eating disorders Flashcards

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1
Q

eating disorders in males

A

emphasis on fitness
lean muscularity
stringent weight requirements for certain sports
higher incidence in homosexuals

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2
Q

populations most frequently diagnosed with eating disorders

A

white
affluent
well-educated
adolescent and female

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3
Q

factors contributing to eating disorders

A

vulnerable personality
female
hx of obesity
uncontrolled dieting
genetics
onset of puberty
major life changes or stressors
family functioning style
sociocultural emphasis on slimness
perfectionism
impulsivity

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4
Q

etiology of eating disorders

A

genetic: strong genetic component
neurobiological: altered brain serotonin contributes to the dysregulation of appetite, mood, impulse control
psychological: eating disorders are learned behavior that has positive reinforcement
environmental: childhood trauma

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5
Q

psychological factors of eating disorders

A

low self esteem
feelings of inadequacy, lack of control in life
depression, anxiety, stress, loneliness, trauma

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6
Q

interpersonal factors of eating disorders

A

troubled relationships
difficulty expressing emotions
hx of being teased based on size/weight
hx of physical/sexual abuse

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7
Q

social factors of eating disorders

A

culture pressure of thinness
narrow definitions of beauty

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8
Q

biological factors of eating disorders

A

irregular hormone functions
genetics

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9
Q

co-morbidities and dual diagnoses in eating disorders

A

associated between depression, anxiety, and eating disorders
anorexia have hx of anxiety
binge-purge behavior have co-morbid alcohol or substance abuse problem
bulimia frequently co-exists with major depression

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10
Q

treating eating disorders

A

rarely seek help
not motivated to change
often leave treatment
some recover spontaneously, whereas others have long term problems

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11
Q

anorexia nervosa

A

refusal to maintain body weight appropriate for age, intense fear of gaining weight or becoming obese
severely distorted body image
refusal to acknowledge the seriousness of wt loss

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12
Q

restricting type AN

A

individuals that do not regularly engage in binge eating or purging
calorie count and excessive exercise

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13
Q

binge eating and purging type AN

A

regularly engage in binge eating or purging behaviors
self induces vomiting or misuse of laxatives, diuretics or enemas

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14
Q

physical characteristics of AN

A

low body weight
lack of energy, fatigue
muscular weakness
decreased balance, unsteady gate
low body temp, BP, pulse rate
tingling in hands and feet
thinning hair or hair loss
lanugo
heart arrhythmias
loss of periods
low testo levels

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15
Q

etiology of AN

A

biological factors (genetics/neurobiological)
psychological factors
environmental factors

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16
Q

warning signs of AN

A

dramatic weight loss
preoccupation with food, calories, grams of fat, and dieting
refusal of certain foods, progressing to avoidance against whole food catagories

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17
Q

risk factors of AN

A

female
hx of eating disorders
history of obesity
dieting
over exercising
low self esteem
body dissatisfaction
lack of assertiveness
hx abuse
comorbid conditions
distorted body image
media
fashion industry
being an athlete

18
Q

clinical course of AN

A

onset in early adolescence
chronic condition with relapses characterized by significant weight loss
often preoccupied with food
may develop bulimia nervosa
poor outcome related to initial lower minimum weight, presence of purging, and earlier age of onset
CAN BE CURED

19
Q

complications due to weight loss/starvation

A

musculoskeletal: loss of muscle mass, fat, early onset osteoporosis
metabolic: hypothyroidism, hypoglycemia, electrolyte abnormalities
cardiac: bradycardia, hypotension, loss of cardiac mass, small heart, arrhythmias, chest pain, sudden death
GI: delayed gastric emptying, bloating, constipation, abdominal pain, gas and diarrhea, GERD, hemorrhoids
Reproductive: amenorrhea, irregular periods, loss of libido, infertility
dermatologic: dry cracking skin, brittle hair and nails, lanugo, edema, acrocyanosis, yellowish skins
hematologic: leukopenia, anemia, thrombocytopenia, hypercholesterolemia, hypercarotenemia
neuropsychiatric: abnormal taste, apathetic depression, mild organic mental symptoms, sleep disturbances and fatigue

