Eating Disorders Flashcards
Diagnostic features of anorexia nervosa?
Significantly low BMI (<18.5), rapid weight loss >20% in 6mths
Extreme fear of weight gain
Excessive pre-occupation with body weight or shape
Relies on compulsive compensatory behaviours when food cannot be avoided.
As mentioned, anorexia relies on compulsive compensatory behaviours when food cannot be avoided.
Give some examples of these behaviours.
Self-induced vomiting
Laxative abuse
Excessive exercise
Abuse of appetite suppressants/diuretics
What are some features/symptoms of anorexia nervosa?
Cold intolerance
Blue hands and feet
Constipation
Bloating
Delayed puberty
Amenorrhoea, primary or secondary
Dry skin
Fainting
Hypotension
Lanugo hair
Scalp hair loss
Early satiety
Weakness
Fatigue
Short stature
Osteopenia, osteoporosis
What are some of the warning signs of anorexia nervosa?
Avoiding meals
Eating in secret
Slow eating, picking food
Cooking for others, but not eating
Raiding the fridge
Leaving table after eating
Daily exercise
Low calorie foods
Denial of dieting
Excessive school work
Intolerant of disruptions to daily routine
Wearing baggy clothing
Constant reading of food labels
Body checking
Medication abuse
What is bulimia nervosa?
Episodes of binge eating with a sense of loss of control.
Binge eating is followed by a compensatory behaviour
What are some of the compensatory behaviours seen in bulimia nervosa after binging?
Purging type:
-self-induced vomiting
-laxative abuse
-diuretic abuse
-insulin omission
Non-purging type:
-excessive exercise
-fasting
-strict diet
Signs and symptoms of bulimia nervosa?
Mouth sores
Pharyngeal trauma
Dental caries
Heartburn, chest pain
Oesophageal spasm
Impulsivity: stealing, alcohol abuse, drugs/alcohol
Muscle cramps
Weakness
Bloody diarrhoea
Irregular periods
Fainting
Swollen parotid glands
Hypotension
What is meant by a binge eating disorder?
Similar to bulimia, but lack of ‘purging’ behaviours
Ongoing and/or repetitive cycles often include:
unusually fast eating, usually alone.
unusually large amounts consumed.
uncomfortably full; often “buzzed” after eating.
embarrassment, shame, guilt, depression
TIDE?
Type 1 diabetic related eating disorder
->can be anorexia variant or bulimia variant
Why may a patient with anorexia nervosa open windows or not wear enough layers?
They are trying to force themselves to shiver, to use up energy
For a diagnosis of bulimia nervosa to be made, how often does do the binging and compensatory behaviours need to take place?
A minimum of once per week over at least a month.
ARFID?
Avoidance Restrictive Food Intake Disorder
What happens in ARFID?
Avoidance or restriction of food intake for a number of reasons.
->e.g. sensitivity to texture, smell or appearance of certain foods. A previous bad experience with food EG choking or vomiting leading to concern about the consequences of eating.
OSFED?
Other specified feeding or eating disorder
Which conditions fall under OSFED?
A person may have OSFED if their symptoms do not exactly fit the expected symptoms for any specific ED.
Some examples are Atypical anorexia ( similar behaviours but weight remains within a normal range) or Atypical bulimia ( binges don’t happen as often or over as long a period of time). Purging disorder, not part of a binge/purge cycle. Night eating syndrome.
This is the most common eating disorder.
Which psychiatric condition has the highest death rate?
Anorexia nervosa
Which other condition may ARFID be more common in?
Those with autisim
What are some of the precipitating factors for eating disorders?
Puberty
Dieting or even non-deliberate weight loss
Increased exercise
Stressful life events
What are some of the perpetuating factors for eating disorders?
Delayed gastric emptying- feelings of fulless, ‘fatness’
Narrowing focus- avoidance of interpersonal interest, change of values so that food becomes the most salient stimulus
Obsessionality- body checking
What can be done in the treatment of eating disorders?
Refeeding
CBT
IPT- interpersonal therapy
Antidepressants
Olanzapine- anti-psychotic
Specialised family work for anorexia nervosa, particularly for younger patients
