Eating disorders Flashcards
What are some iatrogenic causes of obesity?
- anti-psychotics and/or antidepressants
- block H1 –> increase appetite
- block achm –> weight gain
- block 5-HT2c –> sensitivity of leptin, increase weight
what are 3 pharmacologic therapies for obesity?
- amphetamines (decreases appetite)
- orlistat (lipase inhibitor) –> can’t absorb fat; side effect: diarrhea
- topiramate and zonisamide (anti-convulsants)
What’s is the DSM-5 diagnosis of anorexia nervosa?
- refusal to maintain 85% typical weight
- restriction of energy intake requirements –> low body weight
- fear of gaining
- body image disturbance (dysmorphism)
- missed menstrual cycles x 3 (DSM-IV)
- restricting type = does not eat, does not purge
- binge/purge type = does binge or purge
- severity is based on BMI
What’s the mortality rate of anorexia nervosa?
18%
What’s the personality profile of someone who has anorexia nervosa?
rigid and controlling and high achieving or are being rigidly controlled
What are some comorbidities assoc with anorexia nervosa?
- weight loss
- suicide increase
- OCD
- anxiety disorders
- rigid and perfectionistic traits
- delayed psychosexual development
- denial
- minimization
- delusion
What are some medical issues assoc with anorexia nervosa?
- weight loss
- hypothermia
- edema
- bradycardia, hypotension, syncope
- amenorrhea
- electrolyte imbalance, low K+
- cardiac changes
- lanugo hair
- osteoporosis
- delayed gastric emptying
- metabolic acidosis
- organ failure
What is the DSM-5 diagnosis of bulimia nervosa?
- recurrent binge eating
- eating an atypically large amt in discrete period of time disproportionate to typical eating
- purging vs non-purging types
- no anorexia present
- loss of control
- vomiting, laxative use, enema,s diuretics, exercise
- binges 1x/wk for 3 months
- compensatory behaviors necessary for diagnosis
Which has greater prevalence: anorexia nervosa or bulimia?
bulimia
Unlike anorexia nervosa in which the affected person has a rigid, high acheiving personality, what does a person with bulimia have?
dysfunctional family, less rigid and more conflued, outgoing, angry, impulsive traits, borderline personality, more substance abuse & personality d/o
What are some medical signs of someone with bulimia nervosa?
- poor dentition, enamel loss, cavities
- abraided knuckles (Russell’s sign)
- normal/overweight
- sexually active
- high amylase/salivary enlargement
- low PO4, low Mg
Which meds are approved for bulimia nervosa?
SSRIs
What is avoidant/restrictive food intake disorder?
- failure to meet diet/energy needs
- weight loss, nutritional deficiency
- supplementation needed
- psychosocial distress
- doesn’t meet full anorexia criteria
What is binge eating disorder?
- binges
- lack of control
- ego dystonic
- 1x/wk for 3 months
- no purges or compensations
What is PICA?
- persistent eating of non-nutritive substance for 1 month
- not developmentally or culturally appropriate
- not medical or from intell disability or autism