Eating Disorders Flashcards
What screening tool is used for eating disorders?
SCOFF
What does SCOFF stand for?
S - Sick. Make self sick when uncomfortably full.
C - Control. Lost control over how much one eats
O - One stone. Lost more than one stone in 3 months
F - Fat. Believes self as fat despite what others say.
F - Food. Food dominates your life.
Anorexia nervosa presentation acronyms?
WRAP
How does anorexia nervosa present?
- Weight: <17.5 BMI and >15% under expected weight
- Restricts calorie intake, relies on compensatory behaviour
- Amenorrhea/Hormonal imbalance
- Poor perception of self - sees self as overweight even if underweight
Other aspects of anorexia?
- Obsessive fear of fatness
- Fear of weight gain
- Compensatory behaviours such as vomiting, laxative abuse, abuse of appetite suppressants/diuretics, excessive exercise.
What are the signs of anorexia?
- Appearance: Lanugo hair, Scalp hair loss
- Temperature regulation (cold)
- Skin: dry
- Neuro: Fainting, weakness, fatigue
- CVS: Hypotension, heart walls become thinner due to breakdown of muscle
- GI: early satiety, constipation, bloating
- Hormonal: delayed puberty, amenorrhea, short stature, osteopaenia/osteoporosis
Bulimia nervosa presentation acronym?
ABC, but reversed so CBA
How does bulimia nervosa present?
- Compulsion to eat (uncontrollable)
- Binging
- Afraid of gaining weight so compensate with purging and other behaviours
Timeline of bulimia nervosa?
Binging 2x/week for 3 months
What are the signs of bulimia?
- Neuro: Impulsivity (crime + substance abuse), Fainting
- ENT: Swollen parotid glands
- CVS: Hypotension, Chest pain
- GI: Heartburn, Oesophageal rupture, Bloody diarrhoea
- MSK: Muscle cramps, Weakness
- Hormonal: Irregular periods
Typical behaviours of eating disorder patients?
Getting rid of calories
Avoidance of calorie intake
Other behaviours: Body checking, displaying emancipation, pro-ana, competing, self harm
Consequences of eating disorder patients?
Psychological consequences
- Unable to interpret emotion
- Anxiety, depression
Social
- Forced to lie and cheat
Physical
- Physical damage
- Neurochemical disruption
- Arrythmias
- Potassium imbalance
Key principle in treating younger ED patients?
Nutrition is more urgent the younger the patient
Precipitating and perpetuating factors of ED?
Precipitating factors
- Puberty
- Dieting/Exercise
- Stressful life events
Perpetuating factors
- Gastric emptying
- Narrowing focus
- Obessionality
- Families
- Emotional expression
Treatment of ED patients?
- Re-feeding
- CBT
- Fluoxetine (SSRI) for binging
- Olanzapine (anti-psychotic) to shut out thoughts as well as better engagement with treatment
