Eating Disorders Flashcards
(46 cards)
What body weight criteria defines anorexia in DSM 5? What about BMI in ICD10?
Less than 85% of expected
Or BMI less than 17.5
What are the 4 main criteria for anorexia diagnosis?
Body weight (17.5 BMI or 85% of expected)
Intense fear of being overweight despite objective evidence of being underweight
Body image disturbance, undue influence of body weight on self evaluation or denial of seriousness of current low body weight
Amenorrhoea for at least 3 consecutive cycles or primary
What are the 2 types of anorexia?
Restrictive type
Purgative type
How does diagnosis of anorexia differ for men than women?
Criteria is same but body image requirements often different
E.g. Muscle tone and definition, fitness, strength
But also hormonal dysfunction - reduced libido, low testosterone
What is binge eating disorder? 3 main criteria
Recurrent episodes of binge eating with no corrective activity
Sense of lack of control during episodes
Occurs at least once per week for 3 months
What is the difference between binge eating disorder and bulimia?
No corrective activity/compensatory behaviour in bulimia
What constitutes a “binge” in binge eating disorder or bulimia?
Excessive consumption of food past feeling of satiety within a 2 hour period
What defines bulimia? 4 criteria
Repeated binges
Compensatory behaviour following these e.g. Purging, laxatives, diuretics, fasting, diet pills, excessive exercise
Self evaluation influenced by body shape/weight
The above at least once a week for 3 months
What is EDNOS?
Eating disorder not otherwise specified - doesn’t fit criteria for BN, AN or BED
E.g. Shorter than 3m or less than once a week, or not meeting weight criteria etc.
What is the most common group of eating disorders? How do you define these?
EDNOS - define according to which group it fits most closely with
What is the SCOFF screening questionnaire?
Make yourself SICK when feeling full?
Feel like lost CONTROL of eating?
Lost more than ONE stone in past 3 months?
See yourself as FAT when others see you as thin?
Does FOOD dominate your life?
Predisposing factors for eating disorders?
Genetics
Premorbid personality - obsessive, conscientious, often high achieving
Developmental factors and upbringing
Family and cultural factors
Precipitating factors for eating disorders?
Dieting
Major life events
Changing school, university etc.
Perpetuating factors for eating disorders?
Starvation high
Secondary gain/sick role
Relief from stresses or demands
What is there often a FH of in eating disorders?
OCD or depression
What psychological factor is at the core of most patients with eating disorders?
Low self esteem and negative self evaluation
What does the DVLA say about eating disorders, BMI and driving?
Won’t let people drive with BMI under 16 due to likely cognitive slowing and psychomotor retardation
What are the most common causes of ED-associated mortality?
Starvation - sudden e.g. Cardiac event or gradual
Self harm and suicide
Physical risks associated with low BMI and starvation?
Chronic problems e.g. Osteoporosis (females), bone marrow suppression, impaired fertility, renal and liver failure, muscle wasting, pressure sores
Postural hypotension and cardiac arrythmias
Hypothermia
Impaired cognition
Physical risks associated with vomiting?
Electrolyte imbalance - esp hypokalaemia
Gastric and oesophageal trauma
Poor dentition
Swollen parotids
Risks of laxative overuse?
Constipation Dehydration Electrolyte imbalances Rectal bleeding Abdominal cramps
What eating disorder is the most common to see self harm in?
Bulimia
Nutritional management of anorexia?
Psychoeducation regarding starvation, metabolism and nutrition
Regular meals 3 per day plus 2 to 3 snacks
Aim for weight gain of 0.5kg per week OP, 1kg per week IP
Food hierarchy
Practice eating in different situations, shopping, cooking etc.
Psychological management of anorexia?
Individual psychotherapy and psychoeducation
Specialist therapist with good relationship
Often family based in children at least initially
Plus dietary counselling
