Stress And Eating Disorder In Young People Sample Essay

What is Stress?

Stress is the physical and mental response of the body to any negative or positive changes. It is not the events that cause us stress but rather our response to it. cite{The University of St. Andrews, 2020}. Stress overall is not bad because a little stress is needed to perform our tasks optimally while no stress leads to boredom. Generally, when we speak of stress, we only focus on the negative part of it and completely abandon the thought of positive stress. Based on Dr. Han Selye’s work, Dr. Lazarus in his study explained that there is difference in positive and negative stress. Positive stress or Eustress are the ones that energize us to do things differently. It is short termed and is perceived as within our coping capabilities. In contrast to it, negative stress or Distress causes more collateral affect on people than Eustress.[footnoteRef:2] [2: Mills, H., Reiss, N. and Dombeck, M., 2008. Types of stressors (Eustress vs. distress). Retrieved on January, 17, p.2010.]

How Stress Affects Students?

Several factors contribute in causing stress in human life. According to the data published by the American Institute of Stress in Aug 2019, every age group experience stress in their life but the individuals of 18-33 age groups were found to be the most stressed. Usually new university students have to think about different factors which lead them to stress, anxiety and even depression. [footnoteRef:3] Along with high grades; other potential sources such as unclear assignments, deadlines, pressure of combining paid work and study, difficulty in organizing work, poor housing, adjusting to life in a new environment and even country, difficulties with personal relationships, etc. contributes in causing the negative stress in the students. cite{Ross S, Neibling B, Heckert T (1999) Sources of stress among college students. College Student Journal 33: 312-317.} In order to relieve their stress, they rely on more sedentary stress management techniques than other generations, such as listening to music, surfing the internet or going online, laying awake at night due to stress and, either eating more unhealthy foods or not eating at all.[footnoteRef:4] It is directly affecting the eating and sleeping habits causing adverse affect on the student health. [3: Ross S, Neibling B, Heckert T (1999) Sources of stress among college students. College Student Journal 33: 312-317.] [4: Anderson, N.B., Belar, C.D., Breckler, S.J., Nordal, K.C., Ballard, D.W., Bufka, L.F. and Wiggins, K., 2015. Stress in America: Paying with our health. American Psychological Association, pp.1-19.]

Why do Students Switch to Eating Disorder During Stress?

One important variable is using of food by individuals to cope with stress and emotions. A coping mechanism of eating has been recognized for the improvement and dealing with stress and emotions that is either by under eating or overeating.[footnoteRef:5] The energy consumption vary in a same person depending on the emotion they are dealing with (Macht, 2008).Generally young adults tend to switch to overeating on days of high negative emotions leading to overweight and obesity. According to the World Health Organization 2020 factsheet, the prevalence of obesity is tripled since 1975. More than 1.9 billion adults, 18 years and older, were found to be overweight of which over 650 million were obese in 2016.[footnoteRef:6] A vital role in obesity is played by the selection of type of food and the amount of food consumed during stress. Conner et al. (1999) found that high levels of stress was associated with both increased consumption of sweets, saturated fat, dense foods as snacks and decreased overall calories food intake by adults. This statement was also supported by Wardle et al. and Oliver et al. (2000). In a separate study, Steptoe et al. found that individuals were eating fast food more frequently when reported with greater number of events, thoughts, or situations inducing negative feeling such as annoyance, irritation, worry or frustration. While considering all these, it can be derived that people tend to switch to more palatable and dense food when dealt with stressed. [5: Geliebter A, Aversa A (2003) Emotional eating in overweight, normal weight, and underweight individuals. Eat Behav 3: 341-347. ] [6: World Health Organization [WHO] (2020). Obesity and Overweight. Available at:

Ben-Avi, N., Toker, S. and Heller, D., 2018. “If stress is good for me, it’s probably good for you too”: Stress mindset and judgment of others’ strain. Journal of Experimental Social Psychology, 74, pp.98-110.

Akkermann, H. S. (2017). Positive and negative emotional eating have different associations with overeating and binge eating: Construction and validation of the Positive-Negative Emotional Eating Scale. Appetite , 116, 423-430.

