Multidisciplinary Assessment And Intervention For Young People With Eating Disorders And Their Families, An Essay.

Discuss the multidisciplinary assessment and intervention for young people who have eating disorder and their families who are referred to community child and adolescent?

Eating Disorders

Eating disorders are severe mental complications which make an individual to encounter serious disturbances in taking meals (Pinhas et al., 2017). Additionally, the diseases interfere with exercise behaviors of the affected person since the mental complications distort both emotions and thoughts.  Eating disorders are common among young individuals especially females. Apart from physical exercise and eating, the diseases affect every aspect of an individual’s life. There are five different kinds of eating disorders which fall under the category of mental illnesses. The complications include anorexia nervosa (AN), binge-eating disorder (BED), and bulimia nervosa (BN). The other two eating complications include night-eating disorder (NED), and eating disorder not otherwise specified (EDNOS). Eating disorders have numerous risk factors which include socio-cultural, familial, and individual factors. However, the most critical risk factors are weight control behaviors and low self-esteem. Eating disorders pose both psychological and physical consequences to the affected persons. The diseases cause complications to the endocrine, cardiovascular, and gastrointestinal systems. This paper will discuss the multidisciplinary assessment of eating disorders to the young people and their families. It will also explore the intervention measures.

Anorexia is a condition where individuals feel that they are overweight while everyone else sees them to be underweight (Westwood, Mandy, and Tchanturia, 2017). Such individuals begin to regulate their weight by controlling the kinds and amount of food they take. The symptoms of the condition include restricted eating and emancipation (extreme thinness). The affected individual takes drastic measures to lose weight. Additionally, the mental state makes the patient fear any prospects of gaining additional weight. AN distorts the body image of the patient. The restricted eating makes the client be sluggish and experience a chronic multiorgan failure.

Patients of bulimia consume huge chunks of food and proceed to purge the nutriment (Wagner et al., 2015). BN patients cannot control the amounts of nourishment they take; hence purge to regulate the quantity of food intake. The patients purge by taking diuretics, forced vomiting, among other ways. The clients can also conduct extensive physical exercise to facilitate the quick metabolism of the excess food. The symptoms of BN include electrolyte imbalance and severe dehydration. Gastrointestinal disorders like acid reflux are common with BN patients. Patients also complain of sore throats and swelling of the salivary glands located at the jaw.

Binge eating transforms into a complication when individuals cannot regulate their eating (Reilly et al., 2017). Unlike the BN patients, the clients of BED do not fast or purge to control their eating habits. Patients of BED struggle to control their weight thereby feeling shameful about their inability to regulate their eating habits. BED leads to obesity or overweight to the patients. The symptoms of the complication include eating when an individual is full and eating alone. BED patients always appear ashamed and distressed about their eating habits. The patients also eat hurriedly and exercise frequent dieting sessions without losing weight.

The syndrome consists of insomnia, evening hyperphagia, and morning anorexia (Thomas et al., 2015). NES occurs when an individual switches from the normal daily routine of taking meals to an unusual night routine. The patients restrain from eating during the day and eat twice or more times between 7: 30 PM and 5: 30 AM. A recent study has indicated that  NES patients have more mealtimes than the daily eaters who have an average of three meal times. The night eaters also like consuming carbohydrate-rich foods; thereby easily contacting obesity. The possible causes of NES include low self-esteem, stress, and depression.

Anorexia Nervosa (AN)

These disorders are not as common as the four discussed above. Examples of EDNOS include rumination and pica. Rumination occurs when an individual continually regurgitates nutriment after feeding (Benninga et al., 2016). On the other hand, pica is a complication where an individual consistently feeds on nonfood items (McNicholas, and McDevitt, 2018). Pica and rumination are common among individuals with autism and intellectual disabilities. Pica causes interference with digestion in the gastrointestinal tract.

Assessment of eating disorders involves interviewing young individuals together with their families. The interview should assess crucial areas like family and social history, past and present co-morbidities, and illness history.

The assessor should investigate the perception of the young individual and the family on the causes of mental complication. The assessment should gauge the perceived impact of the disorder on the client and relatives. The duration in which the patient has taken with the disease is also an essential point of assessment. The caregiver should ask the patient about the symptoms of the complication. The psychiatrist should also assess the patient to ascertain if they have any weight control behaviors like vomiting, laxative use, and restrictive eating (Mitchell, 2015). Other points of examination include premorbid growth and weight. The care provider should ask the patients whether they conduct excessive physical exercises or otherwise. The health specialist should also look at the body size and shape to ascertain whether the disorder has distorted the two features or otherwise. The psychiatrist should gauge the extent of the illness and a patient's willingness to change. The family members should explain to the caregivers how the eating disorder affects the young individual at school. Eating disorders can affect the academic progress of the student.

