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Psychiatry > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

Define eating disorder

A

Persistent disturbance of eating behaviours or behaviour intended to control weight, which significantly impairs physical health and/or psychosocial function

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2
Q

What are some ways to distinguish between an eating disorder and abnormal eating habits?

A
  • Intended to control weight
  • Impairing physical health
  • Impairing psychosocial functioning
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3
Q

What are some examples of abnormal behaviours that can define eating disorders?

A

Restricted eating
Self-induced vomiting
Excessive exercise
Laxative/diuretic/substance misuse to control weight

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4
Q

Define anorexia nervosa

A

An eating disorder characterised by:

  • Restriction of energy intake causing low body weight (BMI <17.5)
  • Fear of gaining weight
  • Disturbed body image
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5
Q

What are the subtypes of anorexia nervosa?

A
  • Restricting
  • Binge-eating and purging (must be in the last 3 months)
  • Atypical: characteristics of AN but with normal weight
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6
Q

What is bulimia nervosa?

A

An eating disorder characterised by:

  • Overeating episodes eg. binging
  • Compensatory mechanisms eg. purging or fasting/exercise
  • Body image disturbance
  • Must have episodes of binge-purge 1x/week for 3 months
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7
Q

What is binge-eating disorder?

A

An eating disorder characterised by episodes of overeating without compensation

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8
Q

Explain the difference between anorexia, bulimia, and binge-eating disorder. What is the weight in each?

A
  • Anorexia: restriction, underweight. +/- binge/purging
  • Bulimia: marked binging + compensation to prevent weight gain. Usually normal weight
  • Binge-eating: binging only. Normal/over weight
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9
Q

What is purging disorder?

A

An eating disorder characterised by episodes of purging behaviour intended to influence weight/shape, without binging.

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10
Q

What is ARFID?

A

Avoidant restrictive food intake disorder. An eating disorder characterised by significant weight loss due to abnormal eating behaviours, without the intention of weight loss or any body image disturbance.
eg. no interest in good, limited diet

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11
Q

How common are eating disorders? Which is most common?

A

Very common. Up to 9% lifetime incidence

Anorexia is most common

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12
Q

What are the risk factors for eating disorders?

A 
Perfectionism
Young female
Past history of mental illness, OCD
Occupation/hobbies eg. ballet, gymnastics 
Family Hx
Social factors eg. friends, social media
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13
Q

Name some physical signs and symptoms of anorexia

A 
Muscle wasting, emaciation
Cold 
Tired
Lanugo hair, dry skin and hair
Endocrine dysfunction (amenorrhoea)
Oedema 
Anaemia symptoms- SOB, dizziness
Hypercarotenaemia
Peripheral neuropathy
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14
Q

Name some physical signs and symptoms specific to bulimia

A

Russell’s sign
Dental erosion
Arrhythmia

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15
Q

How do you assess the severity of physical health complications in anorexia? Explain

A

MARSIPAN score

  • BMI <13
  • HR <40
  • Temp <35
  • Na <130
  • K <3
  • ECG abnormality
  • Hypoglycaemia
  • Decline in renal function
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16
Q

What investigations should you do if you suspect anorexia?

A

-Height and weight -> BMI
-Bloods: FBC, CRP, U+Es, TFTs, LFTs, bone profile, LH+FSH, glucose
-ECG
+/- DEXA

17
Q

Describe the fundamentals of management for anorexia

A

Biopsychosocial approach

  • MDT at specialist eating disorder team eg. psychiatrist, psychology, specialist nurses, dietician
  • Assess comorbid mental health risks, severity of illness -> consider need for admission
  • Education
  • Bio: Weight restoration, multivitamin, monitor growth and development in teens. Consider SSRIs if significant depression.
  • Psych: specific therapies eg MANTRA (Maudsley model for Anorexia nervosa Treatment for Adults), SCCM, or CBT-ED. Family therapy or CBT for <18s
18
Q

What is refeeding syndrome?

A

A complication of establishing normal food intake. Due to increase in insulin, there is a drop in K, Mg, and phosphate.

19
Q

T/F. You can treat the physical complications of eating disorders under the MHA

20
Q

What is a charity for eating disorders?

21
Q

What is the management of binge-eating disorder?

A

1st line: Guided self-help for binge-eating disorder

OR group CBT-ED OR individual CBT-ED

22
Q

What is the management of bulimia?

A

Biopsychosocial approach

  • Bio: treat any complications eg electrolyte, dental
  • Psych: bulimia-focused guided self help -> individual CBT-ED
  • <18: Family therapy -> individual CBT-ED
23
Q

If someone does not meet the requirements for anorexia, bulimia, or BED, what is this known as?

A

OSFED: other specified feeding or eating disorder

24
Q

What are the complications of eating disorders?

A

Arrhythmia, osteoporosis, amenorrhoea and subfertility, poor growth, death

25
Q

What is the prognosis for eating disorders?

A

10 years after diagnosis, 50% of AN and 70% of BN will have no eating disorder

Psychiatry (10 decks)

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