Fong, M., Li, A., Hill, A.J., Cunich, M., Skilton, M.R., Madigan, C.D. and Caterson, I.D., 2019. Mood and appetite: Their relationship with discretionary and total daily energy intake. Physiology & behavior, 207, pp.122-131.]

High calorie dense foods that individuals tend to consume during stressful times contribute to the increasing trend of obesity. Past research within the adult population concluded that stress-induced eaters are not only consuming foods higher in sugar and fat content but also their portion sizes have increased. In a study conducted by Laitinen et al. (2002), stress-driven eaters and drinkers ate sausages, pizza, hamburgers, and chocolate more often than those who were not stress driven eaters. On repeated consumption of these foods and alcoholic beverages, it can account for long-term weight gain.[footnoteRef:7] In the prevention of obesity, it is important to distinguish the appropriate solutions towards the consumption of these foods. [7: McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, et al. (1999) Dietary variety within food groups: Association with energy intake and body fatness in men and women. Am J Clin Nutr 69: 440-447. ]

A study by Zellner, et al. (2006) reported that stressed women ate more unhealthy food than women who are not stressed, while consumption of unhealthy food was comparatively higher in unstressed men than the men in the stress group. In 2007, a survey was conducted in UK to examine the result of weight gain in first year university students after reviewing the result of American students. Upon logistic regression analysis, it was demonstrated that the association of stress and risk of weight gain was high and most common in women.[footnoteRef:8] Similar survey was conducted in University of Bahrain in 2019 where the result was different than before as majority of the students were found under eating during negative emotional states.[footnoteRef:9] Women tend to overeat or binge-eat more depending on the severity and frequency of distress. They term this as emotional eating as they tend to switch to more junk food with high in calories and fat when they tackle with negative emotions. (Akkermann, 2017). Moreover, women craved chocolates more when in stress. Taken together, these results suggest that women were comparatively more emotional than men and preferred to deal with their emotions by eating. [8: Serlachius, A., Hamer, M. and Wardle, J., 2007. Stress and weight change in university students in the United Kingdom. Physiology & Behavior, 92(4), pp.548-553.

Conner M, Fitter M, Fletcher W (1999) Stress and snacking: A dietary study of daily hassles and between-meal snacking. Psychology & Health 14: 51-63.

Wardle J, Steptoe A, Oliver G, Lipsey Z (2000) Stress, dietary restraint and food intake. J Psychosom Res 48: 195-202.

Steptoe A, Lipsey Z, Wardle J (1998) Stress, hassles and variations in alcohol consumption, food choice and physical exercise: A daily study. British Journal of Health Psychology 3: 51-63.] [9: Alalwan, T.A., Hilal, S.J., Mahdi, A.M., Ahmed, M.A. and Mandeel, Q.A., 2019. Emotional eating behavior among University of Bahrain students: a cross-sectional study. Arab Journal of Basic and Applied Sciences, 26(1), pp.424-432.

Macht, M., 2008. How emotions affect eating: a five-way model. Appetite, 50(1), pp.1-11.]

There is also the assumption that underweight individuals eat less as compared to overweight people during both eustress and distress.

The Effect Of Cognitive Dissonance Prevention Program Variables On Eating Disorder 

There are many young women in the United States who suffer from eating disorders and never get treated. Eating disorders not only detriment your physical health but your mental health as well and can even become a fatal illness if not treated. That is why it is crucial to advance research into discovering the most beneficial treatment to prevent eating disorders. Dissonance-based prevention programs have been developed to treat and prevent many health problems and have recently been advanced to treat eating disorders such as anorexia and bulimia (Stice, Shaw, Becker, & Rohde, 2008). In this experiment the researcher will use the cognitive dissonance-based prevention program in order to reduce the biggest risk factor for eating disorders which is the thin-ideal internalization. The thin-ideal internalization is when someone is pressured into meeting society’s beauty ideal (Stice, Rizvi, & Telch, 2000). The researcher will have two independent variables that will consist of the amount of sessions participants attend to and the setting in which the dissonance-based prevention program will take place in. The researcher will gather sixty female participants with self-identified body image concerns and randomly assign the young women to the number of sessions they will attend. The program will consist of verbal and written exercises that will help participants reduce the thin-ideal. The experiment will yield a significant difference in that participants who attend six sessions will have less eating disorder symptoms than participants who attend four sessions or two sessions and participants who attend four sessions will have less eating disorder symptoms than those participants who attend two sessions. The greatest difference between eating disorder symptoms will be between school setting and laboratory setting at six sessions. It is important to note that these advances can be crucial into treating and preventing eating disorders and hopefully treating other health problems later on.


