Anorexia Nervosa Flashcards
What are the 3 types of eating disorder?
Anorexia Nervosa (without)
Bulimia Nervosa (ravenous)
OSFED (other specified eating disorder): orthorexia (correct), compulsive eating, binge eating, night eating syndrome
What factors are eating disorders a mix of?
Environmental: i.e. academic, bullying, abuse, criticism of body shape/eating habits, sports, difficult relationships
Genetics: family history
Psychological: prone to depression, anxiety, poor stress resilience, emotional restraint, OCD
What are behavioural S&S of anorexia nervosa?
Strict dieting/calorie counting
Avoidance of fats
Vegan etc as an excuse to avoid certain foods
Purging, hiding, lying
Over exercising
Suppressing appetite with excessive water/appetite suppressants
Socially isolated especially around meals
What physical S&S of AN?
Lack of energy
Muscle atrophy
Poor concentration/focus
Light headed/dizziness
Constipation/stomach pain/bloating
Soft downy hair
Hair loss
Low body temp/blood pressure
Anxiety/poor stress resilience
Amenorrhoea
What are the two types of anorexia?
Restrictive type
Binge-purge type
Is anorexia a physical or mental disorder?
Mental
Which AA is severely depleted in AN resulting in mood changes, depression and anxiety, numbness and tingling in extremities?
Tryptophan (precursor to NT serotonin and Hormone melatonin)
What are vomiting, purging and laxatives risk factors?
Dehydration, electrolyte imbalance, metabolic alkalosis, numbness and tingling in extremities
What BMI is considered anorexic?
17.5
What is an atypical anorexic?
Maintains weight in an unhealthy way
In addition to BMI how would you diagnose AN?
Fear of gaining weight/healthy BMI
Body dysmorphia
Denial of issue with weight
Seeking further weight loss
Fear of fat containing food
What is the orthodox treatment for AN
Re-feeding (hi calorie foods, possibly naso-gastric)
Reward systems
Dietary re-training
SSRIs
Oestrogen replacement therapy
Psychological support
What is key to restore when supporting AN?
Nutrient deficiencies to be able to work the client not the condition i.e. restore energy and brain function so they believe they can and are physically able to gain health
What are symptoms of a Zn deficiency?
Loss of appetite
Lacking motivation
Confusion
Depression
Slow growth and development
Emotional instability
Poor immune response
Low stomach acid
What are symptoms of a Mg deficiency?
Irritability, agitation, sleep disorders, depression
What are the symptoms of Tryptophan/serotonin deficiency?
Slow bowels, anxiety, low mood, sleep disorders
What are the symptoms of protein deficiency?
Weak hair/nails, poor skin
Fatigue and weakness
What are the symptoms of om-3 deficiency?
Depression, mental fatigue, dry skin
What are the symptoms of B Vitamin deficiency?
Anxiety, depression, confusion and irritability, poor concentration and memory, poor stress resilience
What are pyrroles?
Biproduct of haemoglobin synthesis with no know function, should be excreted via urine.
High in mental disorders and stress.
Blocks receptor sites for B6 and Zn - required for synth of GABA and serotonin - anxiety, depression, nervousness, emotional instability etc
What is the link between serotonin and oestrogen?
AN = reduced adipose
Adipose tissue = site for oestrogen production and metabolism = less oestrogen
Aromatase (E2) =
Increases production of tryptophan (= increased serotonin)
Inhibits expression of SERT = maintaining serotonin levels
Upregulates receptors that regulate 5HT2A receptors
What is an alternative word for ‘weight’?
Health
What is an alternative word for ‘weight gain’?
Health restored
What is an alternative word for ‘calories’?
Nutrients
What is an alternative word for ‘fats’?
Lipids
What is an alternative word for ‘carbohydrates’?
Energy
What might supplements be alternatively thought of if you are talking to the anorexic voice?
Food replacement
How much protein should AN eat daily?
1g/ideal body weight based on BMI calculation from height
What is hypermetabolism?
Increased metabolism on commencement of eating for repair of damage and development.
What is re-feeding syndrome?
Oedema resulting from the release of insulin and movement of phosphate, glucose, Mg and H20 to intracellular spaces.
What health issues arise post anorexia?
Gut dysbiosis
Low stomach acid
Poor skin, hair, nails
Food intolerances and low absorption capacity
Menstrual irregularities
Poor immunity
Dentition issues
Poor bone health
Anxiety and depression
Anaemia and low minerals
