Eating disorders Flashcards
three eating disorders
ANOREXIA NERVOSA
BULIMIA NERVOSA
BINGE-EATING DISORDER
OTHER SPECIFIED EATING DISORDER
Anorexia
Criteria
EPI
Mortality rate
causes of deaht
Restriction of intake leading to significantly low body weight
Intense fear of gaining weight or becoming fat
Disturbances in self perception based on body image (“if im not thin i’m a bad person)
No longer require impaired menstruation
Anorexia = 0.3-1% of women, 0.1% of men
F > M
Mortality rate 5-18%, or 5.6% per decade of illness (death due to suicide vs. cardiac failure)
changes in hormones in weight loss
what is the clinical manifestation in women
Increased CRH
Decreased LH, FSH
Impaired regulation of GH
Other characteristics of anorexia
Types of anorexia:
Restricting type
the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior
weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise
Types of anorexia:Binge-Eating/Purging Subtype
uring the last 3 months, the individual has engaged inrecurrent episodes of binge eating or purging behavior
may have had a heavier body weight before AN onset
More likely to be associated with substance abuse
higher suicide rate
Other physical/medical findings of anorexia:
related to purging
Purging: Metabolic – ↓ K, ↓ Mg, hypochloremic alkalosis
Dental with purging: Erosion of dental enamel & corresponding decay
Elevated salivary amylase
Seizures
Other physical/medical findings of anorexia:
Related to weight loss:
Cachexia
Cardiac: Hypotension, loss of heart muscle, arythmias, prolonged QT, ST depression, bradycardia, Vtach
Delayed gastric emptying;
Amenorrhea – low LH, FSH
Lanugo – fine hair
Leukopenia
Osteoporosis (not reversible
Evaluation for anorexia
what labs and tests/
CBC: Leukopenia BMP Elevated salivary amylase Elevated serum cholesterol Vitamin D levels, Ca levels EKG changes, hypotension, bradycardia
Treatment for anorexia
Hospitalization frequently necessary after pt weighs less than 20% of minimum body weight, often for 2-6 months at a time
Behavioral management + group therapy + individual therapy + family education and therapy + nutritional consultants + medications
Total caloric intake 500 calories above what is required;
Gradual transition to outpatient care; overnight stays at hotels; weekend passes to families
Medications:
SSRIs –
some TCA – cardiac side effects
Some naltrexone – block endorphins
common causes of death for anorexia patients
common comorbidity
heart conditions
depression, OCD
Bulimia Nervosa
- general characteristics
- primary symptom?
- definition of this
Epi
Cormorbidities
Binge-eating is the primary symptom (Eating more food than most persons in similar circumstances and in a similar period of time)
Purging, laxatives, excessive exercise
1%-1.5% of young women
F > M, ratio 10:1
Mood disorders, substance abuse, personality disorders
biological pathophys
psychological pathophys
Dysregulation of 5-HT and NE
Abnormal endorphin response? Patients feel a sense of well-being after vomiting.
Dysregulation of 5-HT and NE
Abnormal endorphin response? Patients feel a sense of well-being after vomiting.
who is more likely to seek treatment beteween AN and BN
which has a better prognosis?
BN
BN
BN Criteria
Recurrent episodes of binge eating (eating a shit ton in a discrete amount of time – 2hours, feeling of lack of control)
Recurrent inappropriate compensatory behavior
binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
Self-evaluation is unduly influenced by body shape and weight.
