eating disorders Flashcards
DSM for AN
the behaviors and psychopathology are present for
Restriction of energy intake relative to requirements,
B . Intense fear of gaining weight or of becoming fat, or
persistent behavior that interferes with weight gain
C . Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight
At least 3 months
vital signs :
Lanugo hair*
Electrolyte changes*
*ECG changes :
*Endocrine changes : Low luteinizing hormone, low
follicle-stimulating hormone, low estrogen or
testosterone, low T3, increased ———–
CBC :
hypoglycemia-3
elevated BUN-4
5-TFT ( hypothyroidism)
6-elevated serum salivary amylase concentration if the Pt
bradycardia, hypotension, hypothermia
chronic hypochloremic hypokalemic metabolic alkalosis
T-wave flattening or inversion, ST
segment depression, lengthening of QT interval*
prolactin
anemia-1
is vomiting.
Biological factor
.
NT : serotonin, norepinephrein and dopamine dysregulation-
.PET scan : higher metabolism in the caudate nucleus
- Social factor
may be seen with greatest frequency among young women in
profession that requires thinness as modeling and ballet.
-Families of children with eating disorder may exhibit high level
of hostility and low level of empathy
psychological factors-
Many experience their bodies as somehow under the control
of their parents, so that self-starvation may be an effort to gain
.validation as a unique and special person
AN prevlance 10 to 20 times more often in females
than in males.\
most frequent in developed
countries
14-18
READ AGAIN
Severity based on BMI:
1-Mild =
2-Moderate =
3-Severe =
4-Extreme severe =
BMI >17 kg/m2
BMI 16-16.99 kg/m2
BMI 15-15.99 kg/m2
BMI <15 kg/
Suicide rate is higher in persons with ———– type of anorexia nervosa than in those with the
restricting TYPE
half of patients with anorexia nervosa eventually
will have the symptoms of bulimia, usually within the first
year after the onset of anorexia nervosa
binge eating purging
Mortality rate is high 5-18% due to medical complication
Anorexia Nervosa is associated with depression in
65 % of cases, social phobia in 35% of cases, and OCD in
25% of cases.
AN Tx
Food is the best medicine!
hospital administration
cbt
ssri has no role in AN
BULIMIA NERVOSA DSM-5
. Recurrent episodes of binge eating
2-Recurrent inappropriate compensatory behaviors in
order to prevent weight gain
3-The binge eating and inappropriate compensatory
behaviors both occur, on average, at least once a week for
3 months.
4-Self-evaluation is unduly influenced by body shape and
weight.
5. The disturbance does not occur exclusively during
episodes of anorexia nervosa.
Etiology
1-Biological factors:
-Neurotransmitters: Antidepressants often benefit patients with
bulimia nervosa because serotonin has been linked to satiety,
serotonin and norepinephrine have been implicated.
-MRI : exaggerated perception hunger signals related to sweet
taste mediated by the{{{{{ right anterior insula area of the brain }}}}}}}}}}
:Social factors-2
*Patients with bulimia nervosa, as with those with anorexia
nervosa, tend to be high achievers and to respond to societal
pressures to be slender
Psychological factors: -3
-patients with bulimia nervosa are more
outgoing, ((angry, and impulsive ))0than those with .anorexia nervosa
Bulimia nervosa prognosis
higher rates of
partial and full recovery (40% fully recovered at
follow-up
Cases need hospitalization in bulimia nervosa :
1-additional psychiatric
symptoms.
2-Electrolyte and metabolic disturbance resulting
from severe purging.
3- not response to outpatient TT.
the only drug approved for bulimia nervosa is
avoid———cause they already have fked up metabolites disturbances
fluoxetine ( increase serotonin so satiety) .
* Avoid bupropion because increase risk of seizure .
————– disorder is the most common eating
disorder.
*It is more common in female (4%) than in male (2%
Binge eating
