Eating Disorders Flashcards

1
Q

what are the components of normal eating

A

balanced diet
- not always, people are human
- eat well plate
eating everyday
- 3 meals a day (ish)
- not always (if your ill, fasting)
should be a normal part of your life
- proportionate, not overwhelming

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2
Q

list common eating disorders

A

anorexia nervosa
bulimia nervosa
binge eating disorder
avoidant/ restrictive food intake disorder (ARFID)
other specified feeding or eating disorders (OSFED)
- feeding or eating disorders
- don’t fit into the categories above
- still significant, probably resembles some of the other disorders

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3
Q

what are some clinical symptoms of EDs

A

low K+ levels
- self-induced vomiting
lethargy
rapid weight change
dental issues

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4
Q

possible causes of EDs

A

comorbidity
lack of control
low mood
triggers -> social support
family issues
genetics?
social factors

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5
Q

list some compensating behaviours

A

exercise, laxatives, vomiting

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6
Q

what is bulimia nervosa

A

recurrent episodes of overeating (e.g. once a week or more for more than a month)
accompanied by repeated inappropriate compensatory behaviours
- aimed at preventing weight gain
individual is preoccupied with body shape or weight
- strongly influences self-evaluation
individual not significantly underweight
- does not meet diagnostic criteria for anorexia nervosa

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7
Q

what are management strategies for bulimia nervosa

A

CBT
family-based therapies
psychodynamic therapy
fluoxetine
- antidepressant
- not be used solely - alongside psychological

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8
Q

what is binge eating disorder

A

frequent, recurrent episodes of binge eating
discrete periods of loss of control over their eating behaviour
episodes are not regularly accompanied by inappropriate compensatory behaviours and aimed at preventing weight gain
marked distress about the pattern of binge eating or significant impairment in personals, family, social, educational, occupational or other important areas of functioning

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9
Q

describe the management of binge eating disorder

A

CBT interpersonal psychotherapy
if ^ not affective, consider
- dialectical-based therapy
- integrative cognitive-affective therapy
- brief strategic therapy
schema therapy
medication not recommended as an alternative or as an adjunct to a psychological treatment for patients with BED

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10
Q

what is anorexia nervosa

A

significantly low body weight for the individuals age and developmental stage (BMI <18.5 in adults)
accompanied by a persistent pattern of behaviours to prevent the restoration of normal weight
low body weight is central to the person’s self-evaluation or is inaccurately perceived to be normal or even excessive
- body dysmorphia
comorbidity
- anxiety, severe OCD or high levels of expressed emotion

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11
Q

explain management of anorexia nervosa in young people

A

family-based treatment
- systemic family therapy
- augmented family-based treatment
CBT
- CBT-E as per Fairburn’s model
- 20-40 weekly sessions

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12
Q
A
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13
Q

what is the importance of accessing treatment early

A

clinical, biological and neurological behaviours have shown that the first three years of illness provide a critical window for early effective intervention in EDs

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14
Q

barriers to accepting treatment

A

self-perceptions
egosyntonicity of ED symptoms
stigma an perceived lack of support from others
perceptions of mental health professionals and treatment

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15
Q

what is ARFID

A

abnormal eating or feeding behaviours that result in the intake of insufficient quantity or variety of food
causes significant weight loss/ failure to gain weight/ nutritional deficiencies/ dependence on nutritional
- fear of vomiting/ choking
- no interest in food/ doesn’t recognise hunger cues
- autism
pattern of eating does not reflet concerns about body shape/ weight

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16
Q

what is OFSED

A

ED is called atypical if it does not fit exactly into the diagnostic categories
- may have symptoms of an ED but not all
- may have overlapping symptoms
- may move from one ED to another

17
Q

what is the management of OSFED

A

not much info on the management of atypical ED
- follow guidance on the treatment of the ED that is most closely resembling the individual patients ED

18
Q

physical complications of ED - nervous system

A

impaired concentration, cognitive performance and peripheral neuropathy

19
Q

physical complications of ED - dermatological

A

dry skin, brittle hair, hair loss, lanugo body hair

20
Q

physical complications of ED - cardiovascular

A

low blood pressure, brachycardia arrythmias, prolonged QTC, cardiomyopathy

21
Q

physical complications of ED - haematological

A

anaemia, leucopoenia, thrombocytopenia

22
Q

physical complications of ED - metabolic

A

hypokalaemia, hyponatraemia, hypoglycaemia, hypothermia

23
Q

physical complications of ED - renal

A

renal calculi, impaired renal function

24
Q

physical complications of ED - musculoskeletal

A

myopathy, osteoporosis

25
Q

physical complications of ED - GI

A

prolonged GI transit - delayed gastric emptying, altered antral motility, gastric atrophy, decreased intestinal motility, constipation)

26
Q

physical complications of ED - endocrine + reproductive

A

amenorrhea, infertility, low birth weight of infant

27
Q

describe features of a physical risk assessment on an ED patient

A

low BMI and rapid rate of weight loss
cardiovascular rick (low BP, low pulse)
glucose level/ albumen level
electrolyte abnormalities (low Na, low K, altered eGFR)
liver function abnormailities
bone marrow abnormalities - low WCC, Hb, platelets

28
Q

management of high risk ED patients

A

meal support, nutritional support
- led by an experienced dietitian
support to manage patients’ distress
close physical monitoring (for refeeding syndrome)
impatient treatment
on rare occasions, use of the Mental Health Care and Treatment Scotland Act

29
Q

what is the role of psychiatrist in the multidisciplinary ED team

A

assessment and diagnosis, treating comorbidities
supporting psychologically informed formulation and treatment
Physical Risk Assessment and Management
leading and supporting inpatient/ more intensive treatment
developing services, improving quality, facilitating teaching