12. Eating Disorders Flashcards

1
Q

What is the Screening Tool used for Eating Disorders?

A

SCOFF Questionnaire:
Sick - Because you feel uncomfortably full?
Control - Lost control over how much you eat?
One - Recently lost > 1 stone in a 3 month period?
Fat - Believe yourself to be FAT?
Food - Dominates your life?
Note - Score of 2+ = Likely Eating Disorder

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2
Q

What are the Clinical Features of Anorexia Nervosa?

A
  1. Restriction of Intake to Reduce Weight
  2. Rely on Compulsive Compensatory Behaviours when Food can’t be Avoided
  3. Anorexic if they are 15% below Ideal Body Weight
  4. Fear of Weight Gain
  5. Amenorrhoea - Post-Menarchal Females
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3
Q

What are the Clinical Features of Bulimia Nervosa?

A
  1. Episodes of Binge Eating & Sense of Loss of Control
  2. Binge Eating followed by Compensatory Behaviours
  3. Must occur 2 times per week for 3 months
  4. Dissatisfaction with Body Shape / Weight
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4
Q

What Compulsive Compensatory Behaviours are used when Food Cannot be Avoided / After Binge Eating?

A
  1. Self-Induced Vomiting
  2. Laxative Abuse
  3. Abuse of Appetite Suppressants / Diuretics
  4. Exercise Abuse
  5. Fasting / Strict Diets
    Note - 1-3 = Purging Type / 4-5 = Non-Purging Type
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5
Q

What are common ways of Avoidance of Calorie Intake?

A
  1. Diets - Vegetarian / Vegan
  2. Not touching Food / Grease
  3. Developing Dislikes / Pickiness / “Allergies”
  4. Interpreting all Symptoms as Allergy / Indigestion
  5. Eating Very Slowly / Only Eating at Certain Times
  6. Spoiling / Messing of Food (Bizarre Combinations)
  7. Refusing to Eat more than the person who eats last
  8. Medication Abuse - Appetite Suppressants
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6
Q

What are common ways of Getting Rid of Calroies?

A
  1. Self-Induced Vomiting / Chewing & Spitting Out
  2. Overexercise / Overactivity
  3. Cooling
  4. Blood Letting
  5. Medication Abuse
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7
Q

What are the Consequences of Eating Disorders?

A
  1. Psychological Consequences
  2. Social Consequences
  3. Physical Consequences
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8
Q

What is the Psychopathology of an Eating Disorder?

A
  1. Extreme Overvaluation of Low Weight and Thin / Lean Shape
  2. Obsessive Weight Losing feels like a Solution (Not a Problem)
  3. Cognitive Style shows Reduced Central Coherence and Narrowed Focus of Interest
  4. A Starved Person is unable to interpret emotion - As in Asperger’s
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9
Q

What are the Psychological Consequences of an Eating Disorder?

A

Malnourished Brains experience:

  1. Depression - Poor Response to medication
  2. Anxiety
  3. Obsessionality
  4. Loss of Concentration - on anything but Food
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10
Q

What are the Social Consequences of an Eating Disorder?

A
  1. They turn other people into obstacles to the Disorder
  2. Forced to Lie / Cheat / Steal about Concerns
  3. Withdraw from Friendships
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11
Q

What are the Physical Consequences of an Eating Disorder?

A
  1. Starvation causes Physical Damage - Poor Repair / Reduced Immunity / Anaemia / Heart Damage
  2. Purging Behaviours cause Neuro-Chemical Disruption - Seizures / Arrhythmias
  3. Young People need Good Nutrition to allow Growth - Height / Pubertal Development / Brain Growth
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12
Q

What is the Pathology of an Eating Disorder?

A
  1. High Risk / Obsessionality
  2. Life Events - Transitions / Conflicts / Losses / Stresses
  3. Anorexia Nervosa
  4. a) Prepetuating / Amplifying Factors - Back to 3
  5. b) Resilience and Protective Factors - To 5
  6. Health
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13
Q

What are the Causes of Eating Disorders?

A
  1. Genetic Predisposition - Anxiety Disorders / OCD
  2. Perinatal Factors
  3. Life-Events (and Traumas)
  4. Perpetuating Consequences of Starvation and of Avoidance
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14
Q

What are the Precipitating Factors of an Eating Disorder?

A
  1. Puberty:
  2. a) Physical Effects of Hormonal Changes on the Brain
  3. b) Psychological Response to the Body Changes
  4. Dieting / Non-Deliberate Weight Loss
  5. Increased Exercise
  6. Stressful Life Events - Neglect / Abuse / Difficult Transitions
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15
Q

What are the Perpetuating Factors of an Eating Disorder?

A

Consequences of Starvation Syndrome:

  1. Delayed Gastric Emptying
  2. Narrowing of Focus
  3. Obsessionality
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16
Q

What is the Treatment of Eating Disorders?

A
  1. Cognitive Behavioural Therapy
  2. Education
  3. Interpersonal Therapy
  4. Antidepressant - SSRI (Fluoxetine)
  5. Olanzapine
  6. Detention