P23 · Harmful eating behaviors
Actual Emotions and mind
Definition
Eating patterns such as severe restriction, bingeing, or purging that harm health.- Body image problems
- stress
- need for control
- perfectionism
- Severe restriction
- bingeing or purging
- weight loss
- secrecy
- fear of gaining weight
📋 Scenario
A teenager skips meals and exercises excessively.
Subjective (S): "I'm too fat."
Objective (O): Teen skipping meals; BMI 16; weight down 8 kg; excessive exercise; secretive about food.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: PHQ-9, GAD-7, C-SSRS, MUST, fluid chart, glucose
**CarePath diagnosis:** Harmful eating behaviors related to body image problems, as evidenced by skipped meals, excessive exercise, BMI 16, and weight down 8 kg.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Build trust. | Trust is the base of care for eating problems, because a person who feels judged tends to hide behaviors and resist help. |
| Supervise meals as planned. | Supervised meals make sure planned food is eaten and help her feel supported, which lowers anxiety and the chance of hiding or discarding food. |
| Avoid blame. | Blame increases shame and secrecy, so a neutral, caring tone helps her stay engaged in treatment. |
| Monitor vital signs and labs. | Severe restriction and weight loss can affect heart rate, blood pressure and body chemicals, so checking them finds danger early. |
| Refer to a specialist team. | Specialist teams have training in treating eating disorders and offer therapy, nutrition and medical care together. |
| Involve family. | Family can support meals and recovery at home, and including them helps everyone understand and respond well. |
**Expected outcomes**
- Eats planned meals.
- Weight stabilizes within 2 weeks.
- Vital signs stable.
- Accepts specialist care.
**Linking the data to the diagnosis**
The teenager says, "I'm too fat," while skipping meals and exercising excessively. The nurse records a BMI of 16, an 8 kg weight loss and secrecy about food. These signs show harmful eating is present now and already affecting health, so this is an actual problem. The data describe restriction and over-exercise, not bingeing or purging. The plan aims for her to eat planned meals, have weight stabilize within 2 weeks, keep stable vital signs and accept specialist care.
CarePath diagnosis
Harmful eating behaviors related to body image problems, as evidenced by skipped meals, excessive exercise, BMI 16, and weight down 8 kg.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Build trust. | Trust is the base of care for eating problems, because a person who feels judged tends to hide behaviors and resist help. |
| 2. Supervise meals as planned. | Supervised meals make sure planned food is eaten and help her feel supported, which lowers anxiety and the chance of hiding or discarding food. |
| 3. Avoid blame. | Blame increases shame and secrecy, so a neutral, caring tone helps her stay engaged in treatment. |
| 4. Monitor vital signs and labs. | Severe restriction and weight loss can affect heart rate, blood pressure and body chemicals, so checking them finds danger early. |
| 5. Refer to a specialist team. | Specialist teams have training in treating eating disorders and offer therapy, nutrition and medical care together. |
| 6. Involve family. | Family can support meals and recovery at home, and including them helps everyone understand and respond well. |
Expected outcomes
- Eats planned meals.
- Weight stabilizes within 2 weeks.
- Vital signs stable.
- Accepts specialist care.
Linking the data to the diagnosis
The teenager says, "I'm too fat," while skipping meals and exercising excessively. The nurse records a BMI of 16, an 8 kg weight loss and secrecy about food. These signs show harmful eating is present now and already affecting health, so this is an actual problem. The data describe restriction and over-exercise, not bingeing or purging. The plan aims for her to eat planned meals, have weight stabilize within 2 weeks, keep stable vital signs and accept specialist care.