Eating Disorders Flashcards
1
Q
What is an eating disorder?
A
- mental disorder
- persistent disturbance of eating behaviour or behaviour intended to control weight which significantly impairs physical health or psychosocial functioning
- driven by fear of fatness or extreme distress about eating
2
Q
What are the two disturbances of eating behaviour?
A
- binge eating
- restricted eating (quantity or range)
3
Q
What are behaviours intended to control weight?
A
- fasting
- self-induced vomiting
- excessive exercise
- laxative, diuretic or other energy burning and appetite supressing medication
4
Q
How do eating disorders impair physical health?
A
- impacts growth and development
- stops periods
- affects brain
- osteoporosis
- high mortality
5
Q
How do eating disorders impair psychosocial function?
A
- work
- relationships
- daily living
- distress
6
Q
What are the eating disorders in the DSM-5 and ICD11?
A
- anorexia nervosa
- bullimia nervosa
- binge eating disorder
- other specified feeding and eating disorder (OSFED)
- avoidand/restrictive food intake disorder (ARFID)
- rumination disorder
- pica
7
Q
Wat are the key symptoms of anorexia?
A
- restriction of food intake leading to significantly low body weight
- intense fear of gaining weight or persistent behaviour that interferes with weight gain
- disturbance in experience of weight/shape
8
Q
What are the sub-types of anorexia?
A
- restricting
- binge-purge
9
Q
What are the syptoms of bullimia?
A
- characterised by binging rather than purging
- overeating episodes (large amount of food and lack of self control)
- inappropriate compensatory mechanisms
- body image disturbance
- occurs once a week for at least 3 weeks
10
Q
What are the symptoms of binge eating disorder?
A
- episodes of overeating
- no or minimal compensation
- frequently overweight
11
Q
What is purging disorder?
A
- purging without binging
- vomiting, laxatives, diuretics or other medications including insulin
- weight is often normal
12
Q
Which disorders come under OSFED?
A
- atypical anorexia
- purging disorder
- atypical bullimia
- night eating disorder
13
Q
What are the symptoms of ARFID?
A
- eating disturbance
- significant weight loss
- significant nutritional deficiencies
- dependance on enteral feeding or nutritional substances
- interference with psychosocial functioning
- no weight/shape concerns
14
Q
What are the three main subtypes of ARFID?
A
- not eating enough/little interest in eating
- diet is limited due to sensory issues
- refusing food because of adverse experiences
15
Q
What is the epidemiology of eating disorders?
A
- relativrly common in childhood and adolescence
- around 40% of adolescent girls show ED behaviours by age 16 but only 11% diagnosable
- incidence of anorexia and bullimia are stable
- OSFED and BED are increasing
- anorexia is most common in clinic
16
Q
What is the peak onset for eating disorders in women?
A
15-19
17
Q
What is the most prevelant eating disorder?
A
Binge eating disorder
18
Q
What is the guidance used for medical emergencies caused by eating disorders?
A
MARSIPAN guidance
19
Q
What does the medical team need to do for ED patients in a medical emergency?
A
- actively treat patient
- safe refeeding
- managing fluid and electrolyte imbalances
- arranging discharge to an appropriate setting
- managing ED behaviours
20
Q
What does the mental health team need to do for ED patients in a medical emergency?
A
- assess and treat patients under compulsion
- address family concerns
- advise on appropriate onward care
- advise on patients with complex comorbidities (e.g personality disorders or autism)
21
Q
What are key points to consider in treating patients with an eating disorder?
A
- they are not visible
- normal bloods do not mean things are ok
- cardiovascular parameters are the best pointer to risk
- intake and rate of weight loss > weight
- red for risk means ask someone who knows
22
Q
What are the family risk factors for eating disorders?
A
- history of dieting/eating disorders
- history of depression, anxiety or alcohol dependence
- history of obesity
23
Q
What are some individual risk factors for eating disorders?
A
- female
- genetics
- premature birth
- low self esteem
- perfectionism
- previous depression or anxiety
- previous obesity
- early puberty
- diabetes
- Crohn’s disease
- temperment
- neurocognition
- life events
- trauma
24
Q
What are possible triggers and maintaing factors for eating disorders?
A
- puberty
- socio-cultural pressures
- family
- pressure to achieve
- peer behaviours
- comments about weight
24
How do eating disorders become self-perpetuating?
- weight loss from diet leads to starvation-induced changes
- increses anxiety, depression and obsessionality
- leads to chronic illness
25
What is the most common model for the onset of eating disorders?
- Stice and Argas dual pathway model
- updated Stice and Shaw dual pathway takes into acount that high BMI increases likelihood of developing an eating disorder and that there is a range of eating pathologies
26
What is the triad of evidence based practise?
- best scientific evidence
- clinical experience
- patient preference
27
What is the best scientific evidence for eating disorders?
- evidence of effectiveness of existing treatments is weak across the age range
- few large scale randomized controlled treatment trials and many show no difference between treatment arms
28
What are the main psychological interventions for children and young people with eating disorders?
- ED focused family therapy
- CBT
- adolescent focused therapy for anorexia
29
What are the main psychological interventions for adults with eating disorders?
- MANTRA and SSCM for anorexia
- CBT
30
What does psychoeducation for eating disorders focus on?
- effects of starvation on the body and mind
- regulating body weight
- dieting
- adverse effects of inappropriate compensatory behaviours
31
What is the goal of psychological interventions for eating disorders?
- increasing confidence in making good decision when coping with stress which don't include food or eating
32
What are the most common medications used for eating disorders?
- SSRIs for depression and anxiety
- olanzapine or aripiprazole to reduce emotional dysregulation during refeeding
33
What are the key things to remember about medication for eating disorders?
- should never be used on its own
- tend to manage comorbidities or support symptoms short-term
34
What are the long term complications of eating disorders?
- death
- growth stunting
- osteoporosis
- pregnancy complications
- dental erosison
- mental health comorbidities
- substance misuse
35
What are the outcomes for eating disorders?
- 80% of young people go into remission
- later onset and certain personality traits increase likelihood of persistence
