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Henren- Eating disorders Flashcards

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1
Q

What are the 4 major eating disorders?

A
  • Anorexia nervosa
  • Bulimia nervosa
  • Binge-eating disorder
  • Avoidant/restrictive food intake disorder (ARFID)
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2
Q

Which is the most dangerous eating disorder in which 9% of those affected die?

A

Anorexia Nervosa

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3
Q

What are 5 things that can influence an eating disorder, the main theme being shape desireability?

A

– Preferred body shape

– New “freedoms”

– Media

– Culture

– High risk populations and settings

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4
Q

What are 5 major psychological factors associated with eating disorders?

A

– Difficulty identifying feelings

– External locus of control

– Low self-esteem

– Maturation fears

– Psychodynamics = changes in our body overtime, the conscious and unconscious struggle that determine motivation and personality

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5
Q

When are 2 different ages where eating disorders peak?

A

Beginning of adolescence (puberty, secondary sex characteristics)

Later adolescence (18+, moving out)

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6
Q

What are 3 psychosocial issuses that explain etiology of eating disorders?

A
  • Assumptions and distortions
  • Family influence and conflict
  • Premorbid perfectionism and negative selfevaluation
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7
Q

• There is some evidence for a basis (GWAS, twin studies)

A

genetic

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8
Q

What is the fMRI evidence as related to after and eating disorder has started?

A

abnormal function in corticolimbic circuits involved in appetite (anterior insula)

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9
Q

fMRI evidence of abnormal function in circuits involved in appetite (anterior insula)

A

corticolimbic

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10
Q

Some/multiple neurotransmitter systems implicated after an eating disorder develops

A

multiple

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11
Q

Eating disorder influences of nutrition, metabolism, and vulnerability can be associated with the following factors:

– Set Point

– hypothalamus

– Fat cells

– deficiency

– Leptin and and CNS

– Lack of exercise

A

VMN

Dopamine

ghrelin

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12
Q

What is our bodie’s set point?

A

Our bodies have a preset weight baseline hardwired into our DNA

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13
Q

Can lack of exercise effect our set point?

A

yes

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14
Q

Below are the criteria for Anorexia Nervosa

–Refusal to maintain body weight – generally defined as BMI < for adults

– Intense of weight or fat

– body image

– Amenorrhea

– Restricting and Binge/Purging Types

A

18.5

fear

Distorted

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15
Q

The severity of Anorexia Nervosa is classified by what standard?

A

weight

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16
Q

What is the lifetime prevalence of Anorexia Nervosa?

A

0.6%

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17
Q

Onset of AN typically occurs during what age?

A

late adolescence

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18
Q

AN more common in men/women

A

women

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19
Q

AN is highly comorbid with depression, panic, , and other anxiety disorders

A

OCD

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20
Q

Please review the list of physical exam findings and symptoms of anorexia nervosa:

A
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21
Q

What is xerosis and what eating disorder is it associated with?

A

dry, rough skin

associated with Anorexia Nervosa

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22
Q

What can happen to the CNS of someone with Anorexia Nervosa?

A
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23
Q

What is the first thing to tackle for treatment of Anorexia Nervosa?

A

weight restoration, reestablish normal eating

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24
Q

What multidisciplinary team members should be involved in treatment of Anorexia Nervosa?

