Eating Disorders (21) Flashcards
Define obesity:
More than 20% over ideal body weight (MBI >30)
What are the genetic components involved in obesity?
Leptin receptor mutation
Melanocortin 4 receeptor mutation
What are the iatrogenic components involved in obesity?
Anti- psychotics and/ or ant-depressants
Block H1, Ach, 5HT2c receptors
Increase prolactin by D2 recptor blockade
How can ovesity be managed by surgical means?
Bariatric surgery and gastric banding
How can obesity be managed by pharmacologic means?
Amphetamines, orlistat (lipase inhibitor), AEDs
What are the DSM 5 criteria for anorexia nervosa Dx?
Refusal to maintain 85% typical weight
Restriction of energy intake requirements
Fear of gaining weight
Dysmorphism
What does restricting refer to?
Does not perge, does not eat
What is the severity of anorexia based on?
BMI
What is the prevalence of anorexia?
0.5-4%
Females> Males
What are some possible causes of anorexia?
Industrialization, job?, media?, Personality profile of rigid and controlling
In anorexia, neuroepinephrine levels can be….
Low
T/F: Fear of independence and maturation is a major cause of anorexia
true
What are the comorbidities associated with anorexia?
1- Depression
2- Suicide risk
3- OCD
4- Anxiety disorders
5- Denial/ delusions
6- Minimalization
What are some medical issues seen in anorexia? (9)
1- Weight loss
2- Hypothermia
3- Bradycardia, hypotension
4- Hypokalemia
5- EKG changes
6- LANGUO HAIR
7- Osteoporosis
8-Metabolic acidosis
9- Organ Failure
What symptoms usually persist during recovery from anorexia?
Food preoccupation, poor social relations, depression
Why/ when is hospitization needed for anorexia?
Needed to restore nutritional state once 20% typical weight is loss
Forced tube feedings is severe, end organ damage, electrolyte or cardiac findings or patient unwilling to comply
What programs are used during hospitalization for anorexia treatment?
AM weights, I/Os, labs, inaccessible bathrooms, progressive diets
What psychotherapy is used for anorexia?
Psychodynamic, CBT, Family
What Rx is used for anorexia?
TCA, SSRI, Weight gain cocktails
What is the DSM 5 criteria for Bullemia nervosa Dx?
Recurrent binge eating (1X/ wk for 3 months)
Purging and non purging types
No anorexia present
Compensatory behaviors are present
What is binge eating?
eating an atypically large amount in discrete period of time disproportionate to typical eating
What are the compensatory behaviors seen in bulimia?
vomiting, laxative use, enemas, diuretics, exercise
Which has a greater prevalence, anorexia or bulimia?
Bulemia
Describe the typical weight of a bulimic patient?
Normal to overweight
Possible etiology of bulimia?
Serotonin loss, increased endorphins, perfectionism of society
Medical conditions seen in bulimic patients? (6)
1- Poor dentition. enamel loss, cavities
2- RUSSEL’S SIGN (Abraided knuckles)
3- Normal/ overweight
4- Lab changes (low PO4 and Mg, high amylase)
5- Salivary enlargement
6- Esophagitis/ tears
Typical course of a bulimic patient?
Better than anorexia, wax/ wane course over the years
What treatment is used for bulimia? (incude psycho and Rx)
CBT, group therapy, family therapy
SSRI, TCA, MAOI
What does the following describe?
1- Failure to meet diet/ energy needs
2- Weight loss, nutritional deficiency, supplementation need, psychosocial distress
3- Doesn’t meet full anorexia criteria
Avoidant/ Restrictive Food Intake Disorder
What does the following describe?
1- Binges (1X/ wk for 3 months)
2- Lack of control
3- Ego dystonic
4- No purges or compensations
Binge eating disorder
What is PICA?
Presistent eating of non- nutritive substances x1 mo
Not developmentally or culturally appropriate
No medical form of intellectual disability/ autism
What is rumination?
Repeated regurgiation adn re chewing of food
No weight gain
Often > 6yo
