Eating Disorder Flashcards
Differential dx for weight loss
- Hypethyroidism
- Malignancy
- GI tract disease
- Chronic infectious disease
- Affective disorders (depression)
Screening questions for psychiatric causes of eating disorders
“SCOFF”
- Do you make yourself Sick because you feel uncomfortably full?
- Do you worry you have lost Control over how much you eat?
- Have you recently lost more than One stone (14 pounds) in a three month period?
- Do you believe yourself to be Fat when others say you are thin?
- Would you say that Food dominates your life?
Anorexia is more common in which gender at what age?
Female
18
Deficits in dopaminergic function and serotonergic function in patient’s with eating disorder
- Dopamine: eating behavior, motivation and reward
- Serotonin: mood, impulse control, obsessive behavior
Dx criteria for anorexia nervosa
- Restriction of energy intake that leads to low body weight
Taking into account the sex, age, developmental trajectory, and physical health - Intense fear of gaining weight or becoming fat or persistent behavior that prevents weight gain
- Distorted perception of body weight and shape, undue influence of weight and shape on self-worth,
PE findings:
- Low BMI (<17.5)
- Emaciation
- Hypothermia
- Bradycardia
- Hypotension
- Hypoactive bowel sounds
- Xerosis (dry and scaly skin)
- Brittle hair and hair loss
- Lanugo body hair
- Abdominal distention
Anorexia Nervosa
Bulimia nervosa is more common in which gender and at what age?
3x more common in women
age of onset 18
Dx criteria for bulimia nervosa
- Recurrent episodes of binging and purging and inappropriate compensatory behavior to prevent weight gain
- Occurring on average at least once per week for three months
- Self induced vomiting
- Misuse of laxatives
- Diuretic use
- Enemas
- Fasting
- Excessive exercise
These are compensatory behaviors of?
Bulimia nervosa
Features associated with Bulimia Nervosa
- Mild psychosocial impairment
- Body weight usually within or above normal range
- Neurocognitive functioning (decision making) impaired
- Emotional dysregulation is common
- Self-harm is often seen
- Additional psychiatric disorders are common
Anxiety, depression, PTSD, substance abuse, ADHD, conduct disorders, personality disorders
Clinical findings:
- Dehydration
- Menstrual irregularities
- Mallory-Weiss syndrome
- Pharyngitis
- Erosion of dental enamel
- ECG changes may occur
Bulimia Nervosa
Characteristics of Binge eating disorder
- Uncomfortably full
- Eating when not hungry
- Feelings of embarrassment
- Feelings of disgust, depression
What is pica?
Eating of nonfood substances
Chalk, dirt, hair, metal, etc.
Characteristics of pica
- Inappropriate eating behavior for developmental level
- Not culturally, socially normal eating
- Associated with iron deficiency anemia
What is rumination disorder
- Repeated regurgitation of food
- May be re-chewed, re-swallowed, or spit out
- The regurgitation is not due to GERD, pyloric stenosis, or another medical condition
