Eating Disorders Flashcards
What are the two main subdivisions of anorexia nervosa? Which additional disorders is each associated with?
- Restrictive type: eat very little and may vigorously exercise; more often withdrawn with obsessive-compulsive traits
- Binge eating/purging type: eat in binges followed by purging, laxatives, excessive exercise, and/or diuretics; associated with increased incidence of major depression and substance abuse
What are the DSM-IV criteria for Anorexia Nervosa?
- Body weight at least 15% below normal
- Intense fear of gaining weight or becoming fat
- Disturbed body image
- Amenorrhea
What distinguishes anorexia nervosa from bulimia?
Low body weight
What are some physical findings associated with anorexia nervosa?
- Amenorrhea
- Electrolyte abnormalities
- Arrhythmias
- Cardiac arrest
- Lanugo (fine body hair)
- Melanosis coli (darkened area of colon secondary to laxative abuse)
- Leukopenia
- Osteoporosis
When is the onset of anorexia nervosa?
Usually between ages 10 and 30
In which types of countries is anorexia nervosa more common? What types of professions?
More common in developed countries and professions requiring thin physique (ballet or modeling)
What is the course of anorexia nervosa?
Variable course: may completely recover, have fluctuating symptoms with relapses, or progressively deteriorate
What is the mortality rate in anorexia nervosa? What are the causes of mortality?
10% - due to starvation, suicide, or electrolyte disturbances
How is anorexia nervosa treated? When can patients be treated outpatient?
Treatment involves behavioral therapy, family therapy, and supervised weight gain programs
Some antidepressants may be useful as adjunctive treatment to promote weight gain
Patients may be treated as outpatients unless they are more than 20% below ideal body weight
What are the two subcategories of Bulimia nervosa?
- Purging type: involves vomiting, laxatives, or diuretics
- Nonpurging type: involves excessive exercise or fasting
What are the DSM-IV criteria for Bulimia Nervosa?
- Recurrent episodes of binge eating
- Recurrent, inappropriate attempts to compensate for overeating and prevent weight gain
- The binge eating and compensatory behaviors occur at least twice a week for 3 months
- Perception of self-worth is excessively influenced by body weight and shape
What is the definition of binge eating?
Excessive food intake within a 2-hour period accompanied by a sense of lack of control
Unlike patients with anorexia nervosa, bulimic patients usually maintain a normal weight and their symptoms are more ego-______
ego-dystonic (distressing)
What are the physical findings associated with bulimia nervosa? What electrolyte findings?
- Hypochloremic hypokalemic alkalosis
- Esophagitis
- Dental erosions
- Calloused knuckles
- Salivary gland hypertrophy
Bulimia nervosa is significantly more common in _______ (women/men)
women
Which has the better prognosis, bulimia nervosa or anorexia nervosa?
Bulimia nervosa
What is the prognosis for bulimia nervosis?
One half recover fully with treatment; one half have chronic course with fluctuating symptoms
What is the treatment for bulimia nervosa?
Individual psychotherapy, cognitive behavioral therapy, group therapy, and pharmacotherapy (SSRIs first, then TCAs)
What is obesity? How much of the United States population is obese?
Obesity is defined as being at least 20% over ideal body weight
Over 1/2 of all people in the US are obese
What are the DSM-IV criteria for binge-eating disorder?
- Recurrent episodes of binge eating
- Severe distress over binge eating
- Bingeing occurs at least 2 days a week for 6 months and is not associated with compensatory behaviors
- 3 or more of the following are present
- Eating very rapidly
- Eating until uncomfortably full
- Eating large amounts when not hungry
- Eating alone due to embarassment over eating habits
- Feeling disgusted, depressed, or guilty after overeating
What pharmacotherapy can be used to treat binge-eating disorder? How do they work?
- Stimulants (phentermine and amphetamine) - suppress appetite
- Orlistat (Xenical) - inhibits pancreatic lipase, thus decreasing amount of fat absorbed from GI tract
- Sibutramine (Meridia) - inhibits reuptake of norepinephrine, serotonin, and dopamine
What non-pharmacological treatments are used to treat binge-eating disorder?
Psychotherapy and behavioral therapy with a strict diet and exercise program
