Eating Disorder Flashcards
(35 cards)
Anorexia Nervosa Diagnostic criteria?
Intense fear of gaining wt or becoming fat
Significantly low body wt
Disturbance in ones body wt or shape, denial of the seriousness of the current low body wt
Bulimia Nervosa Diagnostic Criteria?
Recurrent episodes of binge eating
Lack of control of eating during epsidode
Recurrent compensatory behaviour to prevent wt gain
binge eating + compensation 1x/week x 3 months
Self evaluation is disproportionately influenced by body shape and wt
Does Bulimia Nervosa diagnostics have a specific BMI?
NO
Anorexia BMI stages?
Mild: >17
Moderate: 16-16.99
Severe: 15-15.99
Extreme: <15
Main difference between Bulimia and Binge eating disorder?
BED does not have compensatory behaviour to prevent wt gain
What is the criteria to be diagnosed w/ BED?
> 3 of the following;
- eating rapidly
- eating large amounts when not hungry
- eating until uncomfortably full
- eating alone from embarassment
- feeling disgusted, depressed, or guilty after eating
1x/week x 3months
What does starvation, chronic stress, and excessive exercise do in regards to neurobiological dysfunction?
Increase cortisol from adrenal glands leading to suppression of;
- HPA axis
- HPT axis
- HPG axis
What is 5HT synthesized from?
tryptophan
What does 5HT do?
regulates postprandial satiety, anxiety, sleep, mood, impulse control, OCD
What does a deficiency in Dopamine lead to?
decreased energy, anhedonia, decreased feeling of reward
What does a defeciency in NE due to starvation lead to
hypotension
bradycardia
Female or Male more common in eating disorders?
Female; 9 fold in anorexia, 10 fold in bulimia, 2 fold in BED
increase in mortality with anorexia?
6 fold
What % of anorexia pts have co-morbid psych conditions?
70%
~30% of that 70% have OCD
General principles of treatment?
Emphasize on normalization of eating behaviour and attention to underlying psychological and social issues
Consider eating abnormality as coping mechanism and develop other coping mechanisms
form a treatment alliance by offering help with sx or behaviours that are distressing to pt
Identify stressors that predispose eating disorder
Long term amenorrhea b/c of anorexia increase risk of what?
osteoporosis/ osteopenia
Decreased growth velocity
Lack of sexual desire/ sexual dysfunction
Unexpected pregnancies
Pregnancy risks in eating disorder?
Attempting to concieve:
- irregular ovulation
- inhibited sexual desire
- substance use
During PRegnancy:
- micronutrient defeciency
- hyperemesis gravidarum
- poor wt gain
- substance use
- miscarriage
- low birth wt and or premature infant
- cesarean delivery
Postpartum:
- Difficulty breastfeeding
- failure of infant bonding
- Infant feeding problems
- relapse of eating disorder behaviour
- postpartum depression
At what timeframe will a period return?
within 6 months of achieving a body wt of 90% of average for age and ht (BMI of ~19-20)
Is the return of the menstual cycle related to the amount of body fat/ wt gain?
No, related to serum estrogen levels
Review of systems electrolytes?
dehydration
all hypo electrolytes
When would we see hypzincermia in anorexia?
if appetite changes and taste disturbances
when would we see hypochloremia in anorexia?
if vomiting
Review of systems HEENT?
loss of tooth enamel
perioral dermatitis
enlarged parotid glands
Review of systems Neuro?
seizures( b/c of large fluid shifts and electrolyte disturbances)
brain atrophy on CT
Lethargy?
