Eating Disorders Flashcards
Predisposing Factors of Eating Disorders
- Biological influences
- Psychodynamic influences
- Family influences
? - Characteristics
- morbid fear of obesity
- gross distortion of body image
- preoccupation w/food
- refusal to eat (even if suffers hunger pangs)
Anorexia nervosa (AN)
> BMI of 17 or lower or <15 in extreme cases
AN
- Excessive weight loss, may be less than 85% of expected weight
- Reduction in food intake (horde or conceal)
- Possible laxative use, diuretics, purging, use of diet pills
- Preoccupation or obsession w/food
- Possible excessive exercise
- Compulsive behaviors (i.e., excessive handwashing)
AN - Assessment Findings
- Hypothermia, bradycardia (more pronounced at rest), hypotension
- Edema, lanugo, metabolic changes
- Amenorrhea (happens w/severe wt loss)
AN - Diagnostic Criteria
A. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal, or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
? type
The individual, over the last 3 months, has engaged in recurrent episodes of binge-eating or purging behaviors
> i.e., laxatives, enemas, & diuretics
Binge-eating/purging (type)
? type
Means that the individual, over the last 3 months, has engaged in restricting of calorie intake which does not include any sort of purging or binging activity
> They accomplish their wt loss through dieting, fasting, and/or the use of excessive exercise
Restricting (type)
Hospitalization
- Malnutrition
- Dehydration
> Assess for thirst, orthostatic hypotension, tachycardia, & elevated sodium lvls - Severe electrolyte imbalance
> Low K, PO4, Mg - Cardiac arrhythmia or severe bradycardia (<50 bpm)
- Hypothermia (<96.8°)
- Hypotension
- Suicidal ideation
?
- Binging, purging, overconcerned w/appearance & other’s perception
- More common than anorexia; eating high-cal foods in secret
- Most are within normal wt range
Bulimia Nervosa (BN)
BN
- Normal wt range
- Dehydration & electrolyte imbalance
- Erosion of tooth enamel (d/t gastric acid in vomit)
- Tears in gastric mucosa or esophageal mucosa
- Russell’s sign (calluses on dorsal surface of hands, typically knuckles, that’s 2nd to long-term purging)
- Parotid enlargement (from vomiting)
- Dental caries
- Mouth ulcers
BN - Diagnostic Criteria
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period) an amount of food that is definitely larger than most individuals would eat during a similar period of time and under similar circumstances.
- A sense of lack of control over-eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting or the misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Severity of Bulimia
- Mild (1-3) [episodes]
- Moderate (4-7)
- Severe (8-13)
- Extreme (on average, 14 or more episodes/week)
Binge Eating Disorder - Diagnostic Criteria
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
! Etiology isn’t fully understood but brain imaging studies have shown an orbitofrontal cortex displaying increased activity (that center is responsible for the reward & pleasure responses & usually r/t substances [food])
! This disorder is absent of the compensatory purging; there’s no misuse of laxatives or self-induced vomiting
