Eating Disorders

Question 1

what are the main eating disorders
(6)

Answer 1

Anorexia Nervosa
Bulimia Nervosa
Binge eating disorder
Avoidant Restrictive Food Intake Disorder (ARFID)
Pica
Rumination-regurgitation disorder

Question 2

what causes an eating disorder

Answer 2

Biology - genetics, allergies etc

Co-morbid - depression, bipolar, substance misuse

Personality - anxious, low self-esteem

social - interpersonal problems with relationships, bullying, trauma etc

Question 3

what is anorexia

Answer 3

restriction of food intake
associated with body image disturbance and fear of gaining weight

Question 4

what is bulimia

Answer 4

recurrent episodes of binge eating followed by self-induced vomiting/ laxative use or excessive exercise

Question 5

what is binge eating

Answer 5

recurrent episodes of mass eating without compensatory behaviour

Question 6

what is AFRID (avoidant restrictive food intake disorder)

Answer 6

not eating particular foods resulting in weight loss, and nutritional deficiency

normally with other diagnosis (autism, OCD)

NOT avoiding food to loose weight

Question 7

what is pica

Answer 7

eating non-consumable foods or objects

Question 8

what is a healthy BMI range

Answer 8

18.5 to 24.9

Question 9

what is under-weight ranges

Answer 9

Less than 18.5

Question 10

what is the overweight ranges

Answer 10

25 to 29.9

Question 11

what is the function of leptin

Answer 11

inhibits appetite

Question 12

what are the leptin levels in someone with anorexia

Answer 12

low
(released from adipose tissue which they don’t have)

Question 13

what happens to leptin levels when someone with anorexia started to gain weight

Answer 13

leptin increases

Question 14

what is the function of grelin

Answer 14

released by stomach
increases appetite (makes you hungry)

Question 15

what are the ghrelin levels in an anorexia patient

Answer 15

much higher than a normal person

Question 16

what is the impact of low leptin in anorexia

Answer 16

increased ACTH, cortisol
reduced TSH
T4 &T3 reduced - reduced sex hormones

Question 17

how is someone with an eating disorder likely to present to A&E

Answer 17

Syncope
Sports injuries
Fractures
Palpitations, chest pain, MI
Abdo pain
Atypical infections / sepsis
Self-harm – 54%
Substance misuse – 35%
DKA

Question 18

what are the 3 stages in starvation of how glucose is produced

Answer 18

1. glycogen depletion
2. ketogenesis (fat metabolised)
3. proteins catabolised - organ dysfunction

Question 19

what are the side effects of long term self induced vomiting and laxative use

Answer 19

low potassium
dental erosion
trauma to mouth and oesophagus
dehydration and electrolyte dysfunction
abdo cramps

Question 20

what is refeeding syndrome

Answer 20

In a starvation state: endogenous energy stores are catabolised , Insulin production ↓, Electrolytes are ↓especially phosphate, potassium and magnesium

On refeeding insulin production ↑in response to carbohydrate intake. Stimulates electrolyte uptake into cells leading to ↓in already low serum electrolytes. Results in peripheral oedema

Question 21

drop in what can cause multi-organ failure, coma and death

Answer 21

phosphate
needed for energy production in every cell

Question 22

what are the signs and symptoms of low phosphate

Answer 22

muscle weakness, SOB, double vision, swallowing prob’s, seizures, coma, cardiomyopathy

Question 23

what are the signs and symptoms of low magnesium

Answer 23

nausea and vomiting, anorexia, tremors, muscle spasms, seizures, coma, cardiac ischaemia, arrythmia

Question 24

what are the signs and symptoms of low potassium

Answer 24

muscle weakness, cramps, fatigue, constipation, arrythmia, respiratory failure

Question 25

what are the signs and symptoms of thiamine deficiency

Answer 25

delirium, vision prob’s, hypothermia, ataxia, amnesia, confabulation

Question 26

what 3 vitamins do you need to monitor in refeeding

Answer 26

phosphate, potassium and magnesium

Question 27

can someone with an eating disorder be force fed

Answer 27

yes
it is a mental health disorder, so I you can show no capacity then you can section and give food as a treatment