111b - Eating Disorders Flashcards
How can anorexia: binge/purge subtype be differentiated from bulemia nervosa?
- Anorexia
- Characterized by intense fear of gaining weight, history of significant weight loss
- Binging then subsequent purge are to minimize calorie intake
- More likely to have v low BMI
- Bulemia nervosa
- Characterized by loss of control during binges, purge to regain control
- Weight may fluctuate
- May also have fear of gaining weight, body dysmorphia
What are the two types of anorexia nervosa?
- Restrictive
- Binge-purge
List some of the clinical findings of anorexia nervosa
Clinical findings
- Baby hairs on body
- Hair loss on head
- Electrolyte abnormalities
- Dehydration,
- Hypotension
- Edema
- Constipation
- Osteoporosis
What medication can be used to help manage binge eating disorder?
Lisdexamfetamine
Describe the clinical management of anorexia nervosa
Goal = weight restoration
- Phosphorous: may need to replete
-
Psychotherapy = mainstay of treatment
- CBT for adult patient
- Family-based for younger patient
- Nutritionist
- Hospitalization if necessary
Medications are not effective: food is the medication!
But medication may be helpful to manage anxiety, comorbidities
Which psychological disorder has the highest mortality rate?
Anorexia nervosa
Anorexia restrictive type is associated with cluster personality disorders
Anorexia binge/puge type is associated with cluster personality disorders
Anorexia restrictive type is associated with cluster c personality disorders
Anorexia binge/puge type is associated with cluster b personality disorders
Which SSRI can be used to manage bulemia?
Fluoxetine (an SSRI)
But psychotherapy (CBT or DBT) is the mainstay of treatment
A patient has intense fear of gaining weight, body dysmorphia, and restricted food intake
Which eating disorder is most likely?
Anorexia nervosa
The severity of buimia is based on what behavior?
Severity is based on the number of inappropriate compensatory behaviors (not number of binges)
- Mild = 1-3/week
- Moderate = 4-7/week
- Severe = 8-12/week
- Extreme = 14+/week
What is Russel’s sign?
What is it indicative of?
Lacerations/abrasions on the backs of hands/fingers
Due to frequent contact with teeth
Indicative of bulimia nervosa
The prognosis of anorexia is [better/worse] than for bulemia
The prognosis of anorexia is worse than for bulemia
How is bulemia nervosa managed clinically?
- Cognitive behavioral therapy
- Esp. dialectial behaviorla therapy
- Medication
- Fluoxetine (SSRI) - better for adult patients than adolescents
What factors predict good prognosis for anorexia nervosa?
- Younger age of onset
- Restrictive type (vs binge/purge)
- Shorter chronicity of illness
- Higher weight at treatment
- Good social functioning, support
