Bulimia Nervosa – Metabolic Problems Example

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"Bulimia Nervosa" is a great example of a paper on metabolic problems. Despite the observation of the overall decline of bulimia nervosa in the general population since the 90s, prevalence still remains higher among males and in the elder ages. Point prevalence in the USA has been noted to be around 40% of the young adults with about 0.2% being adolescent boys and males in their early adulthood. In the USA, however, as many as 3% of the young adult female population have the requirements for a diagnosis of bulimia nervosa (Ribeiro, 2011).

There are studies that suggest that bulimia nervosa could be linked to culture and attitude as the different ethnic groups interact in the society for instance immigrants moving to a new culture. Bulimia nervosa therefore not only has a cultural but also a historical implication in its etiology (Miller, 2001). The intervening nurse in the case of bulimia nervosa needs to observe the nutritional status of the patient to eliminate life-threatening malnutrition and then go ahead to restore and maintain a balance of nutrients and electrolytes. The nurse also needs to keep checking the weight regularly.

The nurse can also provide mealtime supervision to prevent purging. The nurse can also help remodel the mealtime environment such as time limits and the atmosphere to alter mental focus on the post-prandial sequence of events. The nurse also needs to observe elimination patterns to rule out the overuse of laxatives and diuretics and incidence of constipation; common among bulimia nervosa clients (Walsh, 2007). To get a diagnosis for bulimia nervosa, the patient has to meet the bulimia nervosa diagnostic criteria that show binge eating and post-prandial vomiting behavior.

The patient also may manifest some physiological deficiencies grossly notable such as irregular menses. Other diagnostic measures are intrinsic biomolecules and require biomedicine laboratory services to detect levels of electrolytes, creatinine, magnesium, vitamins. Patients with bulimia nervosa may also require an electrocardiogram to eliminate the risk of a heart attack (Safer, 2018). The patient may also benefit from other investigations that pertain to the esophagus such as esophageal-gastro-duodenoscopy (OGD). The patient with bulimia nervosa may have several indicators critical to caregivers such as hypogeusia and enlarged parotid in the oral cavity.

The patient may also show changes in dental integrity and the throat may have swallowing disturbances. The patient may be at risk of acute pancreatitis if they show an enlarged pancreas and steatorrhea. The patient will need to be educated on how to create a better relationship with food by eliminating extreme dietary habits such as long fasts or strict diets. The patient will need nutritional advice on the effects of purging and its relationship to calorific intake. The patient will also need psychotherapeutic and cognitive education to learn to master shifty emotions and thoughts to manage self-esteem and depression issues.

The patient may also need to be advised on various options available such as antidepressants and cognitive behavioral therapy and support programs for resistant cases of bulimia nervosa. Patients who are diagnosed with bulimia nervosa often get the approved drug fluoxetine as their recommended antidepressant drug. However, with extended use, fluoxetine has been found to have some serious side effects. If the patient has been using fluoxetine since high school and is a young adult they may present with some of the adverse effects such as anorexia and borderline psychological disturbances.

A case of bulimia nervosa will therefore require the input of a dietician, psychologists, a psychiatrist, and physicians in the primary care settings. These patients also require social workers to support them in their families to provide a continuum of care for holistic coverage of care centered on the patient.


Llamas, M. (2019). Prozac. Retrieved May 14, 2019, from drugwatch: https://www.drugwatch.com/ssri/prozac/

Pumariega, M. N. (2001). Culture and eating disorders: a historical and cross-cultural review.  Psychiatry Interpersonal & Biological Processes , 93-110.

Ribeiro, J. P. (2011, June 20). Anorexia nervosa epidemiology. Retrieved May 14, 2019, from Health.am: http://www.health.am/psy/more/anorexia_nevrosa_int7/

Safer, D. L. (2018). Bulimia Nervosa. Briritsh Medical Journal.

Walsh, L. (2007, September 10). Caring for patients who have eating disorders. Retrieved May 14, 2019, from Nursing Times: https://www.nursingtimes.net/clinical-archive/nutrition/caring-for-patients-who-have-eating-disorders/200042.article

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