Many people in the United States suffer from eating disorders, especially young women. Nearly ten percent of young women experience eating disorders and never get treated (Lewinsohn, Striegel-Moore, & Seeley, 2000). Eating disorders such as bulimia nervosa and anorexia nervosa pose a high risk for negative effects on physical and mental health throughout an adolescent’s life. Eating disorders can increase risk of anxiety disorder, emergence of obesity, depression, substance abuse, and more health-related problems (Johnson, Cohen, Kasen, & Brook, 2002). The importance to treat this disorder is crucial to many young women. The prevention program using cognitive dissonance is able to reduce the risk factors for eating disorders and aid in the reduction of eating disorder symptoms (Stice, Mazotti, Weibel, & Agras, 2000).

Eating disorders which include bulimia nervosa and anorexia nervosa have symptoms of binge eating and purging. An individual will eat food even though the individual is full and purge. Purging is distinguished by self-induced vomiting, excessive use of dietary pills and misuse of laxatives (Treasure, Claudino, & Zucher, 2010). It is also characterized as the individual feeling very guilty and embarrassed for eating, especially in front of other people. Anorexia nervosa includes symptoms of very low food intake and excessive exercise. Also, someone with anorexia nervosa will be extremely under-weight and try to lose more weight. These eating disorders can lead to other health problems such as cardiovascular problems, depressive disorders, chronic fatigue and pain, infectious diseases, difficulty sleeping, neurological symptoms, and suicide attempts during early adulthood (Johnson et al., 2002).

The cognitive dissonance prevention program will be designed to help young women at risk of having an eating disorder and its effects. The cognitive dissonance theory expresses that the retention of inconsistent thoughts or actions creates psychological tension that motivates people to change their cognitions to produce greater consistency (Festinger & Carlsmith, 1959). Previous experiments have found that when individuals take a counter attitudinal stance (individuals are pushed to act in a way that is contrary to an original attitude) it creates a tension that leads individuals to change their attitudes to reduce the inconsistency between the original and the new thought or attitude (Leippe & Eisenstadt, 1994). Also, evidence suggests that a person may change their future attitude or behavior to reduce cognitive dissonance, especially if it challenges the beliefs a person possesses (Leippe & Eisenstadt, 1994). This theory has been used to help with eating disorder prevention and other health related problems.

Previous research done by Stice and Associates in 2001 looked into two types of intervention: healthy weight intervention & dissonance-based intervention. Stice and Associates gathered eighty-seven young women with self-identified body image concerns and randomized the participants to the two interventions. The results show a greater reduction in thin-ideal internalization and body dissatisfaction for the dissonance-based intervention than in the healthy weight intervention (Stice, Rizvi, & Telch, 2000). Another experiment done in 2001by Stice and Associates looked into the cognitive dissonance prevention program being given at a high school setting. Their findings show that the effects of the cognitive dissonance prevention program were significant at different term follow ups. But, it is important to note that clinical experience in this experiment could’ve significantly changed the outcomes and made the results more persistent in the long term (Stice, Rhode, Shaw, & Gau, 2001)

One of the most established risk factors that lead to the eating disorders is the thin-internalization. Thin-internalization is characterized by the pressure individuals come across by society’s thin ideal standards. It highly contributes to body-dissatisfaction, negative affect, bulimic symptoms, and other eating disorder symptoms (Stice et al., 2000). The cognitive dissonance prevention program’s goal is to target this risk factor in order to prevent and reduce eating disorder symptoms. The cognitive dissonance prevention program will have participants who have internalized the thin ideal argue against this idea by participating in an intervention that includes written, verbal, and behavioral exercises. Theoretically, the discomfort experienced by the participants will be resolved by reducing agreement thoughts of society’s thin ideal (Stice et al., 2008).

