Eating Disorders

Question 1

What type of hair do anorexic people grow to keep them warm?

Answer 1

Lanugo hair

Question 2

What is Anorexia Nervosa?

Answer 2

Psychosomatic syndrome of self-induce weight loss which usually occurs in adolescent girls and young women.

Characterised by excessive use of behaviours directed at bringing about weight loss.

Question 3

What is the prescribed treatment for Anorexia Nervosa?

Answer 3

Prescribed usually one of two antipsychotic drugs that usually treat schizophrenia.

But there isn’t an effective treatment yet.

Question 4

Define Refeeding Syndrome

Answer 4

Describes a potentially fatal shift of fluid and electrolytes that occurs when refeeding a malnourished patient.

Some serious consequences include: cardiac or respiratory failure; gastrointestinal problems; delirium; death.

Question 5

DSM-5 BULIMIA NERVOSA criteria

Answer 5

A. Recurrent episodes of binge eating; characterised by:

• eating, in a discrete period of time (within any 2-hour period), an amount of food that is definietly larger than what most individuals would eat in a similar period of time under similar circumstances
• a sense of lack of control over eating during the episode

B. Recurrent inappropriate compensatory behaviours in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives; fasting; excessive exercise

C. The binge eating and inappropriate compensatory behaviours both occur, on average, at least once a week for 3 months

Question 6

Define difference between partial remission or full remission for BULIMIA NERVOSA

Answer 6

Partial remission = after full criteria for bulimia nervosa were previously met, some, but not all, of the criteria have been met for a sustained period of time

Full remission = after full criteria for bulimia nervosa were previously met, none of the criteria have been met for a sustained period of time

Question 7

Specify current severity of BULIMIA NERVOSA (mild, moderate, severe, extreme)

Answer 7

Mild = average of 1-3 episodes a week

Moderate = average of 4-7 episodes a week

Severe = average of 8-13 episodes a week

Extreme = average of 14 or more episodes a week

Question 8

Epidemiology of BULIMIA NERVOSA

Answer 8

Occurs predominantly in women.

Question 9

BULIMIA NERVOSA comorbidities

Answer 9

Substance abuse; depression; suicidality; personality disorders (mainly borderline personality); anxiety disorders

Question 10

Describe the CBT-E: Cognitive Behaviour Therapy for BULIMIA NERVOSA treatment

Answer 10

Usually lasts 20 weeks; semi structured; problem oriented; has three stages of treatment

First establish a sound therapeutic relationship; educate the patient about why behaviour and cognitive change is needed; try to reduce the frequency of overeating by introducing a pattern of regular eating.

Next tackle the dieting; enhance problem solving skills and address concerns about shape and weight.

Finally have a couple of interviews to ensure that the progress is maintained and relapse prevented.

Question 11

What is the prescription of a regular pattern of eating for BULIMIA NERVOSA?

Answer 11

• Eat 3 meals per day

- Eat 2 snacks

Question 12

Why should you try to incorporate forbidden foods in a BULIMIA NERVOSA diet?

Answer 12

To attempt to normalise the forbidden foods, and stop them triggering the binge eating. You have to teach them to regulate the foods that they previously binged on; because you can’t prevent them from eating that food.

Question 13

DSM-5 BINGE EATING DISORDER criteria

Answer 13

A. Recurrent episodes of binge eating, characterised by:

• eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
• a sense of lack of control over eating during the episode

B. The binge-eating episodes are associated with three or more:

• eating much more rapidly than normal
• eating until feeling uncomfortable full
• eating large amounts of food when not feeling physically hungry
• eating alone because of feeling embarrassed by how much one is eating
• feeling disgusted with oneself, depressed, or very guilty afterwards

C. Marked distress regarding binge eating is present.

D. The binge occurs, on average, at least once a week for 3 months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviour as in Bulimia Nervosa and does not occur exclusively during the course of Bulimia Nervosa or Anorexia Nervosa

Question 14

BINGE-EATING DISORDER genetic influences?

Answer 14

BED appears to run in families, which may reflect genetic influences

Question 15

BINGE-EATING DISORDER comorbidities

Answer 15

Depression, anxiety and substance use

Question 16

First treatment option for BINGE-EATING DISORDER?

Answer 16

Psychological Therapy (CBT)

CBT most validated and effective treatment for BED; effective for reducing binge episodes