CT 9 - Eating Disorders Flashcards
What is an eating disorder
Mental disorder characterised by abnormal eating habits that negatively affect a persons physical or mental health
What % of women have anorexia
4%
What % of women have bulimia
2%
What % of women have binge eating disorder
2%
What is pica
Consumption of things that are not food and have no nutritional value
What is orthorexia
Unhealthy obsession with only eating foods that are healthy and pure
Incidence of anorexia nervosa
9 in 1000
More common in women 10: 1
What are the main risk factors for developing AN
Female gender
Living in western society
Family history
Pre morbid experience: sexual abuse, dieting behaviour in family, occupation or recreational pressure to be slim, criticism about weight
Personality traits: perfectionism, Low self esteem, obsessive traits, borderline PD
Severe life stresses
What are the clinical and physical features of AN
Clinical:
-Refusal to maintain normal BMI (either by refusing to put on weight or rapid loss of weight)
- dieting + restricting
-denying there is a problem
- enhancing weight loss with excessive exercise,laxatives and self induced vomiting
Physical :
- amenorrhoea
-GI (constipation,dysphagia, pain)
-fatigue, fainting +dizzy - lanugo hair
What examinations and investigations would you do for someone with AN
-height weight and BMI
-core temp
-peripheral circulation + oedema
- pulse and BP (may be low)
- test muscle power
U&Es, bloods, ECG, DEXA
What is the psychological management of anorexia
CBT
What are some of the complications of anorexia
Hypokalemia
Hypotension
Anaemia
Osteoporosis
Hypoglycaemia
Infertility and lack of growth in teens
Renal stones
What is bulimia nervosa
ED characterised by repeated binges followed by compensatory weight loss behaviours (vomiting, restriction, intensive exercise + abuse of substances)
What things can patients abuse in order to lose weight
Laxatives
Diuretics
Thyroxine
Amphetamines
What are the risk factors for bulimia
Same as AN
Diagnostic criteria for bulimia
Regular binge episodes (1 a week for at least 3 months)
Preoccupation with weight, body shape and image)
Preoccupation with food + diet
What are physical symptoms of bulimia
Bloating
Lethargy
Heartburn
Abdominal pain
Sore throat and poor dental health
Mood disturbances (more likely to be depressive than AN) + self harm
Psychological management of BN
Under 18: BN focused family therapy or CBT-ED
> 18 =
Self help programmes
CBT-ED
Complications of BN
Haematemesis
Metabolic abormalities after vomiting
Electrolyte imbalance.—> arrhythmia
Dental erosions
Enlargement of parotid gland
Tetany from hypocalcemia
10-15% develop anorexia
What questionnaire for screening for AN and BN
SCOFF
What organic causes may mimic eating disorders
Malabsorption
Endocrine
Cancer
What are the features of binge eating disorder
Eating fast in short amount of time
Losing control over how much you eat or eating a lot when not hungry
Special binge foods - planned binges
Eating alone or in secret due to embarrassment of how much food consumed
Dazed mental state during binge
Feelings of shame, guilt or disgust following a binge
Management of binge eating disorders
Self help programmes
CBT-BED
DBT
SSRI
What is re feeding syndrome
Occurs 4 days to 2 weeks after commencing feeding after a period of starvation
Patients develop electrolyte imbalances, specifically hypophosphatemia. Coma, HF and convulsions
First visible sign is peripheral oedema
Cardiac arrhythmias most common cause of death
