Eating disorders

Question 1

What is Anorexia Nervosa?

Answer 1

Restriction of energy intake leading to a significantly low body weight

Intense fear of gaining weight, persistent behavior that interferes with weight gain

Disturbance in the way in which one’s body weight or shape is experienced (Distorted Body Image)

Question 2

What are the signs and symptoms of Anorexia Nervosa?

Answer 2

Cachexia, body mass index (BMI) < 18.5 kg/m2, lanugo (soft hair), dry skin, bradycardia, lethargy, hypotension, cold intolerance, and hypothermia (as low as 35°C).

Question 3

How to diagnose Anorexia Nervosa?

Answer 3

Measure height and weight; check BMI; check CBC, electrolytes, endocrine levels, and ECG.

Perform a psychiatric evaluation to screen patients for comorbid conditions.

Question 4

What is the severity scale of BMI?

BMI= Body mass divided by the square of the body height Kg/m2

Answer 4

The level of severity is based on current BMI:

Mild: BMI > 17 Kg/m2

Extreme: BMI < 15 kg/m2

Question 5

What are the 2 types of Anorexia Nervosa?

Answer 5

1. Restricting Type:
   Weight loss is achieved through dieting, fasting, and or excessive exercise.
2. Binge Eating/purging type:
   recurrent episodes of binge eating / purging behavior (iteself induced vomiting, misuse of laxatives, diuretics.

Duration of at least 3 months

Question 6

What is the treatment of Anorexia Nervosa (Psychological therapies)?

Answer 6

1. Family Therapy: in children/adolescents
2. Individual therapy:
   a) Cognitive Behavior Therapy (CBT)
   b) Motivational approaches: Cycle of change
3. Medications:
   Antidepressants (SSRIs) are not effective
   Treat comorbidities. Avoid bupropion because of risk for seizure

Question 7

Compare between Anorexia Nervosa and Bulimia nervosa.

Answer 7

Patients with bulimia tend to be more disturbed by their behavior than patients with anorexia and are more easily engaged in therapy.

Patients with anorexia often deny health risks associated with their behavior, making them resistant to treatment.

Question 8

Differences between Anorexia and Bulimia

Answer 8

Weight-in BN normal weight range (marked weight fluctuations)

Age of onset –BN later onset, is rare in childhood and early adolescent

Specific psychopathology –in BN there is lack of control

Prevalence:
AN 0.7% (15-20 yrs)
BN 1-2 % (16-35 yrs)