eating disorders Flashcards
Bulimia
uncontrolled eating binges
compensate with purging
laxatives/ vomiting
how can you compensate a purge?
vomiting, diuretics, over exercising
two subtypes of Bulimia nervosa?
over exercising / restricting and purging
with bulimia what kind of support to help?
dental ; pitted teeth
callous on knuckles - Russell’s sign
diuretic : electrolyte abnormality
laxative: electrolyte abnormality
what medication can help bulimia ?
consider family therapy
bulimia nervosa focused guided self help programme
SSRI’s fluoxetine shown to reduce binge and enhance impulse control
recommend BEAT
refeeding syndrome
depletion of cardiac muscles secondary to starvation
but when food intake is released insulin is released
this causes changes in potassium, phosphate, magnesium
low phosphate > cardiac failure
how to avoid refeeding syndrome
measure all electrolytes
monitor every 5-7 days
start at 1200 every 5 days
monitor for tachycardia and oedema
anorexia nervosa
self induced weight loss primarily through restricted food intake
anorexia nervosa
> 15% below normal BMI <17.5
amenorrhoea
binge purge
restrictive
blood test changes in AN
low LH, FSH, oestradiol, T3
increased cortisol
hypogylcaemia
hypokalaemia, hyponatraemia, metabolic alkalosis
prolonged QT interval
AN management
CBT
maudsley anorexia nervosa treatment for adults
SSCM
children AN management
1st line: anorexia focused family therapy
2nd: CBT
where can you refer for severe AN
community eating disorder service
CEDS
