17. Disorders of Eating Flashcards
What are 4 ways to measure percentage body fat?
Skinfold
Electrical impedance
Calculate from density
Dual-energy x-ray absorption
Does BMI or waist-to-hip ratio have a more linear relationship with mortality?
Wait-to-hip ratio
What adjustment to BMI calculations must be done for children?
Must /m^3 instead of m^2
What is the function of the hormone Ghrelin?
Triggers the desire to eat
Where is Ghrelin produced?
Stomach
What receptor does Ghrelin act on?
GHS-R receptor in the arcuate nucleus of the brain
Triggers dopamine reward pathways
What is the function of leptin?
Satiety hormone
Increases secretion of POMC
Precursor for a and b melanocyte-stimulating hormone
Where is leptin made?
Adipose
How is obesity treated?
Behavioural therapy
Dietary therapy
Pharmacological therapy
Surgery
What is the first drug of choice for treating obesity?
Orlistat
What is the function of liposuction?
Reduces subcutaneous body fat but has no clinical benefit
Doesn’t improve insulin sensitivity or decrease inflammatory biomarkers
What is the function of bariatric surgery?
Decrease consumption or absorption of food
The stomach size is reduced so the patient feels fuller quicker
Who is surgery recommended for?
BMI>40
What are the symptoms of marasmus?
Hunger Low weight and height for age Weakness Bradycardia and hypotension Atrophy of muscle and subcutaneous fat
What are the symptoms of kwashiorkor?
Anorexia Normal weight and height for age Severe generalised oedema Round cheeks Dry, peeling skin
What issues have to be addressed before treating someone with malnourishment?
Hypoglycaemia, hypothermia, dehydration, infection
What is RUTF?
Ready to use Therapeutic Food
Peanuts, oil, sugar, powdered milk, vitamins and minerals
What is anorexia nerviosa?
Refusal to maintain body weight above minimum for age and height
What is bulimia nerviosa?
Binge eating followed by compensatory behaviour for at least 2x per week for 3 months
What are the markers for binge eating disorder?
Large amounts of food when not hungry Eating more rapidly than normal Eating until uncomfortably full Eating alone out of embarrassment Feeling disgusted, depressed or guilty after overeating
What is cachexia?
Loss of appetite and un-intended weight and muscle loss due to an underlying disease or ageing
What is the treatment for anorexia?
Nutritional rehab
Medical monitoring
Psychotherapy
What conditions are associated with refeeding syndrome?
Hypophosphataemia Hypokalaemia Hypomagnesemia Vitamin and trace mineral deficiency Volume overload Oedema
What is a correct feeding strategy?
Correct electrolyte balances
Begin with base energy expenditure
Increase by 300-400 calories every 3-4 days
Aim to gain 1kg per week