 The caregiver should assess the mental history of the patient and remedies towards the past complications. The care provider should also look at the co-morbid conditions like anxiety and mood disorders (Polanczyk et al., 2015). Additional psychological history like depression, trauma, and suicidal thoughts can also cause eating disorders. The health specialist should check at the personality traits of the patient. Eating disorder clients can have traits like obsessiveness and perfectionism.

 The caregiver should gauge the strengths and interests of the patient. The specialist should ask if a member of the family has had an eating disorder in the past. The care provider should also gauge the family history on mental illness. The relationship between the members of the family is another essential point of consideration. The atmosphere of the family can also determine whether the young individual gets eating disorders or otherwise. A family full of tension can make the child develop the disorders (Robinson, Dolhanty, and Greenberg, 2015). However, effective communication between the family and the children can prevent the development of the complications. A family that has useful problem-solving frameworks can prevent the child from developing eating difficulties — furthermore, a family that is cooperative with the team of psychiatrists assists in the quick recovery of the sick patient.

 The specialists should measure the height and weight of the patient. Calibrated scales assist in measuring the weight while a stadiometer measures the height of the patient (McDougall et al., 2018). The health specialist should use the measurements to calculate the BMI of the patient. The assessor should also gauge the temperature, blood pressure, and pulse of the patient. Skin inspection and oral examination are the other essential elements of physical examination in physical assessment.

Bulimia Nervosa (BN)

After identification and assessment, efficient care is necessary to correct the eating disorders. Psychotherapy is a remedy that is effective to all the feeding complications (Carr, 2014). By definition, psychotherapy refers to counseling or talk therapy. Psychotherapy can help the family of the young patient and the psychotherapist to examine the behaviors and thoughts of the patients. The two elements influence eating behaviors and dent the body image. Family therapy is a highly recommended type of psychotherapy due to its numerous advantages. A stress-free family reduces the chances of getting the eating disorders. Therefore, the family should improve the communication channels to solve eating disorders among their children.

Nutritional education is another remedy that cuts across all the discussed eating disorders. For the underweight individuals, the nutritionists should suggest effective treatments to restore their weight (Katterman et al., 2014). Overweight individuals like BED patients also require nutritional advice to regain a healthy weight. The nutritionists should train the patients of eating disorders on how to control their feeding habits. Additionally, the food specialists should ask the night-eaters to regulate their rate of taking carbohydrate-rich foods.  The nutritionists should also caution the pica and the rumination eaters about the impacts of their habits to the gastrointestinal tract.

In-patient treatment is also useful in caring for severe complications due to eating disorders. Life threatening complications like obesity require specialized attention from various caregivers (Roberto et al., 2016).  In-patient care is highly intensive as it enables the client to obtain sufficient treatment. Nutritional interventions are necessary to care components for patients with dietary disorders. The patients also require in-depth counseling to enhance proper physical and mental health. The caregivers should monitor the renal problems and electrolyte disturbances in patients. Care providers should also assess the psychopathology of BN and anorexia patients at the initial phases of the complications.

Medications also play a crucial role in the care towards the treatment of eating disorders. Specific drugs are available to decrease the urge to purging food. Additionally, medications are available to counter the desire for binge eating. Depression is a significant cause of most eating disorders. Therefore, the caregivers should prescribe antidepressants to combat stress and anxiety. Fluoxetine is an antidepressant approved to treat BN (McElroy et al., 2018). Medications decrease the symptoms of anorexia and other eating disorders. However, psychotherapy is the most appropriate solution to the complications. Patients should avoid the bupropion line of antidepressants as they increase the risk of seizure.

The family members have a critical role to play in assisting the young patients.  Parents should encourage their children to develop healthy eating habits (Le Grange et al., 2015). The family should also discuss media advertisement with the young individuals. Some adverts can mislead the young individuals on the type of body shape and size that they should have. Parents should also assist their children in maintaining self-esteem. The family should also explain the negative impacts of emotional eating and dieting to the children.

Conclusion

Eating disorders are mental complications that make an individual encounter severe disturbances in taking meals. Anorexia nervosa is a disorder in which individuals feel that they are overweight while others view them as underweight. Bulimia nervosa occurs when individuals cannot regulate the amount of food they take. Therefore, the patients resort to habits like forced vomiting to control their feeding habit. Binge-eating disorder is similar to BN; however, the patient does not attempt to control the eating behavior by any means. Night-eating disorder is when an individual schedule the meal times at night. Other eating disorders include pica and rumination. Multidisciplinary assessment of the disorders involves gauging the history of the eating disorder and the mental status of the patient. Additional assessment areas include a physical examination and looking at family and social history. The intervention measures include psychotherapy, nutritional education, and in-patient treatment. Other remedies include medications and family-based therapy. Drugs like antidepressants assist in reducing the levels of depression in patients. The family should help the young ones to maintain high self-esteem among other methods.

References

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