Eating Disorders

Question 1

Which eating disorders are there in ICD10?

Answer 1

• Anorexia nervosa
• Atypical anorexia nervosa
• Bulimia nervosa
• Atypical bulimia nervosa
• Overeating associated with other psychological disturbances
• Vomiting associated with other psychological disturbances
• Other eating disorders
• Unspecified eating disorders

Question 2

Define anorexia nervosa

Answer 2

A disorder characterized by deliberate weight loss, induced and sustained by the patient.

Question 3

Who does anorexia nervosa affect?

Answer 3

It occurs most commonly in adolescent girls and young women, but adolescent boys and young men may also be affected, as may children approaching puberty and older women up to the menopause.

Question 4

What is the underlying psychopathology of anorexia nervosa?

Answer 4

A dread of fatness and flabbiness of body contour persists as an intrusive overvalued idea, and the patients impose a low weight threshold on themselves.

Question 5

What physical illness is associated with anorexia nervosa?

Answer 5

There is usually undernutrition of varying severity with secondary endocrine and metabolic changes and disturbances of bodily function.

Question 6

What are the symptoms of anorexia nervosa?

Answer 6

restricted dietary choice, excessive exercise, induced vomiting and purgation, and use of appetite suppressants and diuretics.

Question 7

What is atypical anorexia nervosa?

Answer 7

Disorders that fulfil some of the features of AN but which the clinical picture does not justify that diagnosis.

Question 8

What is bulimia nervosa?

Answer 8

A syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading to a pattern of overeating followed by vomiting or use of purgatives.

Question 9

What key feature do bulimia nervosa and anorexia nervosa share?

Answer 9

Overconcern with body shape and weight

Question 10

What is a common complication of bulimia nervosa?

Answer 10

Electrolyte disturbances and physical complications due to repeated vomiting

Question 11

What is atypical bulimia nervosa?

Answer 11

Disorders that fulfil some of the features of bulimia nervosa, but in which the overall clinical picture does not justify that diagnosis.

Question 12

What psychological disturbances can cause a pt to overeat?

Answer 12

Stressful events eg bereavement, accidents, childbirth

Question 13

What are the 2 subtypes of anorexia nervosa?

Answer 13

• Restrictive

- Binge/purge

Question 14

How do pts with AN lose weight?

Answer 14

• Ignore hunger
• Eat very little
• Compensate for what they have eaten

Question 15

How can a pt with diabetes and AN lose weight?

Answer 15

Omit or reduce insulin doses, which can cause collateral damage

Question 16

How common is AN?

Answer 16

10-30 per 100,000

Question 17

How common in BN?

Answer 17

50-100 per 100,000

Question 18

What are the different types of BN?

Answer 18

Purging and non-purging

Question 19

What are some of the physical symptoms of AN?

Answer 19

• Dry skin
• Lanugo body hair
• Acrocyanosis
• Breast atrophy
• Hair thinning
• Peripheral oedmea

Question 20

What CVS complications can AN cause?

Answer 20

Bradycardia
Hypotension
Decreased LV mass and abnormal systolic function
(Low K+ ->) Ventricular arrhythmia

Question 21

What endocrine/metabolic complications can AN cause?

Answer 21

• Amenorrhoea
• Reduced fertility
• Euthyroid sick syndrome
• Osteopenia

Question 22

What GI complications can AN cause?

Answer 22

Constipation

Question 23

What is a common finding in prepubescent pts who develop AN?

Answer 23

Premorbid anxiety disorders