Eating Disorder

Question 1

What is the overview of Eating Disorders?

Answer 1

• Anorexia, Bulimia [Binge & Purge], Healthy Eating, Binge Eating, Obesity

Question 2

How does the DSM-5 describe Anorexia Nervosa?

Answer 2

• Restriction of energy intake leading to a significantly low body weight
• Intense fear of gaining weight or becoming fat

Question 3

What is some of the diagnostic criteria for Anorexia Nervosa?

Answer 3

• More prevalent in females
• Depression, Obsessive Compulsive Disorder, and Suicidal Ideation are more common in Anorexia Nervosa

Question 4

What are the two specifiers of Anorexia Nervosa?

Answer 4

• Restricting Type
• Binge Eating/Purging Type

Question 5

What is Restricting Type of Specifier of Anorexia Nervosa?

Answer 5

• Last 3 months, has NOT engaged in recurrent episodes of binge eating or purging behavior
• Weight loss - dieting, fasting, exercise

Question 6

What is Binging Eating/Purging Type of Specifier of Anorexia Nervosa?

Answer 6

• Last 3 months, HAS engaged in recurrent episodes of binge eating or purging behavior
• Difference between purging and bulimia is LOW BODY WEIGHT in anorexia nervosa

Question 7

What are some of the health consequences for Anorexia Nervosa?

Answer 7

• Decreased HR, Low BP, Decreased bone density, Muscle Loss, Fatigue, Dry Skin, Dehydration…

Question 8

What is Re-Feeding Syndrome in Anorexia Nervosa?

Answer 8

• Re-feedings results in a shift from FAT METABOLISM to GLUCOSE METABOLISM
• The rapid glucose metabolism will increase insulin & uptake of K, Mg.
• Resulting in Hypokalemia, Water Retention, Edema
• Causing MULTIPLE ORGAN FAILURE

Question 9

What are some of the treatments for Anorexia Nervosa?

Answer 9

• Concern: Re-feeding Syndrome
• Correct: Electrolyte, Decrease Fluids, Vitamins…
• Increase: Increase CALORIES slowly
• Therapy: Cognitive Behavioral [Best Outsomes] or Psychotherapy
• Pharmacotherapy: No drug [Bupropion is CONTRAINDICATED]

Question 10

How does the DSM-5 describe Binge Eating Disorders?

Answer 10

• Eating in discrete periods of time an amount of food that is larger than what most people would eat
• NOT associated with the recurrent use of inappropriate compensatory behavior

Question 11

What are some of the common severity specifiers for Binge Eating Disorders and Bulimia Nervosa?

Answer 11

• Mild: 1-3 episodes/week
• Moderate: 4-7 episodes/week
• Severe: 8-13 episodes/week
• Extreme: >14 episodes/week

Question 12

What are some of the health consequences for Binge Eating Disorders?

Answer 12

• Similar to Obesity
• HTN, Elevated Cholesterol, Cardiovascular Disease, Type 2 Diabetes, Gallbladder Disease

Question 13

What are some of the treatment options for Binge Eating Disorder?

Answer 13

• Cognitive Behavioral Therapy
• Lisdexamfetamine: FDA-approved
• CBT + Medication: BEST OUTCOMES

Question 14

How does the DSM-5 describe Bulimia Nervosa?

Answer 14

• Recurrent episodes of binge eating
• Cravings -> Binge eating -> Purging -> Disgust -> Dieting - Repeat

Question 15

What is the way that we specify some to have Anorexia Nervosa?

Answer 15

• Using the ICD-10; ther BMI
• LOW END BMI is 18.5

Question 16

What are some of the Severiy Specifiers for Bulimia Nervosa.

Answer 16

• Mild: 1-3 episodes/week
• Moderate: 4-7 episodes/week
• Severe: 8-13 episodes/week
• Extreme: >14 episodes/week

Question 17

What are some of the health complications associated with Bulimia Nervosa?

Answer 17

• Electrolyte Imbalance
• Mallory Weiss Tears [Gastric Rupture]
• Tooth Decay or Staining
• Irregular Bowel movements

Question 18

What are the methods of purging associated with Bulimia Nervosa?

Answer 18

• Vomiting, Laxative, Diuretics, Excessive Exercise, Diabulimia

Question 19

What is the treatment for Bulimia Nervosa?

Answer 19

• Cognitive Behavior Therapy
• Fluoxetine 60mg
• Combo of both