Flashcards in CM: Eating Disorders Deck (21):
What are the clinical symptoms related to eating disorders?
What are the psychological symptoms associated w eating disorders?
psyche: thoughts and feelings
thoughts = low self esteem, thoughts about body shape, weight, perfectionism, food
feelings: anxiety (pre-existing disorders), depression
What is an eating disorder?
eating separated from nutritional needs, social interaction, free choices
When and how are electrolytes altered in eating disorders?
only in bulimia (purging) - hypochloremic metabolic acidosis, low K, Cl, Mg
What is the percentage of body fat required for menstruation?
What is refeeding syndrome?
body has reserves of electrolytes in bone, muscle, etc
after starving 5 days or more metabolism changes - when food resumed, demand for these electrolytes may exceed availability in reserves --> acute depletion
What is the diagnostic criteria for anorexia nervosa?
restriction of energy intake leading to low body weight
intense fear of gaining weight or becoming fat even though underweight
disturbance about body, undue influence of weight on self-eval, denial of seriousness of low body weight
What are the subtypes of anorexia nervosa?
based on behavior over last 3 months
restricting type - no binging/purging
What is the epidemiology of anorexia?
onset 14-18 YO, more common in women
common comorbids = anxiety (social phobias inc childhood separation anxiety, OCD), depression
What are the clinical features of anorexia?
NO loss of appetite until late in disorder
peculiar behaviors with food/hiding food
rigid and perfectionistic
denial despite emaciation
poor sexual adjustment
What are the physical findings associated with anorexia?
cachexia, slowing of cardiac fxning and arrhythmias, GI symptoms, skin symptoms, leukopenia, osteoporosis
What are the lab findings associated with anorexia?
hypokalemia --> ST and T wave changes, hypochloremic acidosis, hypomagnesemia
salivary gland enlargement, pancreatic inflammation (increased amylase), seizures and neuropathies
gastric and dental erosions
What is general treatment for anorexia?
hospitalization for nutrition
psychotherapy: cognitive-behavioral therapy, family therapy (best outcomes)
No FDA approved meds
What is the diagnostic criteria for bulimia?
recurrent binge eating and compensatory behaviors to prevent weight gain (vomiting, laxatives, fasting, exercise)
behaviors occur at least 1 times/week for 3 months (2 in DSM-IV)
does not occur during episodes of anorexia
What are the subtypes of bulimia?
mostly purging type
only 5% nonpurging type (fast or exercise instead)
What is the epidemiology of bulimia?
onset later in adolescence than anorexia
pts usually normal weight or overweight (if underweight = anorexia)
etiology is multifactorial
What is the prognosis of bulimia compared to anorexia?
thought to be better
less likely to obtain treatment in milder cases
mood disorders commonly comorbid
generally more waxing and waning
What is the general treatment of bulimia?
hospitalization less often than anorexia
cognitive behavioral therapy
What is eating disorder NOS?
any combo of eating symptoms that doesn't quite reach significance
What is binge-eating disorder?
recurrent episodes of binge eating
3 or more of following associated w binge: eating rapidly, until uncomfortably full, large amounts when not physically hungry, eating alone because feel embarrassed, disgusted depressed or guilty afterward