eating disorders

Question 1

eating disorders in males

Answer 1

emphasis on fitness
lean muscularity
stringent weight requirements for certain sports
higher incidence in homosexuals

Question 2

populations most frequently diagnosed with eating disorders

Answer 2

white
affluent
well-educated
adolescent and female

Question 3

factors contributing to eating disorders

Answer 3

vulnerable personality
female
hx of obesity
uncontrolled dieting
genetics
onset of puberty
major life changes or stressors
family functioning style
sociocultural emphasis on slimness
perfectionism
impulsivity

Question 4

etiology of eating disorders

Answer 4

genetic: strong genetic component
neurobiological: altered brain serotonin contributes to the dysregulation of appetite, mood, impulse control
psychological: eating disorders are learned behavior that has positive reinforcement
environmental: childhood trauma

Question 5

psychological factors of eating disorders

Answer 5

low self esteem
feelings of inadequacy, lack of control in life
depression, anxiety, stress, loneliness, trauma

Question 6

interpersonal factors of eating disorders

Answer 6

troubled relationships
difficulty expressing emotions
hx of being teased based on size/weight
hx of physical/sexual abuse

Question 7

social factors of eating disorders

Answer 7

culture pressure of thinness
narrow definitions of beauty

Question 8

biological factors of eating disorders

Answer 8

irregular hormone functions
genetics

Question 9

co-morbidities and dual diagnoses in eating disorders

Answer 9

associated between depression, anxiety, and eating disorders
anorexia have hx of anxiety
binge-purge behavior have co-morbid alcohol or substance abuse problem
bulimia frequently co-exists with major depression

Question 10

treating eating disorders

Answer 10

rarely seek help
not motivated to change
often leave treatment
some recover spontaneously, whereas others have long term problems

Question 11

anorexia nervosa

Answer 11

refusal to maintain body weight appropriate for age, intense fear of gaining weight or becoming obese
severely distorted body image
refusal to acknowledge the seriousness of wt loss

Question 12

restricting type AN

Answer 12

individuals that do not regularly engage in binge eating or purging
calorie count and excessive exercise

Question 13

binge eating and purging type AN

Answer 13

regularly engage in binge eating or purging behaviors
self induces vomiting or misuse of laxatives, diuretics or enemas

Question 14

physical characteristics of AN

Answer 14

low body weight
lack of energy, fatigue
muscular weakness
decreased balance, unsteady gate
low body temp, BP, pulse rate
tingling in hands and feet
thinning hair or hair loss
lanugo
heart arrhythmias
loss of periods
low testo levels

Question 15

etiology of AN

Answer 15

biological factors (genetics/neurobiological)
psychological factors
environmental factors

Question 16

warning signs of AN

Answer 16

dramatic weight loss
preoccupation with food, calories, grams of fat, and dieting
refusal of certain foods, progressing to avoidance against whole food catagories

Question 17

risk factors of AN

Answer 17

female
hx of eating disorders
history of obesity
dieting
over exercising
low self esteem
body dissatisfaction
lack of assertiveness
hx abuse
comorbid conditions
distorted body image
media
fashion industry
being an athlete

Question 18

clinical course of AN

Answer 18

onset in early adolescence
chronic condition with relapses characterized by significant weight loss
often preoccupied with food
may develop bulimia nervosa
poor outcome related to initial lower minimum weight, presence of purging, and earlier age of onset
CAN BE CURED

Question 19

complications due to weight loss/starvation

Answer 19

musculoskeletal: loss of muscle mass, fat, early onset osteoporosis
metabolic: hypothyroidism, hypoglycemia, electrolyte abnormalities
cardiac: bradycardia, hypotension, loss of cardiac mass, small heart, arrhythmias, chest pain, sudden death
GI: delayed gastric emptying, bloating, constipation, abdominal pain, gas and diarrhea, GERD, hemorrhoids
Reproductive: amenorrhea, irregular periods, loss of libido, infertility
dermatologic: dry cracking skin, brittle hair and nails, lanugo, edema, acrocyanosis, yellowish skins
hematologic: leukopenia, anemia, thrombocytopenia, hypercholesterolemia, hypercarotenemia
neuropsychiatric: abnormal taste, apathetic depression, mild organic mental symptoms, sleep disturbances and fatigue

