Eating Disorders Flashcards
RF for eating disorders?
- genetics
- psychological RF: perfectionism, obsessive-compulsiveness, neuroticism
- developmental: early childhood abuse/disturbance, obesity in childhood
- cultural: cultural standards, society, social media, pressures from activities
def eating disorder
disruptive eating behaviour with excessive concern about body weight that results in impaired functioning and impaired physical health
def binge eating disorder
binge eating activity ➔ consuming food in a larger amount than normal in a short time period
no purging/compensatory behaviour
no obsession about weight/body shape
def bulimia
binge (eat tons in short period of time) and purging (compensatory behaviour) activity ➔ vomiting, laxatives, diuretics, excessive exercise
fear of gaining weight despite
normal weight
def anorexia nervosa
very low weight, fear of gaining weight/strong desire to be thin, and distorted body image
how do people feel after binging in binge eating disorder?
guilt
shame
disgust
types of anorexia nervosa (2)
- restricting type ➔ lose weight via fasting, excessive exercise
- binging/purge-eating time ➔ vomiting, laxatives, diuretics
healthy BMI
15.5-24.9
underweight BMI
<18.5
overweight BMI
> 25
cardiac cx of eating disorders
- arrhythmias
- sudden death
- hypotension
- bradycardia
- prolonged QT interval
differentials for obesity
- medication use ➔ antipsychotics, antidepressants (SSRI), steroids, BB, OCP
- endocrine: Cushing’s, hypothyroid, PCOS
- fluid retention from cardiac or renal failure
- low physical activity
- genetic ➔ Prader-Willi
GI cx of eating disorders
- Mouth sores/ulcers
- Mallory Weiss tears
- esophageal tear
- vitamin deficiency: folate, B12, thiamine, D
GU cx of eating disorders
- amenorrhea
- stones
what are immediately life threatening cx of eating disorders
- arrhythmias
- bradycardia
- electrolyte imbalances ➔ refeeding syndrome
- dehydration (hypotension)
what is refeeding syndrome?
Clinical and metabolic changes from aggressive nutritional rehabilitation of a malnourished pt
Tx for eating disorders?
- nutritional support ➔ dietician, pt education on caloric requirements/portion sizes; replace vitamins and minerals
- therapy ➔ CBT and interpersonal therapy ➔ group, family therapy
- tx comorbid conditions ➔ SSRI for depression
- consider giving antipsychotics to increase weight and suppress ED thoughts
- consider admission if vitals unstable (<65% standard body weight, hypovolemic, bradycardic or tachycardic, hypothermia, etc.) refer to guidelines
Other cx of eating disorders (1xderm, 1xneuro, 1xmsk)
- lanugo: soft fine hair to protect vs the cold
- seizures
- osteoporosis ➔ stress fractures
general LT cx for eating disorders (thick big picture for the younger pt)
infertility
delayed puberty or failure to thrive
cx of obesity from BED
CVD
stroke
MI
DM
OSA
