Eating Disorders Flashcards
What are co-morbidities of eating disorders?
- Depression and anxiety
- Estimated lifetime prevalence of mood disorders
- Anorexia nervosa ranges from 31% to 89%.
- Bulimia nervosa ranges from 24% to 90%. - Obsessive-compulsive disorder (OCD)
- As high as 25% in people with anorexia nervosa - Personality disorders
- May occur in 42% to 75% of people with eating disorders
- There is a high rate of avoidant personality disorders.
What are risk factors of eating disorders?
- Biological factors
- Genetics – strong (60%) heritability twin link
- Neurobiological causes- Serotonin, Tryptophan - Psychological - learned behaviour with positive reinforcement, and trauma
- Environmental factors: western cultural ideal
Describe anorexia nervosa
An eating disorder characterized by a restriction of intake leading to a below normal weight, an intense fear of gaining weight, body image disturbance/undue influence of body weight on self evaluation.
- Induce vomiting
- Use/abuse laxatives/diuretics
- Exercise excessively
Does anorexia start earlier or later on in life?
Earlier
Does bulimia start earlier or later on in life?
Later
What is the highest mortality rate of any psychiatric disorder in young females?
Anorexia, which leads to suicide.
What are some S/S of anorexia?
- Low weight
- Amenorrhea (absence of mensturation)
- Yellow skin
- Lanugo (a soft, fine hair that covers the fetus while inside the uterus - it helps protect them and keep them warm)
- Cold extremities
- Peripheral edema
- Muscle weakening
- Impaired renal function
- Abnormal lab values
- Cardiovascular abnormalities
- Abnormal CT, EEG
- Hypokalemia
- Decreased bone density
- Constipation
- Mottled skin on extremities
- Anemic pancytopenia - reduction of red, white blood cells, and platelets
- Low BP, HR and temp
- Malnourished and dehydrated
What are thoughts and behaviours associated with anorexia nervosa?
- Terror of gaining weight
- Preoccupation of food
- View of self as fat even when emaciated
- Peculiar handling of food
- Cutting food into small bits
- Pushing pieces of food around the plate - Possible development of rigorous exercise regimen
- Possible self-induced vomiting, use of laxatives and diuretics
- Cognition so disturbed that individual judges self-worth by their weight
What assessment factors would you include for an individual with anorexia?
- Perception of the problem
- Eating habits, history of dieting
- Methods used to achieve weight control (restricting, purging, exercising)
- Value attached to a specific shape and weight
- Interpersonal and social functioning
- Mental status and physiological parameters
What takes priority when choosing a diagnosis: physical or psych needs?
Physical needs take priority until medically stable, then psych (i.e., imbalanced nutrition).
What is re-feeding syndrome?
- Occurs within 4 days of re-feeding.
- Fluid and electrolyte disorders along with complications across various systems - neurological, CVS, rest, neuromuscular, etc.
- Cardiac arrhythmia’s most common cause of death during re-feeding
- Other significant risks are confusion, coma, convulsions and cardiac failure.
Anorexia recovery
- Relapse is common, recovery is a process
- Discharge BMI was found the singularly best predictor of full recovery
- Ongoing nutritional counselling and support can prevent relapse and facilitate full recovery
- Continuum of care needed - discharge planning
Describe bulimia nervosa
- An eating disorder characterized by repeated episodes of binge eating followed by compensatory behaviours, such as:
- Self-induced vomiting
- Misuse of laxatives/diuretics or other medications
- Fasting
- Excessive exercise - At least once a week for 3 months
- Self evaluation influenced by weight
- Disturbance does not occur exclusively within periods of anorexia
- Has levels of severity ranging from mild to extreme
What is the epidemiology of bulimia?
- Lifetime prevalence, 3% to 8% (more prevalent than anorexia nervosa).
- Onset is between ages 18 and 24 (older than anorexia nervosa).
- First-degree relatives more likely to develop.
What are some S/S of bulimia?
- Normal to slightly low weight (can fluctuate or be higher than the person’s otherwise normal wt)
- Dental caries, tooth erosion
- Parotid swelling
- Gastric dilation/rupture
- Calluses, scars, on hand (Russell’s sign)
- Peripheral edema
- Muscle weakening
- Abnormal lab values (electrolyte disturbances)
- Cardiovascular abnormalities
- Cardiac failure
