17. Disorders of Eating

Question 1

What are 4 ways to measure percentage body fat?

Answer 1

Skinfold
Electrical impedance
Calculate from density
Dual-energy x-ray absorption

Question 2

Does BMI or waist-to-hip ratio have a more linear relationship with mortality?

Answer 2

Wait-to-hip ratio

Question 3

What adjustment to BMI calculations must be done for children?

Answer 3

Must /m^3 instead of m^2

Question 4

What is the function of the hormone Ghrelin?

Answer 4

Triggers the desire to eat

Question 5

Where is Ghrelin produced?

Answer 5

Stomach

Question 6

What receptor does Ghrelin act on?

Answer 6

GHS-R receptor in the arcuate nucleus of the brain

Triggers dopamine reward pathways

Question 7

What is the function of leptin?

Answer 7

Satiety hormone
Increases secretion of POMC
Precursor for a and b melanocyte-stimulating hormone

Question 8

Where is leptin made?

Answer 8

Adipose

Question 9

How is obesity treated?

Answer 9

Behavioural therapy
Dietary therapy
Pharmacological therapy
Surgery

Question 10

What is the first drug of choice for treating obesity?

Answer 10

Orlistat

Question 11

What is the function of liposuction?

Answer 11

Reduces subcutaneous body fat but has no clinical benefit

Doesn’t improve insulin sensitivity or decrease inflammatory biomarkers

Question 12

What is the function of bariatric surgery?

Answer 12

Decrease consumption or absorption of food

The stomach size is reduced so the patient feels fuller quicker

Question 13

Who is surgery recommended for?

Answer 13

BMI>40

Question 14

What are the symptoms of marasmus?

Answer 14

Hunger
Low weight and height for age
Weakness
Bradycardia and hypotension
Atrophy of muscle and subcutaneous fat

Question 15

What are the symptoms of kwashiorkor?

Answer 15

Anorexia
Normal weight and height for age
Severe generalised oedema
Round cheeks
Dry, peeling skin

Question 16

What issues have to be addressed before treating someone with malnourishment?

Answer 16

Hypoglycaemia, hypothermia, dehydration, infection

Question 17

What is RUTF?

Answer 17

Ready to use Therapeutic Food

Peanuts, oil, sugar, powdered milk, vitamins and minerals

Question 18

What is anorexia nerviosa?

Answer 18

Refusal to maintain body weight above minimum for age and height

Question 19

What is bulimia nerviosa?

Answer 19

Binge eating followed by compensatory behaviour for at least 2x per week for 3 months

Question 20

What are the markers for binge eating disorder?

Answer 20

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

Question 21

What is cachexia?

Answer 21

Loss of appetite and un-intended weight and muscle loss due to an underlying disease or ageing

Question 22

What is the treatment for anorexia?

Answer 22

Nutritional rehab
Medical monitoring
Psychotherapy

Question 23

What conditions are associated with refeeding syndrome?

Answer 23

Hypophosphataemia
Hypokalaemia
Hypomagnesemia
Vitamin and trace mineral deficiency
Volume overload
Oedema

Question 24

What is a correct feeding strategy?

Answer 24

Correct electrolyte balances
Begin with base energy expenditure
Increase by 300-400 calories every 3-4 days
Aim to gain 1kg per week

Question 25

What drugs are used in the treatment of bulimia?

Answer 25

Fluoxetine

Antidepressants

Question 26

What drugs are used in binge eating treatment?

Answer 26

Fluoxetine

Topiramate

Question 27

What agents are used to stimulate hunger in cachexia?

Answer 27

Glucocorticoids (dexamethasome)
Progesterone analogues (megestrol)

Question 28

What agent is used to block cytokines in cachexia?

Answer 28

Thalidomide