Eating Disorders Flashcards
A healthy BMI for women over age 20 is what range?
19-25
On the BMI scale, what is considered overweight?
over 25
On the BMI scale, what is considered obese?
over 30
Those under a BMI of what are considered to be at risk for health problems
related to anorexia?
17.5
However, young teenagers can have lower BMIs without necessarily being
anorexic
What are some causes of eating disorders?
Genetics
Developmental events
Family dynamics
Peer pressures
Cultural influences
More than a quarter of eating disorder patients have a comorbid what?
mood disorder
> 90% have at least one additional ________ diagnosis in a lifetime
psychiatric
Self imposed starvation is called what disorder?
Anorexia Nervosa
Approximately what percentage of cases of anorexia nervosea occur in females?
90%
What are the two types of Anorexia Nervosa?
Restricting
Binge Eating/Purging
What are the criteria for anorexia nervosa?
Refusal to maintain body weight at or above that expected for age and height (<85%)
Intense fear of gaining weight or becoming fat despite being severely underweight
Distortion in the way one’s body size is experienced and denial of seriousness of low weight
Amenorrhea in postmenarcheal females
What type of anorexia is described below?
Person eats very little and does not regularly engage in binge eating or purging behavior
Restricting
What type of anorexia is described below?
Characterized by patient eating in binges and subsequent purging
Binge Eating/Purging
What is a useful interviewing tool in screening for anorexia nervosa?
SCOFF Questionnaire
When should an anorexia nervosa patient be hospitalized?
Hospitalization if patient is 20% below the expected body weight
What antidepressants may be useful in anorexia nervosa?
Paroxetine (Paxil)
Mirtazapine (Remeron)
What medications or classes of medications should be avoided in anorexia nervosa?
Stimulants
Buproprion
TCAs
Recurrent episodes of binge eating and recurrent compensatory mechanisms
Bulimia Nervosa
What are some recurrent compensatory mechanisms in bulimia nervosa?
Self-induced vomiting
Laxative use
Fasting
Excessive exercise
The following list is characteristics of which eating disorder?
Greater incidence in people that tend to be high achievers succumbing to
pressure of being thin
Usually associated with overweight or obesity
eating behavior is more ego-dystonic
Bulimia Nervosa
What are the two types of Bulimia Nervosa?
Purging
Non-Purging
What is the diagnostic criteria for Bulimia Nervosa?
Binge/Purge episodes occur on average at least two or more times a week for at least three months
Characterized by the consumption of a larger amount of food in two hours than the average person would consume
Self-esteem influenced by weight/body shape
Current weight does not meet criteria for anorexia nervousa (>85% ideal body weight)
Binge eating episodes are associated with three or more of the following: Eating faster than normal, Eating until feeling uncomfortably full, Eating to excess, Eating even though not hungry, Eating alone out of embarrassment with feelings of disgust, guilt, or depression after the episode
List some common cardiovascular medical issues seen in bulimia nervosa
Orthostatic hypotension
Bradycardia
Prolonged QT and T-wave abnormalities on EKG
Mitral valve prolapse
Cardiomyopathy
List some common cell count medical issues seen in bulimia nervosa
Low WBC
anemia
List some common GI medical issues seen in bulimia nervosa
Bloating
Nausea
Elevated liver enzymes
Elevated cholesterol
Constipation/decreased motility
Esophageal tears (Mallory-Weiss)
List some common fluid/electrolyte medical issues seen in bulimia nervosa
Dehydration
Decreased albumin
Peripheral edema and effusions
Electrolyte disturbances
List some common dermatologic medical issues seen in bulimia nervosa
Hair loss
Dull hair
Lanugo hair
Dry skin
Calloused or scarred knuckles (from purging) - Russell’s sign: Repeated induced vomiting over long periods of time, Contact with the incisor teeth
Acrocyanosis
List some common reproductive medical issues seen in bulimia nervosa
Reduced fertility at low weight
Higher rates of obstetric difficulties
Decreased intrauterine growth of baby
Amenorrhea (for at least three cycles)
Indications for Inpatient Care in bulimia patients
Syncope
Hypokalemia (<3.2 mmol/L)
Hypochloremia (<88 mmol/L)
Esophageal tears
Cardiac arrhythmias (including prolonged QTc interval)
Intractable vomiting
Hematemesis
Failure to respond to outpatient treatment
Severity of psychiatric comorbidities
What medications or classes of medications should be avoided in bulimia nervosa?
Stimulants
Buproprion
TCAs
