the public schools and they restricted the amount of freedom and authority the teachers were able to use in their classrooms. On several different occasions the â€Å"Dunne† members of the board attempted to lower the restriction on the teachers side but were warned-off with tales of the politicians and the difficulties previous attempts encountered. Addams' describes the situation between the superintendent and the Teachers' Federation as â€Å"an epitome of the struggle between efficiency and democracy† (171). She clearly understood both standpoints and why they both felt compelled to make their argument, although she does mention that they both â€Å"inevitably exaggerated the difficulties of the situation† (171). As a member of the school board, Addams tried to influence the Federation to make changes that would be in the best interest of the children, but after the legal struggle and following months of constant change, many of the important measure were withdrawn. Although she did have an opportunity to debate these measures in a democratic way, they were dismissed because of (more or less) political reasons. Jane Addams' role for education in an effort to reform the city was to take the disruptive delinquents the public schools rejected and accept them unconditionally into the settlement. Give them the opportunity to learn domestic training and trade teachings. She felt that even people of lesser means were interested in the same topics as the â€Å"well-to-do† people of society. She also thought that if you give a child encouragement and a sense of self-worth combined with an opportunity to become something in society that they would try to become productive. Hull-House offered educational opportunities for anyone who wanted to attend with no political or economic restrictions. Hull-House also offered the opportunity for recreation, such as supervised sports matches, which hundreds of youths seemed to prefer. Jane Addams' makes an important statement that â€Å"The educational activities of a Settlement, as well as its philanthropic, civic, and social undertakings, are but differing manifestations of the attempt to socialize democracy, as is the very existence of the Settlement itself,† (206). That illustrates her idea of education, which I believe is what she wanted for the public school system, but was unable to achieve while she was a member of the board.

Psychology The Mind And How It Works - 1287 Words

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