Eating Disorders Flashcards
what is the main characteristic of anorexia nervosa?
weight loss (or failure to gain weight in children)
what weight is suggestive of AN?
BMI <17.5
OR 85% weight for height in children
what are the psychological characteristics of anorexia nervosa?
fear of fatness and weight gain
overvalued importance placed on weight
mood determined by weight
what are the two subtypes of anorexia nervosa?
restricting
binge-purge
what is restricting anorexia nervosa?
weight loss accomplished by dieting and excessive exercise
what is binge purge anorexia?
still low in weight
regularly engaging in binge eating or purging behaviours
what is bulimia nervosa?
recurrent binge eating followed by compensatory behaviours to avoid weight gain
how often do episodes occur for a diagnosis of bulimia nervosa?
at least once a week for three months
what can body weight be like in sufferers of bulimia nervosa?
normal range
may fluctuate
what is the best predictor of a binge in bulimia nervosa?
a period of restricting resulting in physical hunger
what characterises binge eating disorder?
recurrent episodes of excessive food consumption over short periods of time, often to the point of discomfort accompanied by feelings of guilt
how often do episodes need to occur for a diagnosis of binge eating disorder?
at least once a week for three months
what can sufferers weight be like in binge eating disorder?
may become obese/overweight but they do not need to be
what can binge eating be for a patient?
a coping mechanism
an attempt to manage emotional stress
what does OFSED stand for?
other specified feeding or eating disorder
what is OFSED?
a group of disorders that do not fit the exact diagnostic criteria for other eating disorders, but mimic them in some ways
name three examples of OFSED
atypical anorexia
atypical bulimia
purging disorder
what is atypical anorexia?
all symptoms
weight in a normal range
what is atypical anorexia?
all symptoms
weight in a normal range
what is atypical bulimia nervosa?
all symptoms
binge purge cycle don’t happen as often or for as long
what is atypical BED?
all symptoms
episodes less frequent and shorter
what is purging disorder?
where someone purges to affect their weight but not as part of a binge purge cycle
what is night eating syndrome?
when someone repeatedly eats at night after waking or eating lots after their evening meal
what eating disorder is not about weight or the patients perceptions of weight?
ARFID
what eating disorder is not about weight or the patients perceptions of weight?
ARFID
what does ARFID stand for?
avoidant restrictive food intake disorder
how do patients with ARFID eat?
restrict eating to small amounts of food
avoid certain foods/food groups
may be uninterested in eating
what age group is more commonly diagnosed with ARFID?
childen
what psychiatric conditions can make a diagnosis of ARFID more likely?
autism
anxiety
ADHD
what area of the brain is first affected by starvation?
the forebrain
this is where the self regulation system is found
receptors for which neurotransmitters are found to be reduced in the acute stage of an eating disorder
serotonin
dopamine
what are some common comorbidities in patients with eating disorders?
depression anxiety personality disorders substance abuse bipolar disorder OCD
what is physical assessment used for in a patient with a suspected eating disorder?
establish risk of harm and need for admission
NOT FOR DIAGNOSIS
what BMI/weight loss makes a patient high risk?
<13
>1kg per week
what can often be seen when measuring BP in someone with an eating disorder?
orthostatic hypotension
what test is done as part of the physical examination of a suspected eating disorder patient?
sit up squat stand test (SUSS)
what sodium level is considered high risk?
<130 mmol/L
what is diabetes burnout?
when diabetics skip insulin doses to lose weight
what is the risk of diabetes burnout?
can lead to things like DKA
what screening tool can be used to screen patients for an eating disorder?
sick control one fat food (SCOFF)
what score on SCOFF indicates high probability of an ED?
> 2
what are the five questions asked in a SCOFF screening test?
purging behaviours? worry you've lost control over eating? lost/gained more than 1 stone in three months? believe you're fat when others disagree? thoughts and fears about food?
what does MaRSIPAN stand for?
management of really sick patients with AN
what is the key approach to treating a patient with AN in hospital?
slowly and carefully restart the feeding process
what is the management for AN in adults?
CBT-ED
MANTRA
SSCM
FPT focussed on ED’s if none of these options are appropriate
what is the management for AN in children?
family therapy focused on AN (FT AN)
what is the management of BED?
- guided self help
- group CBT-ED
- individual CBT-ED
what is the management of bulimia nervosa in adults?
guided self help
not appropriate/ineffective after 4 weeks, CBT-ED
what is the management of bulimia nervosa in children?
family therapy focused on BN (FT-BN)
what is the management for OFSED?
offer treatments recommended for the type of ED most similar to the patients symptoms
what is the management for ARFID in young people?
refer to ED service/CAMHS
what is the management for ARFID in adults?
refer to local ED service or community mental health team
