Eating Disorders Flashcards
Anorexia nervosa signs
Hypokalaemia Raised growth hormone Raised glucose Salivary gland hypertrophy Raised cortisol Raised cholesterol Carotinaemia
Bradycardia Hypotension Low FSH Low T3 Lanugo hair
Definition of bulimia
Episodes of binge eating followed by intentional vomiting or other purgative behaviours such as diuretic or laxative use or exercising
Bulimia criteria
- Recurrent - at least once per week for 3 months
- Lack of control
- purgative behaviours
- binge eating
- self evaluation influences by body shape and weight
Management of bulimia
- referral to specialist care
Biological:
- fluoxetine
Psychological:
- psychoeducation
- bulimia nervous focussed guided self help
- CBT - ED if self guided self help unsuccessful for 4 weeks
- if child - family therapy
Body dysmorphic disorder
Preoccupation with an imagined defect in appearance
- mirror gazing
- comparison of features
- skin picking
- reassurance seeking
Signs of bulimia
Hypertrophy of the salivary glands
Russell’s sign - calluses on the knuckles on the back of the hands
Hypokalaemia
Normal BMI
Anorexia nervosa
Deliberate weight loss by restricting energy intake
Distorted body image
BMI < 17.5
Fear or gaining weight
Management of anorexia
Biological:
- fluoxetine
- may need admitting with NG tube insertion
Psychological:
- family therapy
- CBT
- nutritional education
- psychodynamic therapy
Social:
- interpersonal therapy
-
Bulimia complications
Teeth erosions
Parotitis
SCOFF screening tool
Screening for anorexia and bulimia nervosa
If score > 2 take a full history
- Do you make yourself sick because you feel full
- Have you lost control
- Have you lost more that one stone in 3 months
- Do you believe you are fat
- Does food dominate your life?
