● Promote the participation of health care workers in research pertaining to binge-eating disorder, being overweight, and obesity. ● Promote the incorporation of research findings pertaining to binge-eating disorder, being overweight, and obesity into evidence-based healthcare practice. ● Promote the publication of research findings pertaining to binge-eating disorder, being overweight, and obesity into evidence-based healthcare practice. ● Promote positive role models in print and visual media. Write to print and visual media representatives explaining the need for positive, realistic role models. ● Work with professional development specialists to develop continuing education regarding binge-eating disorder, being overweight, and obesity. ● Work with healthcare staff to develop objective means of self-analysis regarding feelings, beliefs, and attitudes toward clients who binge or who are overweight or obese.
● Encourage the development of appropriate nutrition programs and weight reduction programs as part of the organization’s employee health initiatives. ● Encourage the development of an eating disorder recognition and treatment program as part of the organization’s employee health initiatives. In summary, healthcare professionals have obligations to clients, their colleagues, and their subordinates. They also have obligations beyond the organizations for which they work. They have a responsibility to work with the community, including media representatives, to dispel myths regarding eating disorders and to promote realistic images of a healthy body size and shape. Healthcare leaders should also promote appropriate weight loss efforts. All too often celebrities espouse fad diets or dietary products and lose a great deal of weight, which triggers a rush to buy the product that the celebrity endorses. Healthcare leaders should also address the issue of fad diets and weight loss products that might be dangerous.
IDENTIFICATION OF OTHER SPECIFIED FEEDING OR EATING DISORDERS
The recently published DSM-5 includes information on a newly described disorder and describes a category of “other specified feeding or eating disorder.” Avoidant/Restrictive Food Intake Disorder Avoidant/restrictive food intake disorder (ARFID) replaces and extends the DSM-IV diagnosis of feeding disorder of infancy or early childhood. The primary diagnostic characteristic of this disorder is avoidance or restriction of food intake (American Psychiatric Association, 2013). These are the diagnostic criteria for ARFID (American Psychiatric Association, 2013): ● Significant weight loss or failure to achieve expected weight gain or faltering growth in children occurs. ● Significant nutritional deficiency exists. ● Child is dependent on enteral feeding oral nutritional supplements. ● Significant interference with psychosocial functioning occurs. Other Specified Feeding or Eating Disorders This category, as published in the DSM-5, applies to disorders in which symptoms exist that are characteristic of a feeding and eating disorder that causes significant distress or functional impairment at home, at work, at school, in social settings or other important areas of functioning. However, these symptoms do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class (American Psychiatric Association, 2013). Here are examples of presentations that are part of the “other specified feeding or eating disorders” (American Psychiatric Association, 2013): ● Atypical anorexia nervosa: This disorder is described as meeting all of the criteria for anorexia nervosa except that the affected person, despite their weight loss, remains within or even above the normal weight range. ● Bulimia nervosa of low frequency or limited duration: This disorder exists when all of the criteria for bulimia nervosa are met except that the affected person binges and performs inappropriate purging behaviors on average less than once a week or for less than 3 months. Definition Obesity is defined as an excess of body fat. The medical definition depends on the amount of body fat a person has, which means that a person can weigh more than is believed to be healthy but is medically not obese. For example, athletes may weigh more than what is normally considered to be healthy. However, their excess weight is muscle, not fat.
● This eating or feeding disturbance is not more appropriately explained by lack of available food or a cultural practice. ● This eating or feeding disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. There must not be evidence of a disturbance in the way one’s body shape or weight is experienced. ● This eating disturbance cannot be attributed to a concurrent medical condition or better explained by another mental disorder. Healthcare consideration : The eating or feeding disturbance can be manifested as a lack of interest in eating of food or adverse consequences of eating (American Psychiatric Association, 2013). ● Binge-eating disorder of low frequency or limited duration: The presentation of symptoms meets all of the criteria for binge-eating disorder except that the binge eating takes place, on average, less than once a week or for less than 3 months. ● Purging disorder: Recurrent purging behaviors occur to influence weight or shape. However, binge eating does not occur. Examples of purging behaviors are self-induced vomiting and abuse of laxatives, diuretics, or other medications. ● Night eating syndrome: This disorder is characterized by recurrent episodes of night eating—eating after waking up from sleep or by excessive food consumption after the evening meal. The affected person is aware of and remembers the eating. The disorder is not better explained by external factors such as changes in the sleep–wake cycle or by social norms. This pattern of night eating is not more appropriately explained by binge-eating disorder or other mental disorders, including substance use, nor can it be attributed to another medical disorder or to the effects of medication.
OBESITY
Therefore, they are not considered obese (Obesity Action Coalition, 2018; WebMD, 2017c). Until recently, obesity was defined as weighing at least 20% more than the ideal body weight. This definition has been replaced by the body mass index (BMI), which is based on a person’s height and weight and provides a better estimate of
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Book Code: PYMA2024
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