Eating Disorders Flashcards
What is criteria for Anorexia Nervosa?
- Intense weight loss – self induced starvation
- intense dieting / exercising
- disrupted body image
- signs of starvation
What are the subtypes of Anorexia?
- Binge/Purge – large amount of food in a short amount of time, then compensatory behavior to rid the food/weight
- Restricting Type – severely limiting caloric intake
What might be some key signs of starvation symptoms?
- hypothermia, cold intolerance
- amenorrhea
- bradycardia/hypotension
- alopecia/dry skin
- Pancytopenia
- Fatigue
- *Every Organ System Affected**
Who most likely develop Anorexia?
- Females, mid-teens
- Dieting for one reason or another can lead to it
- FamHx of mood disorders
- Usually onset at beginning of puberty
What are the social influences that can contribute?
- Performance pressures in sports (Gymnastics, Wrestling)
- Teasing about weight
- Media Influences
What is the biggest red flag in Anorexia?
Weight Loss in Teenagers!
What is the best treatment option of Anorexia?
Typically they are resistant to treatment and there is no sure-fire test to confirm it other than symptoms and excessive weight loss.
- Food
- May requrie inpatient hospitalization to correct metabolic abnormalities
- Team approach to therapy working in all aspects of their life eating, medical, psych, behavior
How is bulimia nervosa different from Anorexia?
- Episodes of Over-eating, then compensatory behavior to prevent weight gain occuring at least 1x per week for 3 months. Depending on number of episodes a week correlates to severity.
What are common methods of purging besides vomiting?
- Misuse of Laxatives, diuretics, enemas
- Excessive Exercise, restrictive dieting, skipping meals
What might be physical signs that can make you suspicious a patient is bulimic?
- Parotid Hypertrophy
- Russel’s Sign – abrasions on knuckles from inducing vomiting
- Dental erosions and caries (Freq dental visits)
You are seeing a patient who you are suspicious of being bulimic and do electrolyte testing, what might be the finding if they are abusing laxatives?
- Low Potassium, High Chloride, Low Bicarb
You are seeing a patient who you are suspicious of being bulimic and do electrolyte testing, what might be the finding if they are abusing diuretics?
- Low Potassium, Low Sodium, High Bicarb
If you are suspicious of a patient to have an eating disorder and or electrolyte testing. The results indicate she has hypokalemia, hyponatremia, elevated bicarb, hypomagnesium, elevated serum amylase. What should you suspect?
The patient is purging by vomiting or abusing diuretics
What is a possible symptoms of the hypokalemia experienced from vomiting in bulimia?
Cardiac Arrhythmias
If a patient is found to be purging more than 3 times per week with their binge eating, what should be the recommended treatment?
Inpatient Evaluation and treatment.
What are social conditions associated with bulimia?
- Depression
- Temperament –overachiever, secretive, self-critical, outgoing, impulsive
- Other substance use and abuse
What are the most common treatments that can help bulmia nervosa successfully?
Most are outpatients unless 3x+ per week
- Cognitive-Behavioral Therapy
- Family Therapy (to be more supportive)
- SSRI – Fluoxetine
What is it considered if a person multiple times per month has a single sitting in which they binge eat countless calories, even though they had been speaking of how they are on a diet and worried about what they eat. After this binge episode there is no compensatory behavior to counter-act the food.
Binge-Eating Disorder
- Binge Eating with marked distress minimum once per week in a 3 month period
- However, NO Compensatory Behavior
How are Anorexia Nervosa and Avoidant/Restrictive Food Intake disorder different from one another?
- Both involve persistent failure to meet appropriate guidelines of nutrition/energy needs
- However – These patients do not experience a distorted self-image on how their body is viewed
How is purging disorder different from bulimia disorder?
Purging Disorder – the patients frequently purge, but do not necessarily have a distorted body image or restricted diet/obsessing over food.
What is considered reasonable weight loss in an adult?
- 5-10% Body Weight Loss over 6 months or 1-2 lbs lost per week
Children/Teens – should lose weight slower than adults or have a goal to just maintain weight
What are reasonable dietary changes to help weight loss goals?
- Limit Portion Sizes
- Behavioral Modifications – BEST, food diary, change patterns of eating and how you eat.