20
Q

complications of eating disorders due to purging

A

erosion of enamel, seizures, fatigues, weakness, milk organic metal symptoms, ipecac cardiomyopathy, arrhythmias, Russel’s sign

21
Q

initial goal treatment of AN

A

assess suicidal ideation
initiating nutritional rehabilitation

22
Q

later goal treatment of AN

A

Resolving conflicts around body image disturbance
increasing effecting coping
addressing underlying conflicts r/t maturity fears and role conflict
family therapy

23
Q

treatment modalities of AN

A

hospitalization usually necessary
intensive therapies

24
Q

refeeding syndrome

A

serious and potentially fatal condition caused by sudden shifts in electrolytes that help body metabolize food.

25
Q

treatments of AN

A

precise meal times, adherence to selected menu
observation during and after meals and regularly scheduled weigh ins
constant monitoring during bathroom trips
long term treatment provided on outpatient basis

26
Q

meds for AN

A

fluoxetine helpful for compulsive behaviors after pt has reached maintenance wt.

27
Q

when is hospitalization required for eating disorders?

A

extreme electrolyte imbalance or weight below 75% of ideal body weight
less than 10% body fat
daytime HR less than 50 bpm
systolic bp less than 90
body temp less than 96
arrhythmias

28
Q

what is an acceptable BMI?

A

18.5-24.9

29
Q

Bulimia Nervosa

A

recurrent episodes of binge to avoid weight gain through purging. such as self inflicted vomiting, diuretics, enemas, emetics, or excessive exercise or fasting

30
Q

risk factors for BN

A

high achievers
social pressure to be thin
depression
chaotic family
outgoing
angry
impulsive
substance abuse

31
Q

clinical course of BN

A

few outward signs
binge and purge in secret
treatment often delayed for years
typically normal body weight
once tx is over typically there is complete recovery except is depression and personality disorders present
they feel shame, guilt, and disgust regarding binging and purging

32
Q

warning signs of BN

A

disappearance of large amounts for food
finding wrappers and containers
evidence of purging, frequent trips to the bathroom after meals, signs and or smells of vomiting, laxatives or diuretic wrappers
unusual swelling of cheeks and jaws
Russells sign
discoloration or staining of teeth
withdraw from usual friends and activities

33
Q

symptoms of BN

A

enamel erosion
xerostomia (dry mouth)
tooth decay

34
Q

treatment of BN

A

hospitalization if experiencing life threatening complications/SI
treatment is usually outpatient
stabilizing and normalizing eating, stop the binge-purge cycle
teaching health boundaries
reshape dysfunctional thoughts
CBT,DBT

35
Q

meds for BN

A

SSRI’s- fluoxetine, is the most effective in conjunction with CBT
behavioral techniques such as using food diary
nutritional counseling
group psychotherapy and support groups
family therapy

36
Q

Binge eating disorder

A

recurrent episodes of binge eating with accompanying marked distress and impaired control over behavior

37
Q

causes and comorbidities of BED

A

lower dietary restraint and higher in weight
BED occurs in normal-weight/overweight and obese
genetic

38
Q

most common psych disorders with BED

A

bipolar, MDD, anxiety, SUD
low self esteem, body dissatisfaction, deduced level of coping and adverse childhood events

39
Q

symptoms of BED

A

frequent episodes of eating large quantities of food in short periods of time
out of control, over eating
depressed, guilty, or disgusted by behavior
eating when not hungry, eating alone, uncomfortably full
upper and lower GI problems that bring attention to HCP’s.

40
Q

consequences of BED

A

HTN
high cholesterol
heart disease
DM
GI diseases
Gallbladder disease
musculoskeletal problems

41
Q

treatment of binge eating disorders

A

hospitalization not usually required
individual or group CBT
DBT
nutritional counseling
support groups
psychopharmacology (SSRI’s, Vyvanse)