Eating Disorders Flashcards
two core psychopathologies of eating d/o:
disturbed eating behavior +
intense preoccupation w/weight and shape
mortality rate of >10%
Anorexia n.
starvation, electrolyte imbalance, suicide
3 features of anorexia nervosa
refusal to maintain weight
fear of gaining weight
disturbed perception of size/shape of one’s body
binge eating w/compensatory methods to prevent weight gain
bulimia n.
less severe course than AN
what distinguishes AN from BN?
BN can have normal weight
frequent episodes of consuming lg amounts of food and feeling a lack of control over eating
binge-eating d/o
ratio of eating d/o among M:F
1:10
onset of AN/BN/dieting
co-morbidities of AN?
AN: 14-18, after 40 is rare
BN: late adolescence, early adulthood
dieting onset at puberty
depression (2/3); social phobia (1/3); OCD (1/4)
MZ concordance of AN
70%
neurochemical changes assoc w AN (NE, 5HT, CRF, cortisol, thyroid)
down NE, thyroid
up 5HT, CRF, cortisol
sx of AN improve after administration of what drug?
opioid antagonists
rigid, perfectionistic, close but troubled relationships with parents
anorexia nervosa
key to AN dx?
discrepancy between actual weight and perceived body image
AN includes abuse of which 3 meds? (LDS)
self-induced vomiting
laxatives, diuretics, stimulants
sequelae of AN
amenorrhea
low T
hypogonadism
mood/cognition effects
criteria for AN: 3 (RFD)
A. Restriction of E intake –> low body weight
B. Fear of gaining weight/becoming fat
C. Disturbance of experience of one’s weight/shape
timeline for distinguishing restricting v. binge/purging type of AN
3 months (during this time has individual had binge/purge behavior?)
predictors of poor outcome for AN
duration OLDER age of onset prior psych hospitalizations poor adjustment co-morbid personality d/o
complications of purging
hypocalcemia hypokalemia met alk ECG changes fatty degeneration of liver parotid gland enlargement calluses/dental caries/esophageal tears
recurrent episodes of binge eating but w/o compensatory behaviors to prevent weight gain
binge eating d/o
episodes followed by embarrassment, disgust, depression or guilt
criteria for BN (BCDE)
A. Recurrent binge eating (eating w/in 2-hr period a larger amt of food + sense of lack of control)
B. Inapp compensatory behaviors (vomiting, laxatives, diuretics, fasting, exercise)
C. Binging and compensatory behaviors occur 2x/wk for >3mo
D. Self-evaluation influenced by shape/weight
E. Not occur excl during AN periods
goals of eating d/o tx
restore nutrition
modify eating behaviors
change distorted beliefs about wt/wt loss
hospitalize if depression/SI
Re-feeding syndrome sx
due to? how to avoid?
resp/cardiac failure, hypotension, arryth/seizures/coma/death
sudden shift from fat–>carbohydrate metabolism
cellular uptake of Pi
avoid via slow initiating w/vitamins,
electrolytes
psychosocial interventions for eating d/o
CBT: monitor intake, ID assoc emotions, challenge beliefs about self-image; set goals for eating and weight; behaviors are shaped via positive reinforcement
Interpersonal psychoterapy: targets relational stressors which may trigger binge episodes
