Eating Disorders Flashcards
What group most often gets eating disorders?
Young (>22) women
How can we screen for eating disorders?
SCOFF questionnaire
What are the questions in the SCOFF questionnaire?
2+ yes answers = ED likely:
- do you make yourself SICK?
- do you worry you’ve lost CONTROL of how much you eat?
- have you lost >ONE stone in any 3 months?
- do you think you’re too FAT when others say you’re too thin?
- does FOOD dominate your life?
What are the criteria for anorexia nervosa?
An obsessive fear of weight gain
+ Restriction of intake
+ Compulsive compensatory behaviours
A BMI <17.5 is also required
What signs can you spot in an anorexic patient?
Hypotension, bradycardia & Fainting
Cold intolerance
Constipation & bloating
Delayed puberty, amenorrhoea, impotence & decreased libido
Lanugo hair
Weakness/fatigue
Risk of osteopenia & osteoporosis
What compensatory behaviours are common in AN?
Excessive exercise
Vomiting
Drug abuse - Laxatives, diuretics & appetite suppresants
What make’s bulimia different to AN?
BN has obsessive fear of fat
+ compensatory mechanisms
+ Binge eating (vs AN’s restriction of intake)
BN can present at any weight
How often do BN suffers binge eat?
They must have a binge eating + compensation “Cycle” atleast twice/wk for atleast 3 months to be diagnosed
What signs would suggest BN?
Mouth sores, dental caries etc.
Heartburn/chest pain
Impulsive behaviour
Hypotension & fainting
Muscle cramps & weakness
Bloody diarrhoea
Irregular periods
Swollen parotids
Binge Eating Disorder is different to BN, how so?
IT involves binge eating but without the purging.
Instead they have cycles of binge eating followed by embarrassment, shame & guilt
What are the common forms of compensatory behaviours in eating disorders?
Restrictive - Diets, “allergies”, obsessed with gut symptoms, avoiding social occasions & med abuse
Purging - Vomiting, spitting out, overactivity, cooling, blood letting & med abuse
Others - Body checking, self-harm, competing in thinness, displaying emaciation & seeking out pro-ana sites
We split the aetiology of eating disorders into predisposing, precipitating and perpetuating factors. List some predisposing ones?
- Genetic
- Perinatal complications
- Life events/traumas
List some factors that precipitate an eating disorder?
Puberty
Dieting/non-deliberate weight loss
Increased exercise
Life events e.g. loss, abuse or moving
What factors will perpetuate an existing eating disorder?
Delays gastric emptying
Narrows focus (avoiding other interests)
Obsessionality (phobia worsens with avoidance)
How can we manage someone with an eating disorder?
If dangerously thin –> Admit and do re-feeding/dietary support
Otherwise:
- CBT/IPT
- Antidepressants
- Olanzapine
- Family interventions
