Eating Disorders. Flashcards
Eating Disorders
Anorexia Nervosa and Bulimia Nervosa. Have disturbed body image and use extensive measures to avoid gaining weight (Vomiting, laxatives, diuretics, enemas, fasting and excessive exercise.)
Anorexia Nervosa
Preoccupation with weight, body image and being thin.
Restrictive type: Has not engaged in binge or purge behavior. Often with OCPD traits
Binge/Purge Type: Eat in binges followed by self induced vomiting, using laxatives, excessively exercising and or diuretics .
Less than 85% of ideal body weight or body mass index. BMI < 17.5
Intense fear of becoming fat
Disturbed body image
Amenorrhea
95% are women
Tx: FOOD. Behavioral therapy, family therapy and supervised weight gain programs.
SSRI’s are NOT EFFECTIVE
Low dose Gen 2 Anti-psychotics.
Benzos Pre meal
Bulemia Nervosa
Binge eating + behaviors intended to contract weight gain. Unlike anorexia patients, they typically maintain a normal or overweight status.
DSM
Recurrent episodes of binge eating
Recurrent inappropriate attempts to compensate
Behavior lasts at least twice a week for 3 months
Perception of self worth is excessively influenced by body weight and shape
Tx
Antidepressants + Therapy (SSRI’s are first line)
Fluoxetine is only FDA approved for Bulimia.
Avoid Buproprion due to its ability to lower seizure threshold
Binge Eating Disorder
Suffer emotional distress over their binge eating, but do not try to control weight by purging etc. Are not fixated on body shape and weight.
Recurrent episodes of binge eating.
Binge eating occurs 2 days a week for at least 6 months
Severe distress over binge eating
Eating Rapidly Eating until uncomfortably full Eating large amounts when not hungry Eating alone due to embarrassment over eating habits Guilty after over eating.
Tx: individual psychotherapy
Pharmcotherapy: Stimulants, Orlistat (inhibits pancreatic lipase). Sibutramine (inhibits reuptake of norepinephrin serotonin and dopamine).
