Eating disorders Flashcards
types of eating disorders
AN BN binge eating disorder ARFID Pica Rumination-regurgitation disorder
epidemiology of AN
main peak is 15-19
female predominance
CAMHS community management of AN
psychiatric/physical assessment weight, height and % weioght for height bloods and ECG MARSIPAN risk score family based therapy dietitian olanzapine, SSRI if needed monitor refeeding
CAMHS inpatient management of AN
weight, height, % weight for height physical exam bloods and ECG dietitian MDT monitor refeeding meal time support oral supplements and NG feed if needed individual/group therapy transition to adult services when 18 medicate if needed
adult community management of AN
psychiatric/physical assessment weight/height/BMI patient centred care manage comorbid anxiety/depression/OCD dietitian medical monitor psychological therapy - CBT, MANTRA, SSCM, psychodynamic therapy
adult inpatient management of AN
weight, height, BMI bloods and ECG dietitian MDT refeeding meal time support, supplements, NG feed transition from CAMHS waterlow scale if risk of bed ulceration
What is ARFID
avoidant-restrictive food intake disorder
avoiding or restricting certain foods leading to failure to geow, physical impact and psychological
concern of eating certain foods or little interest in eating
what sensory condition is associated with ARFID
ASD
management of ARFID
CBT/SSRI if anxiety
dietitian and individual therapy
ASD therapy
management of BN
CBT SSRI - fluoxetine avoid admission unless severely underweight and cardiac effects self help family therapy if younger dietitian
epidemiology of binge eating disorder
typically >20
obesity associated and more common in males
management of binge eating disorder
self help/group CBT
patient dependent medication, depending on physical/mental comorbidity
extra considerations to make when managing eating disorders
GU health
bone health
dental health
comorbidity mentally and physically
what is refeeding syndrome and how does it occur
possible fatal response to rapid refeeding
during starvation body switches from carb metabolism to fat/protein
intracellular minerals become depleted but serum often normal
refeeding stimulates insulin so promotes K/Mg/PO4 to be taken up into cells and with change in BMR leads to refeeding
management of refeeding syndrome
low level energy replacement, stepped up every 2/3 days
supplements with multivitamins
blood monitoring
correction of electrolyte imbalance and fluid abnormality - phosphate and K
