Eating Disorders Flashcards
Anorexia Nervosa- Diagnostic criteria
Refuse to maintain minimal weight for age and height (85% of what is expected)
To spite being under weight they have an intense fear of gaining weight, getting fat
Amenorrhea in postmenarchal females (for 3 consecutive cycles)
disturbance in body image experience
undue influence of body weight or shape on self evaluation
denial of serious of current low body weight
What are the 2 types of anorexia nervosa
restricting type
binge purge type
Describe restricting type of anorexia nervosa
what % of anorexics is this
Starve themselves
50%
Describe the binging/ purging type of AN
what % of anorexics have this type
Will eat and then purge
50%
What are methods of purging used in AN
self induced vomiting
misuse of laxatives
diuretics
enemas
Anorexia Nervosa onset
mid teens
anorexia nervosa affects what age range
14-30
anorexia nervosa males vs females
10-20x more common in females
what % of adolescent girls are anorexic
1%
what % of adolescent girls have some symptoms but dont meet all of the criteria
5%
what conditions are comorbid with anorexia nervosa
depression (65%)
Social anxiety disorder (34%)
OCD (26%)
Etiology of Anorexia nervosa
biological factors- family history is important
social factors
psychological factors- dont develop a sense of self outside of their body image, a lot of it has to do with the familial environment
Clinical features of anorexia nervosa
Have a rigid/ perfectionist cognitive style
delayed psychosocial development
they are hungry but make a conscious choice not to eat
They have an altered sense of self both visually and cognitively
They are deceptive about their eating habits so other people don’t find out
Physical signs of Anorexia Nervosa
weight loss is apparent hypothermia bradycardia (HR<50) dependent edema b/c lack protein hypotension Lanugo Dehydration
Complications of weight loss in anorexia nervosa
cachexic skeletal- weak bones hematological- low WBC, anemic Cardiac arrhythmia or failure GI- constipated Reproductive- amenorrea dermatological- dry skin, hair, and nails neuropsychiatric problems- seizures and cognitive dullness
Lab findings in Anorexia nervosa
EKG changes Metabolic changes Leukopenia mild hypothyroid dec in reproductive hormones
Effects of emesis and laxative abuse in anorexia nervosa
metabolic effects
ulcers
dental problems
neuropsychiatric–> seizures
DDx in Anorexia nervosa
depressive disorder
somatotization disorder
schizophrenia
Bulimia nervosa
prognosis of Anorexia nervosa
25% recover completely
50% will be much improved
25% will be chronically underweight
What is the mortality rate of anorexia nervosa
7%
Treatment of Anorexia Nervosa
Hospitalization to deal with acute symptoms
individual and family psychotherapy
Is there a role for pharmacotherapy in treating anorexia nervosa
NO
Criteria for Bulimia Nervosa
episodes of eating more than other people accompanied by feeling like its not in your control.
This is followed by compensatory behaviors to prevent weight gain
this occurs about twice/ week for 3 months
self evaluation is unduly tied to body shape and weight
the disturbance does not occur exclusively during episodes of anorexia nervosa
ESSENTIALLY THESE ARE FAILED ANOREXICS
What compensatory mechanism are used by bulimics to prevent weight gain
self induced vomiting laxatives enemas fasting excessive exercise