Independent Variable 1

The first independent variable will be the amount of dissonance-based intervention sessions the participants attend to. The three levels of this variable will be two sessions, four sessions, and six sessions. The dissonance-based intervention program exercises will be the same for the three levels. The participants will be randomly assigned by alphabetical order to the amount of sessions they attend to. This variable is manipulated to demonstrate if there is an effect on the amount of sessions young women go to receive the treatment and the eating disorder symptoms.

Independent Variable 2

The second independent variable will be the setting of the prevention program. It will have two levels, a high-school setting and a laboratory setting. This variable is manipulated to demonstrate if there is an effect between the setting of the intervention program and the eating disorder symptoms. The importance of the setting is characterized by how the participants will interact in either setting. It’s possible that participants feel ashamed when participating in a high-school setting rather than a laboratory setting where the atmosphere is more professional, and participants feel the need to be honest.

Dependent Variable

The dependent variable will be the eating disorder symptoms. The eating disorder symptoms include binge eating and purging which are characterized by self-induced vomiting or excessive use of dietary pills and misuse of laxatives after eating (Treasure, Claudino, & Zucher, 2010). The study will look at whether the symptoms for eating disorders decreased after the prevention program treatment was given in the different levels.

Recent research studies such as the Stice and Associates study have looked into different variables such as the type of intervention used to help women with eating disorders (Stice et al., 2000). This study, on the other hand will have one dissonance-based prevention program and different variables such as the amount of sessions the participants attend to and the setting of where they receive the dissonance-based prevention program.

The participant attending six sessions will have less eating disorders symptoms than a participant who attends four sessions or two sessions. Participants attending four sessions will have less eating disorder symptoms than participants attending two sessions. The participants attending the dissonance-based prevention program at a laboratory setting will have less eating disorders symptoms than participants who attend the dissonance-based intervention program at a high-school setting. The greatest difference in eating disorder symptoms between school setting and laboratory setting is in six sessions.



The participants in this study are all young women whose ages range from 16 to 18 years old (M = 17). The young women who participate in this study will be self-identified with body image concerns and will voluntarily apply to become part of the study. Members (N = 60) will be randomly assigned to the number of sessions they will attend to. The research does not focus on the ethnicity of the young women, only their age. The reason why the research only includes young women is because the researcher only wants to focus on women participants due to their prevailing risk of having an eating disorder. The recruitment of participants will be by posting ads online as well as emails and news-paper advertisements. Also, there will be announcements made by randomly assigned schools were women can decide whether they want to participate in the study. The compensation for participating in this study will be the treatment itself and $25 for their time


Informed consent and assent forms will be used to provide the participant with information regarding the study, the risks and benefits of participating in the study, and the counseling information as well as the researcher’s contact information. Other materials will include pencils and papers to do the written part of the exercises. Also, laboratory space will be required to conduct part of the study and a high school setting. The two independent variables in this study are the settings in which the study will take place in and the number of sessions the participants will attend to.

Eating Disorder Diagnostic Scale. The Eating Disorder Diagnostic Scale (Stice et al., 2000) will be used as a self-report scale to diagnose eating disorders such as binge eating, bulimia nervosa, and anorexia nervosa. The Eating Disorder Diagnostic Scale will be given after the experiment to determine the measurements of eating disorder symptoms of the participants at the end of the study. The questionnaire will include a series of questions regarding concerns about weight, eating, and shape.

The environment in which this study will take place in will be calm with only the participants and treatment provider in the room. It is important that the participants feel unafraid when participating in the study’s exercises, so they can fully engage in the study.

