eating disorders Flashcards
genetic component to obesity
leptin receptor mutation, melanocortin receptor mutation,
iatrogenic
antipsychotics, antidepressants, antihistamines, D2 blockades increase prolactin.
lifestyle and obesity
sedentary, dependence on automobiles, increased fat, carbs, processed food.
anorexia nervosa
refusal to maintain 85% of typical body weight. fear of gaining, restriction of energy intake requirements, dysmorphism, missed menstrual cycles. there are different types. also severity based on BMI
restricting type
does not eat, does not purge.
binge/purge type
does binge and purge
mild
17
Moderate
16-16.99
severe
15-15.99
extreme
<15
possible etiologies
endogenous opiate imbalance, media/industry, family sacrifice, fear of independence, lack of sense of autonomy, need control in life or being rigidly controlled, neuroepinephrine imbalance -low.
comorbidies and personality types
depression 50%, suicide increase, OCD, anxiety disorders, rigid and perfectionist traits, delayed psychosexual development, denial, delusion, minimization
medical issues associated with anorexia
weightloss, hypothermia, edema, bradycardia, hypotension, syncope, amenorrhea, electrolyte imbalance and cardiac arrhythmia, lanugo hair, osteoporosis, delayed gastric emptying, metabolic acidosis.
treatment
hospitalization, tube feedings, behavioral plan. CBT, family, psychodynamic.
medications
TCA, SSRI, ECT if depressed, treat all comorbidities.
bulimia nervosa
recurrent binge eating (large amounts in discrete time). there are purging and non-purging. no anorexia present. loss of control and compensatory behavior. vomiting, laxatives, enemas, diuretic, exercise, must binge 1x/week, for 3 months. motte prevalent than anorexia, 40% college women. obese common.
personality for bulimia
reckless, out of control. not typically type A. belongs to a dysfunctional family, but more conflicted than rigid. outgoing angry, impulsive traits, borderline personality. more addiction and anxiety.
what is russel’s sign
abraided knuckles from hitting the teeth when purging.
rumination
repeated regurge and chewing and then reswallowing.
what meds are most reasonable for bulimia
SSRI