Question 20

complications of eating disorders due to purging

Answer 20

erosion of enamel, seizures, fatigues, weakness, milk organic metal symptoms, ipecac cardiomyopathy, arrhythmias, Russel’s sign

Question 21

initial goal treatment of AN

Answer 21

assess suicidal ideation
initiating nutritional rehabilitation

Question 22

later goal treatment of AN

Answer 22

Resolving conflicts around body image disturbance
increasing effecting coping
addressing underlying conflicts r/t maturity fears and role conflict
family therapy

Question 23

treatment modalities of AN

Answer 23

hospitalization usually necessary
intensive therapies

Question 24

refeeding syndrome

Answer 24

serious and potentially fatal condition caused by sudden shifts in electrolytes that help body metabolize food.

Question 25

treatments of AN

Answer 25

precise meal times, adherence to selected menu observation during and after meals and regularly scheduled weigh ins constant monitoring during bathroom trips long term treatment provided on outpatient basis

Question 26

meds for AN

Answer 26

fluoxetine helpful for compulsive behaviors after pt has reached maintenance wt.

Question 27

when is hospitalization required for eating disorders?

Answer 27

extreme electrolyte imbalance or weight below 75% of ideal body weight less than 10% body fat daytime HR less than 50 bpm systolic bp less than 90 body temp less than 96 arrhythmias

Question 28

what is an acceptable BMI?

Answer 28

18.5-24.9

Question 29

Bulimia Nervosa

Answer 29

recurrent episodes of binge to avoid weight gain through purging. such as self inflicted vomiting, diuretics, enemas, emetics, or excessive exercise or fasting

Question 30

risk factors for BN

Answer 30

high achievers social pressure to be thin depression chaotic family outgoing angry impulsive substance abuse

Question 31

clinical course of BN

Answer 31

few outward signs binge and purge in secret treatment often delayed for years typically normal body weight once tx is over typically there is complete recovery except is depression and personality disorders present they feel shame, guilt, and disgust regarding binging and purging

Question 32

warning signs of BN

Answer 32

disappearance of large amounts for food finding wrappers and containers evidence of purging, frequent trips to the bathroom after meals, signs and or smells of vomiting, laxatives or diuretic wrappers unusual swelling of cheeks and jaws Russells sign discoloration or staining of teeth withdraw from usual friends and activities

Question 33

symptoms of BN

Answer 33

enamel erosion xerostomia (dry mouth) tooth decay

Question 34

treatment of BN

Answer 34

hospitalization if experiencing life threatening complications/SI treatment is usually outpatient stabilizing and normalizing eating, stop the binge-purge cycle teaching health boundaries reshape dysfunctional thoughts CBT,DBT

Question 35

meds for BN

Answer 35

SSRI's- fluoxetine, is the most effective in conjunction with CBT behavioral techniques such as using food diary nutritional counseling group psychotherapy and support groups family therapy

Question 36

Binge eating disorder

Answer 36

recurrent episodes of binge eating with accompanying marked distress and impaired control over behavior

Question 37

causes and comorbidities of BED

Answer 37

lower dietary restraint and higher in weight BED occurs in normal-weight/overweight and obese genetic

Question 38

most common psych disorders with BED

Answer 38

bipolar, MDD, anxiety, SUD low self esteem, body dissatisfaction, deduced level of coping and adverse childhood events

Question 39

symptoms of BED

Answer 39

frequent episodes of eating large quantities of food in short periods of time out of control, over eating depressed, guilty, or disgusted by behavior eating when not hungry, eating alone, uncomfortably full upper and lower GI problems that bring attention to HCP's.

Question 40

consequences of BED

Answer 40

HTN high cholesterol heart disease DM GI diseases Gallbladder disease musculoskeletal problems

Question 41

treatment of binge eating disorders

Answer 41

hospitalization not usually required individual or group CBT DBT nutritional counseling support groups psychopharmacology (SSRI's, Vyvanse)