Eating Disorders Flashcards
(51 cards)
what is the DSM-5 criteria for anorexia nervosa?
- intense fear of gaining weight or becoming fat
- significantly low body weight (less than what is ideally expected) in related to age, sex, development and physical health
- disturbances in the way ones body weight or shape is experienced and denial of the seriousness of the current low body weight
what are the two subtypes of anorexia and how are they different?
restricting type: during the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behaviour
- weight is accomplished primarily through dieting, fasting, and/or excessive exercise
binge-eating/purging type: during the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behaviour
how is the severity of anorexia classified?
based on BMI
what is the DSM-5 criteria for bulimia nervosa?
- recurrent episodes of binge eating
- recurrent compensatory behaviour to prevent weight gain
- binge eating and compensation 1x/week x 3 months
- self-evaluation is disproportionately influenced by body shape and weight
what are the remission specifications of bulimia?
in partial remission: after full criteria for BN were previously met, some but not all, of the criteria have been met for a sustained period of time
in full remission: after full criteria for BN were previously met, none of the criteria have been met for a sustained period of time
how is the severity of bulimia classified?
based on the frequency of inappropriate compensatory behaviours per week
T or F
diagnosis for bulimia nervosa includes specific BMI?
false
patients with BN are commonly normal to slightly overweight
what BMI is considered underweight?
<18.5
what is the diagnostic criteria for binge eating disorder?
- recurrent episodes of binge eating without compensatory behaviour to prevent weight gain
- eating, in a discrete period of time, an amount of food much larger than most people would eat during the same period of time
- lack of control over eating during the episode
- > 3 of the following: eating rapidly; eating until uncomfortably full; eating large amounts when not hungry; eating alone from embarrassment; feeling disgusted, depressed or guilty after eating
- binge eating 1x/weekly for 3 months
- causes marked distress
what is the etiology of eating disorders?
genetic predisposition
physiologic state: imbalance of NTs and neuropeptides
environmental - complex bio-psychosocial
what is the major appetite and eating control center of the brain?
hypothalamus
what is the most common trigger for binge eating?
stress
what does suppression of the HPG axis cause?
decrease in estradiol, progesterone, and LH production = amenorrhea and decreased libido
what is the average episode duration of AN and BN?
AN: 8 months
BN: 2.9 months
what is the mean duration of illness of AN and BN?
AN: 9-15 years
BN: 7.7-11.7 years
what is the death rate of AN?
10%
which tends to be more fluctuating, AN or BN?
BN
what are some common psych co-morbidities of anorexia?
anxiety: OCD, social phobia
mood disorders: MDD, dysthymia, bipolar
personality disorders - cluster C: avoidant, obsessive compulsive
substance use disorder
what are some common psych co-morbidities of bulimia?
cluster B and C personality disorders: borderline, avoidant, impulsive, narcissistic
substance use
anxiety: OCD, panic, social
mood disorders: MDD, dysthymia, bipolar
impulse control disorder: compulsive buying, kleptomania, self-mutilation
what are the consequences of amenorrhea?
increase risk of
- osteoporosis/osteopenia
- decreased growth velocity
- lack of sexual desire/sexual dysfunction
- unexpected pregnancies
what percentage of women have a relapse in their eating disorder during pregnancy?
22%
what are the risks to the baby if a women suffers with anorexia during pregnancy?
17% newborns failure to thrive
increased risk of child obesity
when will periods return after amenorrhea caused by an eating disorder?
within 6 months of achieving body weight of about 90% of the average for age and height
- related to serum estrogen, but amount of body fat
what the the CV complications associated with anorexia?
- prolonged QT
- cardiac atrophy
- myocardial mass
- sinus bradycardia
- cardiac arrhythmias
- decrease HR variability
- hypotension
