Eating disorders

Question 1

Eating disorders

Answer 1

Mental disorders
Persistent disturbance of eating behaviour which significantly impairs physical health or psychosocial functioning
driven by fear of fatness or extreme distress

Question 2

Types of disturbances of eating

Answer 2

Binge eating, loss of control over eating
Restricted eating, eating too little or only eating a specific food

Question 3

Compensatory behaviours used to control weight

Answer 3

Restricted eating
Self induced vomiting
Excessive exercise
Laxatives, diuretics, appetite suppression

Question 4

Eating disorders and effect on physical health

Answer 4

Impacts growth and development
Stops periods
effects the brain
osteoporosis
high mortality

Question 5

Eating disorders and effect on psychosocial function

Answer 5

impacts work, relationships, daily living
causes distress

Question 6

Anorexia nervosa

Answer 6

restriction of eating causing decrease in body weight
intense fear of weight gain
body image disturbance

amenorrhea is a sign
low weight

Question 7

Bullimia nervosa

Answer 7

Over eating episodes, sense of lack of control
Inappropriate compensatory mechanisms
body image disturbance

normal/overweight

Question 8

Binge eating disorder

Answer 8

Episodes of over eating
No compensation
Frequently overweight

Question 9

Purging disorder

Answer 9

Recurrent purging to influence weight/shape
includes overuse of insulin

Question 10

ARFID - Avoidant/restrictive food intake disorder

Answer 10

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

Question 11

ARFID subtypes

Answer 11

• Insufficient eating
• Limited diet due to sensory features
• food refusal related to aversive experience e.g. fear of choking, vomiting etc

Question 12

Most common eating disorder

Answer 12

Binge eating disorder

Question 13

Treating eating disorders as a medical emergency

Answer 13

Actively treat patient
Re-feeding
Manage fluid and electrolytes
Arrange discharge to appropriate setting
Manage behaviours

Question 14

Mental health teams aims in treating eating disorders

Answer 14

treat patients under compulsion
address family concerns
advise onward care
advise patients with complex comorbidities

Question 15

Investigations done for at risk patients

Answer 15

Blood tests are not diagnostic
Cardiovascular tests are the best indicator, bradycardia, hypotension
Rate of weight loss

Question 16

Family history and risk of eating disorders

Answer 16

genetic link
Hx of obesity
Hx of eating disorders
Hx of depression/anxiety/alcohol dependence

Question 17

Individual risks of eating disorders

Answer 17

Female
Genetics
Premature birth
Low self esteem
Perfectionism
Depression/anxiety
Diabetes
Crohns

Question 18

Triggering factors for eating disorders

Answer 18

Puberty
Socio-cultural pressures
family pressure
peer pressure
comments about weight

Question 19

Psychosocial risk factors of eating disorders

Answer 19

Personality
Neurocognition
self esteem
psychopathology
family
school/peers
trauma
life events

Question 20

Triad of evidence based practice

Answer 20

Scientific evidence - experiments and quantitative studies
Clinical experience - expert panels, practice groups
Patient preferences - satisfaction, QOL, treatment burden and qualitative studies

Question 21

Psychosocial interventions

Answer 21

0-18, family therapy, CBT, adolescent focused therapy
adults, MANTRA for AN treatment, SSCM (supportive clinical management), CBT

Question 22

Medication and eating disorders

Answer 22

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

Question 23

Long term complications of eating disorders

Answer 23

Death
Growth stunting
Osteoporosis
Pregnancy complications
Dental erosion
Mental health comorbidities incl substance abuse