Eating disorders Flashcards
Anorexia Nervosa
Restriction of energy intake leading to a significant low body weight
Intense fear of gaining weight or becoming fat
Common to see depression and anorexia together
Restricting type anorexia
restricting intake
no binge
excess exercise
Binge eating/ purging type
during last 3 months patient has engaged in recurrent episodes of binge eating or purging behavior
DOES NOT HAVE LOW BODY WEIGHT
Normal BMI
18.5kg/m^2
Anorexia severity ranking
Ranking based off of BMI
Health consequences of anorexia
Abnormally slow heart rate, low blood
pressure
Dry skin, hair loss
Decreased bone density
Weakness Downy layer of hair all over body
electrolyte abnormalities hypoglycemia
Cold intolerance
delayed gastric emptying, constipation
Inpatient hospitalization
24hrs a day, 7 days a week
treatment of acute risks
increase weight by 2-3lbs per week
Outpatient hospitalization
Treatment of chronic symptoms and relapse prevention
8-10hours/day, 5-7days/week
Re-feeding syndrome
re-feeding results in shift from fat metabolism to glucose metabolism
hypokalemia, water retention, severe edema
Multiple organ failure
Treatment
increase calories slowly (often eating as low as 300-700kcal/day)
Cognitive behavioral Therapy
Pharmacotherapy treatment
No FDA approved drug therapy
Olanzapine - modest weight gain
SSRIs - little benefit for core symptoms
Bupropion is contraindicated
Binge eating disorder
Recurrent episodes of binge eating
at least once a week for 3 months
NOT associated with recurrent use of inappropriate compensatory behavior (like excess exercise, inappropriate use of laxative)
Ranking severity for binge eating disorder
Based off episodes per week
Binge eating health consequences
Hypertension
Type 2 diabetes
Gallbladder disease
cardiovascular disease
elevated cholesterol
Binge eating disorder - treatment
Lisdexamfetamine (Vyvanse)
cognitive behavioral therapy and medication provides the best outcomes
