Eating disorders Flashcards
what screening tool is used for identifying an eating disorder?
SCOFF questionnaire
what questions are in the SCOFF questionnaire?
do you make yourself sick because you feel uncomfortably full?
do you worry you have lost control over how much you eat?
have you recently lost over one stone in the past 3 months?
you you believe yourself to be fat when people tell you otherwise?
would you say food dominated your life?
at what weight is someone considered anorexic?
BMI 17.5 or less
15% below ideal body weight
what are the physical consequences of anorexia nervosa?
due to starvation; - constipation - delayed gastric emptying causing feeling of fullness - cold intolerence - blue feet and hands - lanugo hair - hypotension - slow heart rate, arrhythmias early satiety - fatigue, weakness - fainting - dry skin - delayed puberty/ primary amenorrhoea - secondary amenorrhoea
what are the key features of anorexia nervosa?
restriction of food intake
relies on compulsive compensatory behaviours in order to counteract food intake i.e. exercise, laxatives
amenorrhoea for > 3 cycles
weight loss > 15% body weight in 3 months or BMI < 17.5
fear of gaining weight
what are the key features of bulimia nervosa?
episodes of binge eating with a sense of loss of control
followed by compensatory behaviour of purging or excessive exercise, fasting
binging and compensatory behaviour must occur twice per week for 3 months
dissatisfaction with body shape and weight
what are the physical consequences of bulimia?
mouth sores pharyngeal trauma dental caries heart burn oesophageal rupture muscle cramps weakness bloddy diarrhoea fainting hypotension swollen parotid gland irregular periods
what are the key features of binge eating disorder?
similar to bulimia but in the absence of the purging behaviour
ongoing or repetitive cycles of;
- eating unusually fast
- unusually large amounts
- usually eat alone
- causes guilt, shame, depression, embarrassment
- uncomfortably full
what are the psychological consequences of eating disorders?
extreme overvaluation of low weight and thin shape
obsessive weight-losing feels like a solution not a problem
starved person unlikely to interpret emotion
depression at low weights
people who rely on eating disorder behaviour to self problems fail to develop other was to cope with life, tolerate stress or feel rewarded and fulfilled
anxiety whilst eating (esp in company) and then guild afterwards
what are the social consequences of eating disorders?
people become ‘obstacles’ to the eating disorder
push people away
lose friendships
lack of interest in sexual relationships
withdrawn
what are the predisposing factors for anorexia nervosa?
OCD anxiety disorders perfectionism perinatal factors life events or traumas
what are the precipitating factors for anorexia nervosa?
increased exercise
dieting or even non deliberate weight loss
stressful life evens
puberty
what are the perpetuating factors for anorexia nervosa?
consequences of starvation syndrome promote the eating disorder behaviours
delayed gastric emptying increasing feeling dn anxiety of fatness
narrowing focus with avoidance of interpersonal interest, change of values so that food becomes the more important thing
obsessionally
- phobia of fat increases as avoidance increases
- body checking amplifies the body image concern
what are the treatment options for anorexia nervosa?
re-feeding CBT family based therapy (children / adolescents) interpersonal therapy flucloxacillin (60mg) clozapine
what is the criteria for admitting someone for inpatient care for an eating disorder?
weight 85% or less of expected weight and/or 1/3 percentile for BMI lack of weight gain significant oedema physiological compromise; - electrolyte disturbance - cardiac disturbance - altered mental status - orthostatic difference 30mmHg or greater temp < 36 heart rate < 45 symptoms cannot be managed by outpatient care psychosis or high risk of suicide
