Eating disorders Flashcards
Anorexia DSM-V criteria
Calorie Restricting Behaviors
Body weight less than 85% expected
Intense fear of weight gain
Body Image Disturbance
Bulimia DSM-V criteria
Recurrent episodes of binge eating followed by self-induced vomiting, laxative or other purgative use (including over exercise)
Self evaluation influenced by body size and shape
Binge/purge behaviors occur at least 1 time per week for 3 months
Binge eating Disorder DSM-V criteria
Eating a large amount of food in a short time span
Feeling out of control with food
Frequent dieting without weight loss
Feeling depressed, disgusted or upset about one’s eating
Risk Factors for eating disorders
participation in activities that promote thinness, such as ballet dancing, modeling, and athletics
personality traits: low self-esteem, difficulty expressing negative emotions, difficulty resolving conflict, and being a perfectionist
Young women with Type 1 diabetes
Family Hx may play a part
Mood disorders in 1st degree relative may play a part
What are the SCOFF questions?
Do you make yourself Sick (induce vomiting) because you feel uncomfortably full?
Do you worry that you have lost Control over how much you eat?
Have you recently lost more than One stone (14 lb [6.4 kg]) in a three-month period?
Do you think you are too Fat, even though others say you are too thin?
Would you say that Food dominates your life?
How are the SCOFF questions scored?
One point for every yes answer; a score ≥ 2 indicates a likely case of anorexia nervosa or bulimia nervosa
Differential Diagnosis for anorexia.
Inflammatory bowel disease Thyroid disease (HYPER-low weight/HYPO-high weight) Cushing’s syndrome (High weight) Diabetes Mellitus CNS lesions Occult malignancy Chronic infections Regional enteritis Chronic infection Kleine-Levin syndrome (excessive sleep eating) - Pt Not associated with the concern of weight gain Mood disorders Major depressive disorder - This person is not obsessing about their weight or shape…just miserable Personality disorders - Borderline: poor impulse control OCD Substance abuse Psychotic Disorders
Medical consequences from eating disorders?
Related to starvation and purging behaviors. DMII Kidney Failure Heart Failure Irreversible Heart Damage Kidney Failure (laxatives) Dental Problems (bulimia)
Anorexia S/S
unconcerned about significant weight loss lack of interest in sex denial denies depression intense fear of obesity
Bulimia S/S
Worry about weight gain
Distress about having disorder
Relatively normal sexually
Reports depression
- amenorrhea
- constipation
- headaches
- fainting
- dizziness
- fatigue
- cold intolerance
Anorexia Hx and symptoms
- Bloating
- Fullness
- Lethargy
- GERD
- Abdominal pain
- Sore throat (vomiting)
Bulimia Hx and symptoms
- Cachexia (general phys. wasting)
- acrocyanosis (cyanos of extreme)
- dry skin
- hair loss
- bradycardia
- orthstatic hypotension
- hypothermia
- loss of muscle mass and subQ fat
- LANUGO
Anorexia physical findings
- knuckle calluses
- dental enamel erosion
- salivary gland enlargement
- cardiomegaly
Bulimia physical findings
- hypoglycemia
- leukopeina
- elevated Liver enzymes
- euthyroid sick syndrome
- Low TSH, normal T3, T4
Anorexia Labs