Design and Procedure

The research design of this study is an experimental research that includes the setting of the study and number of sessions as the independent variables. The participants will be randomly assigned to different amount of sessions given in the study. The participants will be given informed consent and will decide whether or not they want to participate in the study. For the participants younger than 18 years of age, it will be required to obtain an assent as well as the informed consent from a legal guardian. Once the researcher has sixty participants, the researcher will randomly assign the participants to the number of sessions they attend to receive the cognitive dissonance treatment. The participants will be randomly assigned to receive the treatment in a laboratory setting or at a high school setting. Once the participants are in their randomly assigned setting, the treatment provider (researcher) will give the treatment, which consists of multiple exercises in the course of a month. The participants will be given date in which they will have to go to the high school / laboratory and participate in the exercises. Finally, when the treatment has ended a debriefing will take place with each participant to make sure they fully understood the study and check their well- being.


The results will be analyzed with a 2×3 (settings x amount of treatment sessions) factorial analysis of variance (ANOVA). The ANOVA is expected to yield a significant main effect of the settings on the eating disorder symptoms (F(5,59) = 8.1, p = .04) in that participants who receive the treatment at a laboratory setting (M = 10.67, SD = 0.36) will have less eating disorder symptoms than people who receive the treatment at a school setting (M = 15.67, SD = 0.52; see figure 1).

The ANOVA is expected to yield a significant main effect of the amount of treatment sessions on eating disorder symptoms (F(6, 59) = 7.6, p = 0.4) in that participants who receive six treatment sessions (M = 8, SD = 0.27) will have a have less eating disorder symptoms than participants who receive four treatment sessions (M = 12, SD = 0.4), or two treatment sessions (M = 19.5, SD = 0.65; see figure 2).

The ANOVA is expected to yield a significant interaction between the school setting and the laboratory setting in that the greatest difference in eating disorder symptoms between participants who receive the treatment at school and laboratory will be observed when participants are also receiving six treatment sessions (M = 12, SD = 1.2, M = 4, SD = 0.4 respectively; see figure 3). A summary of overall findings is also provided (see table).


For this study our findings suggest that the cognitive dissonance prevention program is more successful when given in numerous sessions. For this study, two, four, and six sessions will be compared and the amount of sessions that reduce eating disorder symptoms the most, will be the six sessions participants attend to. This finding suggests that giving the prevention program in numerous sessions helps participants better engage in the program and fully process the treatment. Also, our findings suggest that when giving the dissonance-based prevention program at different settings, a different out-come is produced. The results suggest that eating disorder symptoms are reduced when the prevention program is given at a laboratory rather than at a high-school setting. There was a magnitude interaction when the participant where receiving the prevention program in two sessions. This interaction between the setting and the amount of sessions might be due to the low impact of the low number of sessions. This suggests that the setting is not very crucial when the participants are receiving the prevention program in only two sessions. However, in the four and six sessions, the setting had an impact on the eating disorder symptoms. The participants given the prevention program at a laboratory setting reduced the eating disorder symptoms more than the participants who received the prevention program at the high-school setting. This finding suggests that participants have a higher level of honesty and are more outspoken in a formal setting such as a laboratory rather than the high-school setting which could make participants more ashamed of sharing among peers. These findings suggest that giving the cognitive dissonance prevention program in a laboratory may yield greater results for reducing eating disorder symptoms as well as having the participants attend more prevention program sessions.

Previous research has shown that cognitive dissonance prevention programs have been very successful in treating numerous health problems, including eating disorders (Stice, Shaw, Becker, & Rohde, 2008). Even though previous research has shown a significant effect of the cognitive dissonance prevention program, it is important to demonstrate how different variables can impact the final outcome of eating disorder symptoms. The Stice and Associates study in 2001 demonstrated that the cognitive dissonance prevention program was more effective in reducing thin-ideal internalization and body dissatisfaction than a healthy weight intervention (Stice et al., 2000). Also, in Mitchell and Associates study in 2007, the results suggested that the dissonance-based intervention program decreased eating disorder symptoms, drive for thinness, and body dissatisfaction more compared to the control group and yoga group (Mitchell, Mazzeo, Rausch, & Cooke, 2007). Therefore, this study supports the cognitive dissonance theory and its application in a prevention program but differs from past research in that this study focuses on different variables that affected the eating disorder symptoms of participants.