A
  • Medical
  • Psychological
  • Nutritional
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25
What is the preferred therapy for Anorexia Nervosa?
family therapy | (some evidence for CBT)
26
What are the 5 things included for treatment of AN?
**• Hospitalization** **• Multidisciplinary Team** - Medical - Psychological - Nutritional **• #1 Weight restoration**, reestablish normal eating **• ID Precipitants**- what causes one to eat or throw up **• Psychotherapy (**family therapy, some evidence for CBT) • Minimal evidence for medications
27
Are medications indicated for the treatment of anorexia nervosa?
minimal evidence for medications | (olanzapine can help with weight gain)
28
As concerning AN, Patients often have or superficial insight into the severity of their illness
poor
29
As concerning AN: Toxic online cultures may perpetuate ideas about the disease There may be pathways for involuntary treatment in some jurisdictions and situations – restoration is key, and this may sometimes necessitate placement of an NG tube
unrealistic Weight
30
As concerning AN: * Patients with severe anorexia nervosa generally have some degree of impairment * When treating patients with eating disorders, interdisciplinary is crucial * If you have a patient who’s in recovery from an eating disorder, ask them how you can work with them to prevent and avoid interventions that may unknowingly exacerbate their illness
cognitive collaboration relapse
31
What are the 5 critieria used to diagnos Bulimia Nervosa?
– Recurrent binge eating and lack of control – Inappropriate compensatory behaviors – Self-evaluation and body shape – Not Anorexia Nervosa – Purging and Non-Purging Types
32
What are some of the innapropriate compensatory behaviors used in order to prevent weight gain with bulimia nervosa?
vomiting, laxatives, diuretics, fasting, excessive exercise, medications
33
How is the severity of bulimia nervosa measured and by what standard:
innappropriate compensatory behaviors per week
34
BN is **more/less** lethal than AN?
less
35
Which medications can be used to treat BN and which type of therapy?
SSRIs CBT
36
Review the medical sequelae of BN:
37
What are some metabolic consequences of BN?
Hypokalemia hypochloremia metabolic acidosis
38
What are 4 GI issues that can occur due to BN?
Pancreatitis GERD consipation Mallory-Weiss tears (tear in lower esophagus)
39
What esophageal tear can occur with Bulimia Nervosa?
Mallory-Weiss tears (tear of tissue of the lower esophagus)
40
Prognosis of AN * 40% recover; 30% improve; % no improvement * Overall mortality is 5-18% * All-cause mortality in anorexia is 4-14x higher than the general population * ~60% due causes * ~25% due to * Anorexia is among the most deadly of all disorders
20 cardiovascular suicide psychiatric
41
Prognosis of Bulimia Nervosa: * Overall better than AN * 50-90% * % continue long term
improve 30
42
An episode of binge eating is characterized by which 2 characteristics?
1. Eating far more than others in a discrete amount of time 2. A sense of lack of control during episode
43
Review the other criteria for binge eating (without compensatory techniques):
44
How is binge eating (without compensatory techniques) specified by severity?
of binge eating episodes per week
45
What is the **most common** eating disorder?
Binge eating (without compensatory behaviors)
46
What % of patients who seek medical care for obesity have a binge eating disorder?
25%
47
Binge eating is more common in **men/women?**
women
48
What is the medication of choice for binge eating and what is the best type of therapy?
SSRIs CBT
49
What is ARFID?
avoidant/restrictive food intake disorder (ARFID)
50
ARFID is an eating or feeding disturbance associated with which 4 criteria:
51
ARFID **is/is not** better explained by lack of food or cultural practices
is not
52
ARFID does not occur exclusively with which 2 eating disorders?
anorexia nervosa bulimia nervosa
53
In ARFID, there **is/ is no** disturbance in the way in which one's body weight or shape is experienced
is no
54
In ARFID, the eating disturbance **is/ is not** attributable to a concurrent medical condition or not better explained by another mental health disorder, or with another disorder (ASD) warrants additional clinical attention
is not
55
Clinically, patients of ARFID are often **underweight/overweight**?
underweight
56
What is the simple 5 question questionnaire that screens for eating disorders?
SCOFF * Do you make yourself **Sick** because you feel uncomfortably full? * Do you worry you have lost **Control** over how much you eat? * Have you recently lost more than **One** stone (14 pounds or 6.35 kg) in a t**hree-month period**? * Do you believe yourself to be **Fat** when others say you are too thin? * Would you say that **Food** dominates your life?
57
Does the patient have a BMI \<18.5? Differentiating between which 2 eating disorders?
Anorexia Nervosa or ARFID (avoidant/restrictive food intake disorder)
58
How do we differentiate between AN and ARFID if patient has BMI less than 18.5?
Does the patient also have negative body cognitions? = AN
59
How to distinguish between BN and Binge eating disorder if BMI over 18.5?
– Is the patient purging? —\> Probably BN
60
Review the question and correct and incorrect answers regarding AN? 1. As you gather further history, which symptoms would support the diagnosis of anorexia nervosa?
61
Review the question and correct and incorrect answers regarding AN? 2. The most appropriate steps in the management of the patient once the diagnosis of anorexia nervosa is confirmed includes:
most importantly = restore weight
62

ICOM - Mental Health (24 decks)

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