Eating Disorders Flashcards
List the main types of eating disorders
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
describe anorexia nervosa
- With anorexia nervosa, the person feels they are overweight despite evidence of normal or low body weight.
- It involves obsessively restricting calorie intake to lose weight.
- Often, the person exercises excessively and may use diet pills or laxatives to limit the absorption of food.
clinical features of anorexia nervosa
- weight loss (e.g., rapid weight loss > 20% in 6 ,months or BMI less than 18.5)
- amenorrhoea (absent periods)
- lanugo hair (fine, soft hair across most of the body)
- hypotension
- hypothermia
- mood changes, including anxiety and depression
why does anorexia nervosa cause amenorrhea?
Occurs due to disruption of the hypothalamic-pituitary-gonadal axis. There is a lack of gonadotrophins (LH and FSH) from the pituitary, leading to reduced activity of he ovaries (hypogonadism).
Anorexia nervosa complications
- Cardiac complications include arrhythmia, cardiac atrophy and sudden cardiac death.
- Low bone mineral density > osteoporosis.
what has the highest mortality rate of any psychiatric condition?
anorexia nervosa
how does bulimia nervosa differ from anorexia nervosa?
- Unlike anorexia, people with bulimia often have a normal body weight. Their body weight tends to fluctuate.
- The condition involves binge eating, followed by purging by inducing vomiting or taking laxatives to prevent the calories from being absorbed.
bulimia nervosa clinical features
- erosion of teeth
- swollen salivary glands
- mouth ulcers
- gastro-oesophageal reflux
- calluses on the knuckles where they have been scraped across the teeth (called Russell’s sign)
what eating disorder can more commonly cause alkalosis?
- bulimia nervosa
- can occur after repeated vomiting of hydrochloric acid from the stomach
describe binge eating disorder
- Characterised by episodes where the person excessively overeats, often as an expression of underlying psychological distress.
- This person typically feels loss of control.
- It is not a restrictive condition like anorexia or bulimia, and patients are likely to be overweight.
what are some possible blood test findings in restrictive eating disorders?
- anaemia (low haemoglobin) *
- leucopenia (low white cell count) *
- thrombocytopenia (low platelets) *
- hypokalaemia (low potassium - due to vomiting or excessive laxatives)
- caused by reduced bone marrow activity
eating disorder management
- will involve specialist services and MDT
- self help resources
- psychological therapies e.g. CBT
- alternatively, IPT, or fluoxetine 60mg daily (or anu antidepressant in high dose)
- olanzapine
- severe cases may require compulsory admission for observed refeeding and monitoring for refeeding syndrome.
refeeding syndrome features
- hypomagnesaemia
- hypokalaemia
- hypophosphataemia
- fluid overload
how is refeeding syndrome managed?
- slowly reintroducing food with limited calories
- magnesium, potassium, phosphate and glucose monitoring
- fluid balance monitoring
- ECG monitoring in severe causes
- supplementation with electrolytes and vitamins, particularly B vitamins and thiamine
what is the most common eating disorder?
- Other specified feeding or eating disorder (OSFED)
- a person may have OSFED if their symptoms do not exactly fit the expected symptoms for any specific ED.
- e.g. atypical anorexia, atypical bulimia, purging disorder, night eating syndrome.
