Eating and Feeding Disorders Flashcards

Question

Later goals of AN treatment

Answer 1

* Resolving conflicts around body image disturbance * Increasing effective coping * Addressing underlying conflicts relating to maturity fears and role conflict * Assisting family with healthy functioning and communication

Answer 2

* Hospitalization usually necessary * Intensive therapies * Outpatient partial hospitalization (for patients who have been stabilized)

Answer 3

* Extreme electrolyte imbalance or weight below 75% of ideal body weight * Less than 10% body fat * Daytime heart rate less than 50 beats/minute * A systolic blood pressure of less than 90 * Temperature less than 96 degrees F * Arrhythmias

Answer 4

* A weight restoration program begins that allows for incremental weight gain * Treatment goal is set at 90% of ideal body weight * Precise mealtimes, adherence to selected menu, observation during and after meals and regularly scheduled weighing * Constant monitoring during bathroom trips * A potential complication is refeeding syndrome or a serious and potentially fatal condition that can occur during refeeding. It’s caused by sudden shifts in the electrolytes that help your body metabolize food * During refeeding the individual participates in milieu therapy focusing on eating behavior and underlying feelings of anxiety, dysphoria, low self-esteem, and lack of control

Answer 5

* No FDA approved medications and research doesn't support pharmacological agents * Fluoxetine has proven helpful for obsessive-compulsive behavior (after the client has reached a maintenance weight)

Answer 6

* Yoga * massage * acupuncture * bright light therapy

Answer 7

No empirical evidence to support any specific psychotherapy model in adults with anorexia nervosa. However, in adolescent patients with anorexia, there is evidence to support its use (insight-oriented therapy, family-based treatment, adolescent focused therapy and CBT)

Answer 8

An eating disorder in which the individual engages in recurrent episodes of uncontrollable binge eating and compensatory behavior to **avoid weight gain** through purging methods such as self-induced vomiting, use of laxatives, diuretics or excessive exercise

Answer 9

* More prevalent * Older at onset (mean onset 18) * Typically, of normal weight * Generally, not life-threatening * Treatment is usually outpatient * Outcomes better * Mortality rates lower * Medications are effective

Answer 10

* Neuropathological; changes in the brain may be due to eating dysregulation * Genetic and familial predispositions; 60% * Gene connection * Biochemical: Lower brain serotonin

Answer 11

* Anxiety disorders or low self-esteem * Impulsivity and compulsivity * Chaotic, non-nurturing family relationships * Difficult interpersonal relationships * Triggers: stress, poor body self-image, food, restrictive dieting, or boredom

Answer 12

* Internalization of a thin body ideal; weight-based teasing or bullying * Childhood sexual or physical abuse, traumatic events and environmental stress

Answer 13

* Few outward signs; initially do not appear physically ill * Often at or close to normal weight * Binge and purge in secret/doesn’t come to the attention of others * Treatment often delayed for years * Treatment initiated when control of eating is lost * Once treatment is complete typically there is complete recovery, except if depression &/or personality disorders are present * Individuals present as overwhelmed, overly committed, “social butterflies”, who have difficulty setting limits & establishing boundaries * They have enormous rules about food & food restriction * They **feel shame, guilt & disgust** regarding their binge eating & purging * They may also be compulsive and impulsive in other areas of their life

Answer 14

* Binge-eating behaviors * History of AN (1/4 - 1/3 of individuals) * Depressive signs and symptoms * Problems with interpersonal relationships * Impulsive behaviors * Increased levels of anxiety and compulsivity * Possible substance use disorders

Answer 15

* Evidence of **binge eating**, including disappearance of large amounts of food in short periods of time or finding wrappers and containers indicating the consumption of large amounts of food * Evidence of **purging** behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics * Excessive, rigid exercise regimen; despite weather, fatigue, illness, or injury, the compulsive need to “burn off” calories taken in * Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions * Withdrawal from usual friends and activities * In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns * **Parotid swelling** or unusual swelling of the cheeks or jaw area * Calluses and/or scars on the back of the hands and knuckles from self-induced vomiting,** Russell’s Sign** *** Dental caries, tooth erosion** and discoloration or staining of the teeth

Answer 16

* **Dental**: erosion of dental enamel * **Neuropsychiatric**: seizures, fatigue, weakness, mild organic mental symptoms * **Cardiac**: Ipecac cardiomyopathy, arrhythmias * **Dermatologic**: Russell’s Sign

Answer 17

* Determine the patient’s perception of the problem * Complete physical assessment, including labs * Psychosocial history including screening for suicide or self-harm behaviors, interpersonal and social functioning * Eating habits and fluid intake; history of dieting * Daily activities, including exercise * Value attached to a specific shape and weight

