Eating Disorder

Question 1

Complications of Eating Disorders….

Answer 1

Arrhythmias, Refeeding Syndrome–>cardiac collapse, Electrolyte abnormaltities, Renal failure, fatigue, Russell’s sign,Hormonal change

Question 2

Anorexia Treatment

Answer 2

No meds

Psychotherapy is best-Family

Question 3

Nutritional Support for AN

Answer 3

Nasogastric feeding tube

TPN ONLY IF SEVERE and other methods have failed

Question 4

Weight gain goals for AN

Answer 4

2-3lbs per wk inpatient

0.5-1 lb per week outpatient

Question 5

Calorie Targets

Answer 5

30-40kcals/kg/day (1000-1600/day)

SEVERE:
20-25kcal/kg/day

Wt gain phase, Up to 100kcals/kg

Question 6

Refeeding Syndrome

Answer 6

Metabolic disturbance once you start eating again after the body has been starved.
Insulin is now being produced and moving everything into the cell causing an electrolyte decrease

Question 7

Refeeding Syndrome Signs

Answer 7

Cardiac, Pulmonary, Neurological

Convulsions, delirium, ataxia, Wernicke’s encephalopathy, Hypotension, Renal failure, arrhthmias, Peripheral Edema

Question 8

Treatment for Anorexia

Answer 8

• Only use SSRI (PROZAC) if there are other comorbidities like depression, anxiety
• Olanzapine 2.5-10mg QD*

Question 9

Why should we not use Wellbutrin for eating disorders?

Answer 9

BBW for increased seizure risk

Question 10

Bulimia Treatment

Answer 10

Outpatient, CBT best

Nutritional counseling, planned meals, self monitoring

Question 11

Bulimia Pharm tx

Answer 11

Prozac is FDA approved for BN

• Topiramate decreases bing/purge frequence
• Lowbenzo dose before eating can decrease anxiety of refeeding (short term)

Question 12

Binge Eating Treatment

Answer 12

Individual and Groupt CBT is BEST

Vyvanse (Lisdezamfetamine)-FDA Approved for binge eating