Eating disorders Flashcards
Eating disorders
Mental disorders
Persistent disturbance of eating behaviour which significantly impairs physical health or psychosocial functioning
driven by fear of fatness or extreme distress
Types of disturbances of eating
Binge eating, loss of control over eating
Restricted eating, eating too little or only eating a specific food
Compensatory behaviours used to control weight
Restricted eating
Self induced vomiting
Excessive exercise
Laxatives, diuretics, appetite suppression
Eating disorders and effect on physical health
Impacts growth and development
Stops periods
effects the brain
osteoporosis
high mortality
Eating disorders and effect on psychosocial function
impacts work, relationships, daily living
causes distress
Anorexia nervosa
restriction of eating causing decrease in body weight
intense fear of weight gain
body image disturbance
amenorrhea is a sign
low weight
Bullimia nervosa
Over eating episodes, sense of lack of control
Inappropriate compensatory mechanisms
body image disturbance
normal/overweight
Binge eating disorder
Episodes of over eating
No compensation
Frequently overweight
Purging disorder
Recurrent purging to influence weight/shape
includes overuse of insulin
ARFID - Avoidant/restrictive food intake disorder
feeding/eating disturbance with
- sig weight loss
- sig nutritional deficiency
- dependence on enteral feeding, supplements
- interference with psychosocial functioning
not driven by weight/shape concerns
ARFID subtypes
- Insufficient eating
- Limited diet due to sensory features
- food refusal related to aversive experience e.g. fear of choking, vomiting etc
Most common eating disorder
Binge eating disorder
Treating eating disorders as a medical emergency
Actively treat patient
Re-feeding
Manage fluid and electrolytes
Arrange discharge to appropriate setting
Manage behaviours
Mental health teams aims in treating eating disorders
treat patients under compulsion
address family concerns
advise onward care
advise patients with complex comorbidities
Investigations done for at risk patients
Blood tests are not diagnostic
Cardiovascular tests are the best indicator, bradycardia, hypotension
Rate of weight loss
Family history and risk of eating disorders
genetic link
Hx of obesity
Hx of eating disorders
Hx of depression/anxiety/alcohol dependence
Individual risks of eating disorders
Female
Genetics
Premature birth
Low self esteem
Perfectionism
Depression/anxiety
Diabetes
Crohns
Triggering factors for eating disorders
Puberty
Socio-cultural pressures
family pressure
peer pressure
comments about weight
Psychosocial risk factors of eating disorders
Personality
Neurocognition
self esteem
psychopathology
family
school/peers
trauma
life events
Triad of evidence based practice
Scientific evidence - experiments and quantitative studies
Clinical experience - expert panels, practice groups
Patient preferences - satisfaction, QOL, treatment burden and qualitative studies
Psychosocial interventions
0-18, family therapy, CBT, adolescent focused therapy
adults, MANTRA for AN treatment, SSCM (supportive clinical management), CBT
Medication and eating disorders
Never used on its own
Usually used to treat comorbidities
SSRIs for anxiety/depression (do not work at low weight)
aripiprazole/olanzapine to reduce emotional dysregulation during refeeding
Long term complications of eating disorders
Death
Growth stunting
Osteoporosis
Pregnancy complications
Dental erosion
Mental health comorbidities incl substance abuse