There are several limitations that should be considered when interpreting the results from this study. The follow up period was set to a month, but findings may vary if the follow up period becomes longer such as one year or more. Also, the study only included high-school participants, future research should investigate other samples such as older women or even younger women, this might affect the findings significantly. Another limitation in this study was the prevention program treatment givers. Using different treatment givers such as nurses or teachers might yield a difference in the findings. With many studies supporting the use of cognitive dissonance as a prevention program treatment, future research should investigate the use of this treatment on males, females, and transgenders. Also, future research should look into giving the dissonance-based prevention program treatment through different methods such as online activities and exercises or computer administered workshops. Future research can also investigate different settings and how they impact the participants eating disorder symptoms. The cognitive dissonance prevention program could be able to help many more people so future research should focus on applying this prevention program to other health related problems such as diabetes care and compliance to medication regiment.

The Role Of A Nurse In Assessing For Eating Disorders Patients

Eating disorders affect roughly 3% of the population and the majority are women (Muscari, 2015). Eating disorders are serious conditions that negatively affect the person’s health and emotion. The exact cause of eating disorders is unknown. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can significantly impact the body in receiving a well-balanced nutrition. Most eating disorders affect on body weight and leading to dangerous eating behaviors. In addition, eating disorders can harm the digestive system and can lead to complications. Eating disorders often happen among teen and young adult, but they can develop at other age groups as well (Muscari, 2015). Eating disorders is a dangerous eating behaviors that need to receive treatment, but only a small percent of the sufferers seek treatment. With proper care and treatment, the person can return to normal, healthy eating habit. As a healthcare professional, nurses have an important role in identifying, assessing, caring and treating eating disorders effectively.

It is important that all nurses are knowledgeable about eating disorders and appropriately understand how to assess, identify and provide care for patients with eating disorders. Many patients are having eating disorders are often not recognised. Nurses need to ensure that they can access eating disorders and provide necessary interventions. The prioprity assessment for eating disorder is to assess patient’s nutritional status. As eating disorders can be life threatening, the most important is to ensure that the patients maintain electrolyte balance and adequate nutrition requirement for the body. The nurse’s role is to take detailed dietary intake. As eating disorders are largely affect young women, a nurse should also take detail history of menstrual function of the patient. If an eating disorder has been identified, the nurse must monitor the weight of the patients on a regular basis. In addition, the nurse should assess patient’s skin condition for breakdown and skin’s poor healing (Muscari, 2015). Protein is necessary in aiding body tissue repairment. A lack of protein intake can result in skin more likely to break down. Moreover, the nurse needs to assess the oral hygiene and dental related problems. It is vital to keep a good oral hygiene due to recurrent vomiting which can cause significant damage to the tooth enamel (Sharp, 2017). It is also essential to assess for waste elimination pattern. It is common in eating disorder patients as they excessively use of diuretics and laxatives. The misuse of diuretics and laxatives, many patients may require intervention to treat constipation. Finally, it is important to assess patient’s activity levels. Patients who is present with anorexia may undertake excessive exercise that can be detrimental to their physiological state. Excessive exercise can delay or slow their recovery if they have physical illness(Muscari, 2015).

Anorexia Nervosa

In anorexia nervosa, patients have an intense fear of weight gain and distorted body image. They have a disturbed perception of their own body image. As a result, these patients restrict on calories and end up with low body mass index. They suffer significant weight loss and refuse to maintain normal body weight. The age of onset is usually from pre-puberty to middle age. The condition primarily affects young women, but the disorder seems to increase nowadays in younger males. In some people, anorexia may occur as an acute in the beginning, then it progresses to chronic condition after many years suffering from the disorder. Signs and symptoms of anorexia nervosa: weight loss, refusal of eating, loss of appetite, fear of being obese, self-induced vomiting, difficulty in swallowing, use or abuse of laxatives, constipation (Muscari, 2015). The nurse should be aware of the signs and symptoms as well as the related physical problems that can become life threatening. Many of the physical problems are: electrolyte imbalance, bradycardia, hypotension, hypothermia, fatigue (Muscari, 2015).

