Eating Disorders Flashcards
5 kinds of eating
anorexia, bulimia binge and purge, healthy, binge, obesity
anorexia nervosa diagnostic criteria
restriction of energy intake leading to significantly low body weight, intense fear of gaining weight or becoming fat
demographics of anorexia nervosa
more diagnosed in females (3:1), ~0.9% prevalence
common comorbidities of anorexia nervosa
depression, OCD, suicidal ideation
those with _____ are more likely to be affected by anorexia nervosa
1st degree relatives
there are two types of anorexia nervosa
restricting type and binge-eating/purging type
what is restricting anorexia
weight loss accomplished by dieting, fasting, or excessive exercise
what is binge-eating/purging type of AN
individual has engaged in recurrent episodes of self-induced vomiting or the misuse of laxatives, diuretics, or enemas
what BMI is considered AN
18.5
What BMI is considered severe AN
less than 15
Consequences of AN (12)
- slow heart rate
- low BP
- decreased bone density
- weakness
- electrolyte imbalance (hypoglycemia)
- dry skin
- hair loss
- severe dehydration
- down layer of hair all over body (lanugo)
- cold intolerance
- delayed gastric emptying
- constipation
what are the treatment focuses of inpatient vs outpatient AN care
inpatient is treatment of acute risks and outpatient is treatment of chronic symptoms and relapse prevention
suicidality, psychosis, severe electrolyte imbalances, and cardiac irregularities are ____ focuses of inpatient care
acute
what is the goal weight increase per week of inpatient AN care
2-3 lbs
what is the goal weight increase per week of outpatient care
0.5-1lb/week
what is re-feeding syndrome
the shift from fat metabolism to glucose metabolism, rapid glucose metabolism and increased insulin secretion
what are the 3 results of re-feeding syndrome
hypokalemia, water retention, and severe edema
Re-feeding may cause what (SEVERE)
multiple organ failure
What does CCI stand for in AN treatment
concern, correct, increase
what is the concern phase of AN treatment
concern of re-feeding syndrome with initial treatment
what is the correct phase of AN treatment
correct electrolytes, fluid deficits, thiamine, vitamin b complex, and other multivitamin supplements
what is the increase phase of AN treatment
increase calories slowly (as low as 300-700 kcal/day
In addition to physical feeding therapy, what other treatments should be considered for anorexia nervosa
CBT for best outcomes and psychotherapy
What drug therapy is FDA approved for anorexia nervosa
none
olanzapine can be used for AN to do what
modest weight gain
Are SSRIs helpful for anorexia nervosa
little benefit for core symptoms
what medication is contraindicated in anorexia nervosa
bupropion
what is binge eating
recurrent episodes of binge eating at least once a week for 3 months, not associated with inappropriate compensatory behavior (purging)
how many calories count as a binge
average of 3,500, some can eat 6,000-10,000 in one episode
demographics of binge eating disorder
more common in females but less skewed than anorexia nervosa, tends to run in families
common co-morbid conditions with binge eating disorder
depression, anxiety, borderline personality disorder, and substance use disorder
Mild BED episode number
1-3
Moderate BED episode number
4-7
severe BED episode number
8-13
extreme BED episode number
over 14
Health consequences of binge eating disorder (5)
hypertension, elevated cholesterol, CVD, T2DM, gallbladder disease
What therapy combination provides the best outcomes for patients with binge eating disorder
CBT + Medication
what drug is approved for the treatment of moderate to severe binge eating disorder
lisdexamfetamine (vyvanse)
Bulimia Nervosa demographics
more diagnosed in females, similar ratio to anorexia nervosa
what history increases the risk for bulimia nervosa
anxiety as a child, HX of sexual for physical abuse, childhood obesity, early pubertal maturation
what is bulimia nervosa
recurrent episodes of binge eating with recurrent inappropriate compensatory behaviors to prevent weight gain that occurs at least once a week for 3 months
Bulimia Nervosa methods of purging (5)
vomiting, laxatives, diuretics, excessive exercise, diabulimia
what is diabulimia
pts with diabetes give themselves less insulin than they need or stop taking insulin to promote weight loss
outward bulimia nervosa signs of purging may include
teeth, lips, eyes, hands
consequences of bulimia nervosa
digestive tract consequences, amenorrhea, orthostatic hypotension, bradycardia, arrhythmias, osteopenia, osteoporosis
what treatment combination provides the best outcomes for patients with bulimia nervosa
CBT + medication
what medication is FDA approved for bulimia nervosa
fluoxetine