Answer 18

Only if experincing life-threatening complications and suicide risk

Answer 19

* Treatment is usually on an outpatient bases unless the individual is suicidal or past outpatient treatments have failed * Stabilizing and normalizing eating; interrupt the binge-purge cycle * Restructuring dysfunctional thoughts and attitudes about eating, weight, & shape * Teaching healthy boundary setting * Nutrition counseling (stabilize & normalize eating) * Behavioral techniques such as using a diary to record binges and purges and precipitating emotions and environmental cues

Answer 20

SSRIs (effective in treating binge eating and purging); fluoxetine is the only FDA approved medication for the treatment of BN in adults; most effective in conjunction with CBT

Answer 21

* Cognitive behavioral therapy (CBT)-**first line treatment for BN** * Dialectical behavioral therapy (DBT) * Group psychotherapy & support groups * Family therapy not usually used due to age of individual

Answer 22

An eating disorder characterized by recurrent episodes of binge eating, with accompanying marked distress and impaired control over such behavior

Answer 23

* Most common eating disorder * Lifetime incidence is 3.6 for women, 2.1% for men * Prevalent among females * All racial and ethnic groups seem to be represented fairly equally * BED occurs in normal-weight/overweight and obese individuals * Approximately half of the risk for BED is genetic * 79% of those with BED have another psychiatric disorder * The most prevalent psychiatric disorders associated with BED are specific phobia, social phobia, PTSD and alcohol abuse or dependence * Impulsivity and reward sensitivity, Low self-esteem, body dissatisfaction, difficulty coping with feelings * History of trauma and adverse childhood events * History of food insecurity

Answer 24

* Frequent episodes of eating large quantities of food in short periods of time * Feeling out of control overeating behavior during the episode * Feeling **depressed, guilty, or disgusted** by the behavior * There are also several behavioral indicators of BED including eating when not hungry, eating alone because of embarrassment over quantities consumed, eating until uncomfortably full * Often have upper and lower GI problems that bring them to the attention of healthcare professionals

Answer 25

* Determine the patient’s perception of the problem * Complete physical assessment, including labs * Psychosocial history * Assess nutritional pattern * Assess the history of weight cycling (i.e. gains and losses) * Careful history of binge-eating triggers, foods and frequency

Answer 26

* Hypertension * High cholesterol levels * Heart disease * Diabetes mellitus * Gastrointestinal diseases * Gallbladder disease * Musculoskeletal problems

Answer 27

* Hospitalization **not usually required**; outpatient treatment * Health teaching and health promotion; healthy eating and excercise

Answer 28

SSRI’s Lisdexamfetamine dimesylate

Answer 29

* Individual or group CBT * DBT * Support Groups

Answer 30

* **Ingestion of substances that have no nutritional value, such as dirt or paint** * The prevalence of pica is unknown but among institutionalized children, the prevalence of this disorder may be as high as 26% * Usually begins in early childhood and lasts for a few months; condition can also appear in adolescence or adulthood. * Males and females are affected equally. * Monitoring of the individual’s eating behavior is obviously an essential aspect of treating this problem. * Behavioral interventions such as rewarding appropriate eating can be helpful. *

Answer 31

* Characterized by **undigested food being returned to the mouth. It is then rechewed, reswallowed, or spit out** * May be diagnosed after 1 month of symptoms; Can begin at any age. In infants, the onset is usually between 3 and 12 months * Ruminating behaviors occur more frequently among people with intellectual disabilities. * Childhood neglect is a predisposing factor to the development of this disorder

Answer 32

* Repositioning infants and small children during feeding * Improving the interaction between caregiver and child and making mealtimes a pleasant experience often reduces rumination * Distracting the child when the behavior starts can also be helpful * Family therapy may be required

Answer 33

* Can result in significant weight loss, nutritional deficiency, dependence on supplements or enteral feeding, and marked interference with functioning. * For some, **food avoidance **may be related to **strong dislikes** related to sensory qualities of food. Appearance, color, smell, texture, temperature, and taste are implicated in food refusal. * Males and females are equally affected by this eating disorder of infancy and early childhood. * Personal anxiety and family anxiety seem to be risk factors

Answer 34

* The primary treatment modality is some form of behavioral modification to increase regular food consumption. * Families caring for a child with a feeding disorder often need support and education in specific behavioral techniques, but family therapy is not usually necessary. * The treatment of anxiety and depressive symptoms may be helpful in some cases.

Eating and Feeding Disorders Flashcards

(58 cards)