Eating Disorders Flashcards
Anorexia Nervosa
Restriction of energy intake that leads to a very LOW body weight
What are some general symptoms of Anorexia Nervosa?
- Intense fear of gaining weight despite being underweight
- Distorted perception of body with high influence on self esteem
What are the 2 types of Anorexia Nervosa?
- Restricting Type
2. Binge-eating/Purging Type
Restricting Type Anorexia Nervosa
Excessive exercising, fasting, dieting
Binge-eating/Purging Type Anorexia Nervosa
3 months of binging and purging behaviors
– self-induced vomiting, laxatives, etc.
What is the severity of Anorexia Nervosa based on? What are the levels?
BMI
- Mild: >17
- Moderation: 16-17
- Severe: 15-16
- Extreme: <15
What condition is highly associated with Anorexia Nervosa?
OCD
– Also depression, personality disorders/traits
OCD is associated with which eating disorder?
Anorexia Nervosa
Why is it important to recognize and treat the comorbidities with Anorexia Nervosa?
INCREASED mortality when another psych disorder is present
– LOTS of medical complications
What is a potentially fatal adverse effect of treating Anorexia Nervosa?
Refeeding Syndrome
What is Refeeding Syndrome?
Complications that occur with fluid/electrolyte shifts when treating Anorexia Nervosa patients
Why should you not rehydrate/feed Anorexia Nervosa patients beyond their current capacity?
Refeeding Syndrome
– electrolyte/fluid shifts that cause complications
What are some signs of Refeeding Syndrome?
CHF Edema Rhabdomyolysis Seizures Hemolysis Decreased K+, phosphate
CHF, edema, rhabdomyolysis, seizures, hemolysis are signs of?
Refeeding Syndrome
How do you avoid Refeeding Syndrome?
Limit calories/fluid in early stages and avoid rapid increases
– closely monitor labs
What is the recommended treatment for Anorexia Nervosa?
Nutritional rehab and Psychotherapy
How long should a patient with Anorexia Nervosa be hospitalized?
Until normal weight is achieved
If an Anorexia Nervosa patient is resistant to nutritional rehab and psychotherapy, what may be considered?
Pharmacotherapy
What are 4 Pharmacotherapy options for Anorexia Nervosa
Olanzapine
Lorazepam
SSRI
2nd Gen antipsychotics
What are the suicide rates with Bulimia Nervosa?
7x higher than normal
What should you be monitoring Bulimia Nervosa patients for?
Suicidal Ideation
Bulimia Nervosa
Recurrent episodes of binge-eating
–> Compensatory behavior (vomiting, exercising, etc.)
What usually differentiates Bulimia Nervosa and Anorexia Nervosa?
Bulimia Nervosa: can be all sizes!
Anorexia Nervosa: UNDERWEIGHT
How do Bulimia Nervosa patients feel when binging?
Dysphoric (unhappy)
What is the treatment of choice for Bulimia Nervosa?
CBT Psychotherapy
What is the best treatment plan for Bulimia Nervosa?
CBT + nutritional rehab + pharmacotherapy
What are some options for Pharmacotherapy for Bulimia Nervosa?
Fluoxetine or other SSRIs
TCAs, etc.
What medication should you avoid with Anorexia and Bulimia?
Bupropion!
Why should Anorexic and Bulimic patients avoid Bupropion?
SEIZURE RISK
Binge Eating Disorder
Episodes of severe binge eating within 2 hours of time
Are there compensatory behaviors present with Binge Eating Disorder?
NO
Eating large amounts of food when not hungry, eats rapidly, gets uncomfortably full, eats alone due to embarrassment
Binge Eating Disorder
What is the treatment for Binge Eating Disorder?
CBT/IPT Psychotherapy
What is the only medication available to treat Binge Eating Disorder?
Vyvanse (lisdexamfetamine Dimesylate)
What is the only medication available for Binge Eating Disorder? What drugs are NOT recommended?
Vyvanse!
– Anti-obesity medications are NOT recommended
