Eating disorders Flashcards
Anorexia nervosa
Restriction of energy intake leading to a significantly low body weight
Intense fear of gaining weight or becoming fat
Depression
Restricting type anorexia nervosa
During the last 3 months, the individual has NOT engaged in recurrent episodes of binge eating or purging behavior
Weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise
Binge-eating/Purging Type Anorexia nervosa
During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
The difference between purging subgroup and bulimia nervosa disorder is the low body weight for AN
Mild: BMI
> 17kg/m2
Moderate: BMI
16-16.99 kg/m2
Severe: BMI =
15-15.99 kg/m2
Extreme: BMI
<15kg/m2
normal BMI
BMI 18.5 kg/m2 to be the low end of normal
AN consequences
Abnormally slow heart rate, low blood pressure, Decreased bone density, weakness,electrolyte abnormalities hypoglycemia,Dry skin, hair loss,Severe dehydration, Downy layer of hair (lanugo) all over body,Cold intolerance
Delayed gastric emptying Constipation
AN tx focus
inpatient:Treatment of acute risks
outpatient:Treatment of chronic symptoms and relapse prevention
AN-re-feeding syndrome
In starvation, energy is principally derived from fat. Re-feeding results in shift from fat metabolism to glucose metabolism
Hypokalemia, water retention, and severe edema Multiple Organ Failure need to increase calories slowly
AN tx
increase calories slowly
cognitive behavioral (best outcome)
buproprion contraindicated
Binge eating Disorder
Recurrent episodes of binge eating at least once a week for 3 months
NOT associated with the recurrent use of inappropriate compensatory behavior
mild BED
1 – 3 episodes per week
Moderate BED
4 – 7 episodes per week
Severe BED
8 – 13 episodes per week
Extreme BED
14 episodes per week
BED health consequence
similar to what observed in obesity
BED tx
CBT, Lisdexamfetamine (Vyvanse®) is FDA-approved or combo for best outcomes
Bulimia Nervosa
Recurrent episodes of binge eating, Recurrent inappropriate compensatory behaviors, at least once a week for 3 months
Mild BN
1 – 3 episodes per week
Moderate BN
4 – 7 episodes per week
Severe BN
8 – 13 episodes per week
Extreme BN
> 14 episodes per week
BN health consequences
Recurrent bingeing and purging can affect the entire digestive tract, Inflammation, gastric rupture, and esophageal rupture from frequent vomiting (Mallory Weiss Tears)
Diabetic Ketoacidosis from withholding insulin in Type 1 DM
BN Tx
CBT+ Med for best outcome
Fluoxetine is FDA-approved
