Clinical Approach to Eating Disorders and Refeeding Syndrome (Cooley) Flashcards
What are the main eating disorder types?
1) Anorexia Nervosa
2) Bulimia Nervosa
3) Binge Eating Disorder
What is a major risk factor for Bulimia and Anorexia Nervosa?
Suicide
Restriction of energy intake relative to requirements, leading to a significantly low body weight weight for age, sex and development is characteristic of?
Anorexia Nervosa
Anorexia Nervosa patients have an intense fear of gaining weight or becoming fat despite?
Being underweight
3 months of no binging or purging (no self-induced vomiting or use of laxatives) describes what type of Anorexia Nervosa?
How is this type accomplished?
1) Restricting Type
2) Excessive exercising, fasting, dieting
3 months of binging and purging behaviors describes what type of Anorexia Nervosa?
How is this type accomplished?
1) Binge-eating/purging type
2) Self-induced vomiting and misuse of laxatives
In regards to Anorexia Nervosa, what is the re-feeding syndrome?
A serous complication due to rehydrating or feeding patients beyond their current capacity
How do you avoid Refeeding syndrome?
1) Limit the amount of calories and fluid provided in the early stages of refeeding
2) Avoid rapid increases in daily amount ingested
3) Closely monitor labs during first few weeks
What disorder is commonly a comorbidity of Anorexia Nervosa?
Obsessive compulsive disorder
How long should hospitalization last when treating Anorexia Nervosa?
Until normal weight is achieved
In the nutritional rehabilitation of Anorexia Nervosa, how many pounds gained per week is the goal for inpatients?
For outpatients?
1) 2-3 pounds
2) 0.5 to 1 pound
Why do you want to avoid bupropion with Anorexia Nervosa patients?
Why do you want to avoid antipsychotics and antidepressants?
1) Increases seizure risk with binging and purging
2) Risk of QT prolongation
Olanzapine is the only adjunctive medication show to help with?
How can lorazepam help?
1) Weight gain
2) Reduce anxiety associated with confronting meals
Recurrent episodes of binge eating followed by recurrent inappropriate compensatory behavior to prevent weight gain is characteristic of?
Bulimia Nervosa
How can patients present in terms of appearance which differs from Anorexia Nervosa?
Patients can vary between normal body weight, slightly underweight, overweight, or obese
What behaviors are used to counteract the weight gain from binge-eating with Bulimia Nervosa?
Purging
Do Bulimia Nervosa patients care more about losing weight or not gaining weight?
Not gaining weight
What is the treatment of choice for Bulimia Nervosa?
CBT Psychotherapy
Similar to Anorexia Nervosa, what drug should be avoided in Bulimia Nervosa due to its increased seizure risk with binging and purging?
Bupropion
What is the first line pharmacotherapy used for Bulimia Nervosa?
Fluoxetine
What disorder is characterized by at least three of the following: Eating large amounts of food when not hungry, eating rapidly, feeling uncomfortably full after eating, eating alone due to embarrassment over amount consumed, feelings of guilt/depression/disgust after eating?
Binge Eating Disorder
How does Binge Eating Disorder differ from Bulimia Nervosa?
No inappropriate compensatory behaviors are used
What is the first line treatment for Binge Eating Disorder?
CBT psychotherapy
In the pharmacologic treatment of Binge Eating Disorder what is Vyvanse (lisdexamfetamine dimesylate)?
The only medication approved to treat moderate to severe Binge Eating Disorder in adults
