Eating behaviours- society, diet, wight and the psyche

Question 1

LO’s

Answer 1

What drives societal norms to diet

describe factors driving population weight gain

be aware of treatmentd for obesity

complications of obesity

define eating disorders

drivers of ewating disorders

framework to manage

Question 2

Societal effects on eating

Answer 2

• hunter- gratherer background, evolved to feast and famine (cling onto excess food)
• humans have always eaten as a group

develops societal bonds

periods of famine reinforce “more = good”

transition to sedentary lifestyle + easier access to more and fattier foods

Question 3

BMI quantifying weight ranges

Answer 3

BMI= weight(kg)/ height

underweight= <18.5

healthy= 18.5- 24.9

overweight= 25- 29.9

obese= 30+

extremely obese= 35+

Question 4

Psychological burden of obesity

Answer 4

not easy to treat for an individual

stigmatising

5x more likely to have major depression

1/3 depressed at time of bariatric surgery

decrased QoL

low self esteem

suicidal ideation

Question 5

Obesity complications

Answer 5

psychological

metabolic syndrome (CVD, diabetes, Hypertension, NAFLD)

cancer

reduced life expectancy

Question 6

obesity management

Answer 6

diets

exercise

boot camps

drugs

surgery

government policy/ education

treat associated morbidity

Question 7

Obesity surgeries (2)

Answer 7

gastric bypass

gstric band

Question 8

Classifications of eating disorders

Answer 8

anorexia nervosa

bulimia nervosa

binge eating disorder

OSFED (other specified feeding or eating disorder)

Question 9

typical patient for eating disorder

Answer 9

BMI < 17.5

weight loss is seen as positive

reinforcing

exercise to excess

amenorrhea (loss of menstrual period)

16-17 onset

Question 10

Bulimia nervosa

Answer 10

binge eating

Compensatory behaviour (exercise, vomiting, laxatives, thyroxine)

slightly older than AN 18-19

Question 11

Binge eating disorder

Answer 11

large food intake over <2hours (loss of control) (eats alone) (no compensatory acts)

embarrassed and negative feelings

Question 12

Aetiology of eating disorders

Answer 12

genetic

pshyical (pre-morbid obesity)

adverse life effects

family factors

socio-cultural

perfectionism

impulsivity

Question 13

how high do eating disorders rank in terms of suicide amongst psychiatric conditions

Answer 13

top

Question 14

General pathology of refeeding syndrome

Answer 14

reintroduce glucose

rush of serum insulin

massive influx of potassium and ohosphate into cells

serum levels then drop

heart attack

Question 15

Physical risks of eating disorders

Answer 15

starvation (high risk <13 BMI)

refeeding syndrome

hypoglycaemia

electrolyte disturbance

ECG abnormalities

sepsis

death

Question 16

behaviours associated w eating disorders

Answer 16

falsify weight

excessive exercise

light clothing- promotes shivering

sabotage feed- NG tube into sink, pillow, water down food

Purging

Splitting (consultant said i didnt have to eat that)

invariably promise to stop with no intent

Question 17

how to manage eating disorders

Answer 17

Agree a contract (0.5-1kg per week)

careful observations (meal times, eye level, 1 to 1 time)

consistency of message

be cynical and don’t beleicve anything

Question 18

Number of kcal per kg to lose, maintain and gain weight

Answer 18

20 kcal/kg

30

40

Question 19

psychologiocal aspect of why someone may develop an eating disorder

Answer 19

advantyage in some careers

coping w stress and trauma

manages low self esteem

feeling special or cared for

perfectionsim

managing depression

responding to peer pressure

coping w emotions

gices an aspect of control

Question 20

Role of clinicians in eating disorders

Answer 20

acknowledge complaex causatio in ED

Acknowledge function of eating disorders (what it helps them achieve )

expect and toelrate their ambivelance

explainrationale for treatment

repetition of instructions and messagaes