Eating Disorders

Question 1

List the 4 main criteria domains for anorexia nervosa

Answer 1

Weight loss at least 15% below the normal weight
Avoidance of “fattening foods” (self-induced weight loss)
Self-perception of being too fat/dread of fatness
Widespread endocrine disorder

Question 2

What are the main endocrine disorders that occur in anorexia nervosa?

Answer 2

Amenorrhoea and reduced breast growth in females

Loss of libido + potency, juvenile genitals in males

Question 3

List the main criteria for diagnosing bulimia nervosa

Answer 3

Recurrent episodes of over-eating with consumption of large quantities of food in short periods
Persistent strong desire to eat (lack of control)
Attempts to counteract fattening by: self-induced vomiting/purging/starvation
Self-perception of being too fat

Question 4

What is the main difference between bulimia and binge-eating disorder? What are the main features of binge-eating disorder?

Answer 4

No compensatory behaviours - no self-induced vomiting or "rectifying" behaviour
Recurrent episodes of binge eating large amounts with no control
3 of:
Being uncomfortably full
Eating large amounts when not hungry
Eating alone
Eating rapidly
Disgusted at themselves

Question 5

List some neuroprogressive effects of severe eating disorders

Answer 5

Loss of grey and white matter
Increased compulsive behaviour
Enhanced response to hedonic and nutrostat signals
Reduced social skills
Focus on food
Impaired concentration + decision-making
Learning stunted

Question 6

CBT in which outpatient group - adolescents or adults - is more effective in the long-term?

Answer 6

Adolescents

Outpatient adults have poor long-term benefit

Question 7

List the low-sev BMI risk assessment for anorexia

Answer 7

Low: 17.5-16
Mod: 16-15
High: 14.9-13
Very high: less than 13

Question 8

With recovery from anorexia nervosa, puberty is completed normally and menarche is late. True/ False?

Answer 8

True

Question 9

What are the two main subtypes of anorexia nervosa?

Answer 9

Restricting

Binge-eating/ purging

Question 10

What age is the typical onset of anorexia nervosa?

Answer 10

18yo

Question 11

What age is the typical onset of bulimia nervosa?

Answer 11

20yo

Question 12

What is Russell’s sign?

Answer 12

Calluses on knuckles/ back of hand due to repeated self-induced vomiting

Question 13

Name a common physical sign of eating disorder

Answer 13

Dental caries

Question 14

List biological, psychological and social risk factors for eating disorders

Answer 14

Biological: genetic, puberty, starvation effects
Psych: low self-esteem, perfectionism, adolescence, sexual abuse
Social: family environment, bullying, academic presure

Question 15

List common co-morbid conditions that occur with eating disorders

Answer 15

Depression
OCD
Substance mususe
Diabetes

Question 16

State the main complication of giving artifical feeding too quickly. How is it prevented?

Answer 16

Refeeding syndrome (depletion of inadequate stores of nutrients (Mg, K, PO4) quickly used up as body starts to repair)
Frequent blood monitoring
Slow initial refeeding

Question 17

List medical complications of eating disorders

Answer 17

Hypothermia
Dehydration
Electrolyte disturbance (low K, Mg, Ca, PO4)
Hypoglycaemia
Increased LFTs

Question 18

List other methods of risk assessment in eating disorder

Answer 18

Rate of weight loss
Blood results
Circulation
Muscle strength
Temperatures
ECG abnormalities

Question 19

What frequency does binge-eating need to occur to be classed as binge-eating disorder?

Answer 19

At least once a week for 3 months