Bulimia Nervosa

In bulimia nervosa, patients is having recurrent pattern of uncontrollable binging. They consume large amounts of food by binge eating, which is followed by vomiting or heavy laxative use known as purging behaviour. In these patients, self-image largely influenced by odly image. Most cases of bulimia nervosa occurs primarily in women during adolescence and early adulthood. The individuals who are affected by bulimia nervosa remains within their normal weight range, but their lives are controlled by this conflict with food. Nurses should be able to identify signs and symptoms as well as their behavior in order to help patients to obtain necessary support and treatment. The signs and symptoms to recognise bulimia nervosa are: inadequate nutritional intake, overuse of laxatives and diuretics, preoccupation with food, diet and weight, induced vomiting after eating, solitary eating or eating in secret, fatigue, distorted body image, excessive exercise, anxiety, perfectionism, poor interpersonal relationships

Binge Eating

Patients who is present with binge eating have recurrent pattern of uncontrollable binging without compensatory behaviors. The binging patterns induce guilt, depression, embarrassment, or disgust. Patients who have binge-eating disorder regularly eat too much food and having trouble to control over eating. In these patients, they may eat quickly or they eat more food than intended even when they are not hungry. After a full eating, they may feel guilty, disgusted or ashamed by the amount of food they consumed or their behavior of over eating. As the result of feeling embarrassment, they end up eating alone to hide their over eating behavior (Muscari, 2015).

Subjective Eating Disorders

The people who are present with eating disorders denying of eating extreme amounts of food. They admit that they are eating relatively small or moderate amounts of food throughout the day. They are misperceiving on the amount of food they consume (Muscari, 2015).

Objective Eating Disorders

They can consume as much as 5,000 to 15,000 calories in a single episode. This is an excessive amount of food intake which exceeds the calorie recommendations for both men and women for an entire day (Muscari, 2015).

Family Education

It is very important for the nurse to educate, family, relative, or who is taking care of the patients, about eating disorder that is related to patient’s symptoms. Family members are very important in providing support and care for the patient. In addition, it is necessary to observe for potential suicide risk of the patient.The nurse wants to ensure that the patients take responsibility for an effective outcome of the treatment by establishing a contract to limit on the amount and type of food to be eaten at each meal.

Cultural Competence

Nurses will have difficulty in learning that minority cultures have differences in their perception for being thin. For example, Asian American individual will not report of having eating disorder as they don’t have the desire to be thin. Nurses in the field of treating eating disorder have to learn that other cultures are different in their eating disorder expression becausthey do not fit with the Westernized ideal of thinness (Muscari, 2015) .

Ethical issue

Patients admit for treatment are under control such as monitoring meals, movement, exercise restriction, bathroom observation, and enforced feeding. These clinical measures can contribute to the loss of autonomy and control of the patients (Sharp, 2017). They feel like they loss the freedom and the choice to make their own decision. When the patients sense that they loss of freedom and choice, they may rebel and result in a lack of compliance. Futhermore, it can also feel like punishment. When patient cooperates in the operation, the outcome is having higher chance to achieve (Muscari, 2015).

Visit Eating Recovery Center

The Eating Recovery Center located in Denver. It offers treatment program related to eating disorder. I asked if someone who is suffering from eating disorders be able to recover after treatment. They said that the person who arrives at their facility and follow up with proper treatment, full and lasting recovery is possible. They also encourage to introduce the facility to those who are suffering from the disorders. They explained that binge eating disorder does not mean somebody lacks self-control. It is an illness that requires specialized therapeutic care. It should not be a shame in having binge eating disorder and there is no shame in seeking professional help. When I work on the paper, I thought binge is uncontrolled eating disorder.


  1. Muscari, M. E. (2015). The Role of the Nurse Practitioner in the Diagnosis and Management of Bulimia Nervosa: Psychosocial Management. Journal of the American Academy of Nurse Practitioners, 5(6), 259-263.
  2. Sharp, Freeman (2017). The medical complications of anorexia nervosa. Br J Psychiatry , 21(2), 452-462.

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