Eating Disorders Flashcards
Define Eating Disorders
Syndromes in which abnormalities of eating behaviours, which are driven by psychological factors, are severe and persistent enough to impair health and nutrition, interfere with social eating, and give rise to distress in the sufferer and those close to them
Features of AN
Restriction of food intake usually because they feel the need to reduce their weight. Profound fear of fatness and weight gain.
Denial about the seriousness of their low weight. The belief that breaking the rules of their diet will lead to uncontrollable weight gain,
Features of BN
Cycle of restriction of foods followed by food craving and uncontrolled excessive eating.
Compensatory behaviours may occur such as:
Purging
Laxative/ diuretic use
excessive exercise
appetite suppressants
WHO diagnostic criteria for AN
BW maintained at 15% below what is expected OR a BMI of <17.5kg/m2
Self-induced weight loss through restriction of foods and/or compensatory behaviours
A refusal to gain weight
Intense fear of weight gain
Denial of seriousness of low BW
Endocrine abnormalities
Explain the endocrine abnormalities seen in AN
Endocrine abnormalities in the hypothalamus and pituitary glands.
Gonads:
- Low oestrogen = amenorreah /low BMD
- Low testosterone
Thyroid:
- Bradycardia
-Hypotension
-Hyperthermia
Adrenal:
- Hypercortisoleamia (prolonged exposure to the hormone cortisol)
Medical Complications of ED’s
Muscular skeletal :
Low BMD -> osteoporosis
Reduction in muscle mass and strength.
Loss in adipose tissue
Cognitive:
Reduced brain mass leads to cognitive impairment.
Cardiac:
Reduction in cardiac muscle mass -> bradycardia -> heart failure.
Endocrine dysfunction
GI :
poor dentation due to vomiting
Slow gastric emptying
bloating/ gas
Immune system:
Low WBC
Immunosuppression
Slow wound healing
Etiology of ED’S
Genetic - inheritability in ED’s especially AN
Personality traits:
- Perfectionism, rigid thinking and compulsivity - AN
- Novelty Seeking and compulsivity - BED
Puberty :
- Common time for ED’s to develop
Environmental:
- Exposure to trauma
- Controlling things when things feel out if control
- Societal overvaluation of thinness
Sexual Orientation:
- ED’s higher in those of a sexual minority
Stages of treatment in AN
Phase 1: Stabilisation
Phase 2: Nutritional Rehabilitation
Phase 3: Maintenance of Improvement and Relapse Prevention
What is included in relapse prevention
Management of compensatory behaviours
Education and psychotherapy to abolish ED behaviours, understand triggers and form new healthy habits
Mood stabilisation
Supervised ‘post-meal periods’
Education on weight fluctuations
Nutritional Aims in management of ED’s
Restore Weight and Nutritional Status
Restore appetite regulation
Management of compensatory behaviours
Avoid Relapse
