eating disorders

Question 1

what group most often gets eating disorders?

Answer 1

young (>22) women

Question 2

what screening tool do you use to identify an eating disorder?

Answer 2

SCOFF

do you make yourself SICK because you feel to full?

do you worry you have lost CONTROL over how much you eat?

have you recently lost more than ONE stone?

do you believe yourself to be FAT when others say you’re too thin?

would you say FOOD dominates your life?

Question 3

anorexia nervosa

Answer 3

restriction of intake to reduce weight

vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants

Question 4

when would you test for anorexia nervosa

Answer 4

if they are 15% below ideal body weight

BMI less than 17.5

Question 5

symptoms and signs of anorexia nervosa:

Answer 5

developmental: amenorrhoea, delayed puberty

GI: bloating, constipation

CVS: cold intolerance, blue hands and feet, hypotension

MSK: osteoporosis, osteopenia

CNS: fainting

general: dry skin, lanugo hair, scalp hair loss, short stature

Question 6

bulimia nervosa

Answer 6

binge eating followed by compensatory behaviour of the purging type (vomiting, laxative abuse) or non purging type (excessive exercise, fasting, strict diets)

Question 7

when would you test for bulimia nervosa

Answer 7

binge and resulting compensatory behaviour must occur 2 times min per week for 3 months

Question 8

signs and symptoms of bulimia nervosa

Answer 8

face: mouth sores, dental caries, pharyngeal trauma, oesophageal rupture, swollen parotids
developmental: irregular periods
cvs: heartburn, chest pain, hypotension

GI: bloody diarrhoea

MSK: muscle cramps/weakness

general: impulsive behaviour, fainting

Question 9

binge eating disorder

Answer 9

similar to bulimia nervosa; absence of purging

Question 10

consequences of eating disorders

Answer 10

psychological
- malnourished brains -> depression, anxiety, loss of concentration

social

physical

• ♡ damage
• reduced immunity
• anaemia
• bone loss
• fertility problems
• pubertal development: growth, height

Question 11

causes of eating disorders

Answer 11

predisposing

• genetics (anxiety disorders, perfectionism)
• perinatal factors
• life events/trauma

precipitating

• puberty: psychological response to body changes
• dieting
• increased exercise
• life events/trauma

perpetuating

• delayed gastric emptying
• obsessionality
• high expressed emotion in family

Question 12

how do you treat eating disorders?

Answer 12

re-feeding

CBT

high dose antidepressants (fluoxetine, olanzipine)