Eating Disorders Flashcards
How is obesity defined?
- more than 20% over ideal weight
- BMI > 30
- *now a medical disorder**
What are the 3 components to the etiology of obesity?
genetic, iatrogenic (medications causing weight gain) and lifestyle
What are 3 effective ways to lose weight for the long term?
- surgery
- pharmacologic (amphetamines, orlistat, topiramate and zonisamide)
- realistic diet and exercise
How is anorexia nervosa defined?
- refusal to maintain 85% typical weight
- fear of gaining weight
- body image disturbance
- missed 3x+ menstrual cycles
- Severity is based on BMI
What is restricting type of anorexia nervosa?
does not eat or purge
What is binge purge type of anorexia nervosa?
does binge or purge
Who is commonly affected by anorexia nervosa?
female 20x more than males mid teens to 20s type A personality work around food or have expertise **may have depression or attempt suicide**
Are addiction rates higher or lower in patients with anorexia nervosa?
lower
Is there a genetic component to anorexia nervosa?
yes
Which 3 ego defense mechanisms are used by people with anorexia nervosa?
denial
minimalization
delusion
What medical issues are seen in patients with anorexia nervosa?
weight loss hypothermia edema bradycardia hypotension syncope amenorrhea Lanugo hair osteoporosis delayed gastric emptying metabolic acidosis organ failure low potassium -->heart problems
What is the course of anorexia nervosa?
spontaneous recovery to gradual starvation and death
how is anorexia nervosa treated in the hospital?
- restore nutritional state once 20% of typical weight is lost
- 2-6 months if 30% of typical weight lost
- *forced tube feedings w/ firm consistency**
- develop behavioral plan
What types of measurements/monitoring is done while anorexia nervosa patients are in the hospital?
- morning weights
- monitor input and output
- labs-to monitor electrolytes
- inaccessible bathrooms
- continue into outpatient
What types of psychotherapy can be used for anorexia nervosa treatment?
psychodynamic
CBT
family
Which of the following medications is not used in the treatment of anorexia nervosa patients? tricyclics MAOI's SSRI Mirtazapine Olanzapine
MAOI’s-not used
**can also use ECT if depressed
How is bulimia nervosa defined?
- recurrent binge eating
- compensatory behavior-vomitting, laxatives, enemas, diuretics, exercise
- No anorexia present
- *binges 1x/week for 3 months
Who is more commonly affected by bulimia nervosa?
females 10x more than males
normal to obese before
40% of college women
Impulsive and outgoing
Is addiction more or less common in people with bulimia nervosa?
more common
What types of medical issues are seen in patients with bulimia nervosa?
poor dentition-->cavities abraided knuckles-->russells sign normal/overweight sexually active salivary enlargement esophagitis/tears
What types of lab changes are seen in patients with bulimia nervosa?
low PO4
low Mg
High amylase
Is the course for bulimia better or worse than for anorexia nervosa?
better
50+% improvement in most patients
What types of therapy are used in the treatment of bulimia nervosa?
CBT
dynamic
group
family
What types of medications are used in the treatment of bulimia nervosa?
SSRI
What is avoidant/restrictive food intake disorder?
patient doesn’t meet full anorexia criteria
What is binge eating disorder?
Binges
No purges or compensation
1x/week for 3 months
What is PICA?
persistent eating of non-nutritive substance for 1 month
What is rumination?
repeated regurgitation and re-chewing of food
no weight gain
usually before 6 years
