Page 80 Complete Your CE Test Online - Click Here Alternative medicine The following alternative medicine approaches may be helpful to persons with binge-eating disorder[12,20] : ● ● Massage and therapeutic touch: May help to reduce anxiety. ● ● Mind-body therapies: May increase awareness of eating and sensations of fullness and promote a sense of well-being. Examples of mind-body therapies are yoga, hypnosis, and biofeedback. ● ● Acupuncture: May help to reduce anxiety and depression. Client reminders Here are some tips to give persons suffering from binge-eating disorder[12,20,21,22] : ● ● Adhere to treatment regimen. Do not skip therapy sessions. If you have been prescribed a diet or meal plan, follow it carefully. Make sure that you eat foods that give you the proper amount and type of nutrients. Work with the healthcare team to identify an appropriate meal plan. ● ● Avoid dieting. Dieting can trigger an increase in binging episodes. ● ● Avoid having large amounts of food available in your home, which may increase the urge to binge. ● ● Stay in touch with family and friends who want to help you. They can be a significant source of support as you deal with your illness. ● ● Exercise. Talk to your physician about a program of physical activity and exercise. Exercise is good for over-all health, especially if you have health problems that are related to being overweight. ● ● Do not be so hard on yourself. Avoid negative thoughts about yourself. Avoid being over critical of yourself. ● ● Identify situations that trigger binge eating. Work with your psychotherapists to identify and deal with these triggers. ● ● Look for positive role models. Remember that excessively thin models and actresses generally do not represent realistic, healthy images. ● ● Look for a confidant. Find someone to talk to that you can respect and trust and who will support you as you work to decrease binging. ● ● Keep a journal about your feelings and behaviors. Journaling can help you become more aware of thoughts and emotions and recognize stressors that trigger episodes of binging. Nursing interventions What are some areas for nursing practice change as they relate to binge-eating disorder? As with other eating disorders, nurses have an obligation to educate clients, families, and professional colleagues about binge-eating disorder. However, there may be a particular obstacle with educating others about this disease. Many people, including family, friends, and even professional colleagues, are disgusted by binging behaviors. They may also be prejudiced against what they perceive as people who are overweight or obese because of their binging[1,20,21,22] . The media promotes the image of unrealistically thin women as the “normal” body shape. In turn, society looks with disdain upon persons who fail to meet this false standard, particularly those who are significantly overweight or obese. Sadly, even some healthcare professionals view obese persons with disdain. This can be especially true for those who suffer from binge-eating disorder. Binging behaviors not only disgust those who commit them, but, at times, family, friends, and co-workers. Even nurses may harbor feelings of revulsion against those who binge, especially those who are obese. Comments such as, “If she wanted to, she could just stop throwing up,” or “She really needs to seriously go on a diet, and all she does is stuff herself with food” may not be overtly stated but may be subconsciously believed. Nursing interventions includes the following actions[12,20,21,22] : ● ● Promote positive role models with healthy, realistic body size and shape. ● ● Include assessment of factors that may contribute to the development of binge-eating disorder and other eating disorders as part of physical and mental health assessments. Such assessment should be conducted regardless of reason for hospitalization, doctor’s office visits, clinics, etc. Nurses may be the first to recognize the existence of an eating disorder. ● ● Request that continuing education be provided regarding achievement and maintenance of a healthy weight as by the organizations for which the nurses work. ● ● Request that continuing education regarding binge-eating disorder and other eating disorders be offered by the organizations for which the nurses work. ● ● Encourage that all nurses and healthcare professionals who work with clients who have binge-eating disorder and/or who are overweight or obese objectively analyze their own feelings about the disorder and how they feel about people who are overweight or obese. They should also analyze their ability to provide quality care and client education while acknowledging their personal feelings. Nurses must battle not only the media’s skewed view of the ideal woman body as that which is thin to nearly the point of emaciation, but also the negative feelings that healthcare professionals might harbor against those who are overweight. They must also confront the negative feelings that might be harbored about binging behaviors. Nurse leaders must constantly be on the alert for bias on the part of their colleagues and subordinates against persons who binge and persons who are obese. Some actions that relate to helping colleagues and subordinates provide the best possible nursing care are[12,20] : ● ● Promote self-analysis among nurses and other healthcare professionals regarding feelings and attitudes about binging behaviors and about those who are overweight or obese. ● ● Model appropriate nursing actions and attitudes towards those who binge and those who are overweight or obese. ● ● Work with members of the nursing professional development department to develop and provide continuing education regarding binge-eating disorder and obesity. ● ● Incorporate, as appropriate, job performance competencies related to providing care to persons who binge and/or are overweight or obese. Nurses should also work to dispel myths regarding eating disorders and obesity and use advanced leadership skills to promote health and wellness among this population. Possible actions include[12,20] : ● ● Promote the identification of nursing research questions that pertain to binge-eating disorder, being overweight, and obesity. ● ● Promote the participation of staff nurses in nursing 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 nursing practice. ● ● Promote the publication of research findings pertaining to binge- eating disorder, being overweight, and obesity into evidence based nursing practice. ● ● Promote positive role models in print and on visual media. Write to print and visual media representatives explaining the need for positive, realistic role models. ● ● Work with nursing professional development specialists to develop continuing education regarding binge-eating disorder, being overweight, and obesity. ● ● Work with nursing staff to develop objective means of self-analysis regarding feelings, beliefs, and attitudes towards clients who binge and/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, nurses 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