Eating Disorders Flashcards
There is an increased UPTAKE of this neurotransmitter in anorexics and bulimics
Serotonin
There is an increase of this satiety peptide in the gut of anorexics and bulimics, causing a decrease in appetite
Peptide tyrosine tyrosine
Baseline and post-prandial cholecystokinin is ____ in anorexics. What does this cause?
Increased! Causes decreased appetite
What hormone is dysfunctional in binge eaters?
Ghrelin (The “hunger hormone”)
What are some comorbid disorders that are common with eating disorders?
Kleptomania, suicide, drug and ETOH abuse, sexual promiscuity
The prevalence of eating disorders is highest in what age and gender?
Adolescents (median age 18-21) and women
What are the two types of anorexia?
Restricting type and binge-eating/purging type
What are the three eating disorders?
Anorexia, bulimia, binge eating disorder
Which test involving 5 questions can be used to identify an eating disorder?
SCOFF test
- Make yourself SICK when you feel uncomfortably full
- Worry you have lost CONTROL over how much you eat
- Recently lost more than 14lbs in the last 3 months (ONE stones worth of weight)
- Believe you are FAT when others say you are too thin
- Would you say that FOOD dominates your life
SCOFF test questions
Persistent restriction of energy intake leading to significantly lower body weight; Either an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain; Disturbances in the way one’s body weight or shape is experienced
Anorexia
What is typically the most obvious clue to anorexia?
Weight loss - Emaciated person who believes that are overweight and continues to try and lose weight
What are the 5 stages of binge/purge type anorexia?
Binge eat, purge, guilt, restrict, feel deprived, repeat
Restricting type anorexia consists of a patient restricting their calorie intake to as little as ___ to ___ calories/day
300 to 600
May have obsessive and compulsive symptoms regarding food, eating habits, and exercise
Restricting type anorexia
BMI greater than or equal to 17
Mild anemia
BMI 16-16.9
Moderate anorexia
BMI 15-15.9
Severe anorexia
BMI less than 15
Extreme anorexia
Eating in a discreet period of time, an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances AND feeling a sense of lack of control over eating during the episode
Binge eating
What two behaviors characterize bulimia nervosa?
Binge eating AND inappropriate compensatory behavior in order to prevent gaining weight
What are some of the compensatory behaviors patients who suffer from bulimia might do in order to prevent gaining weight?
Purging, laxative abuse, diuretics, fasting, or excessive exercise
How often must the binge eating and compensatory behaviors occur simultaneously to make a diagnosis of bulimia nervosa?
On average at least once a week for 3 months
Patient reports feeling a lack of control while eating and engages in inappropriate compensatory behavior to prevent weight gain
Bulimia nervosa
Patients who suffer from bulimia nervosa are often a ______ weight
NORMAL
1-3 episodes of compensatory behavior/week
Mild bulimia nervosa
4-7 episodes of compensatory behavior/week
Moderate bulimia nervosa
8-13 episodes of compensatory behavior/week
Severe bulimia nervosa
14 or more episodes of compensatory behavior/week
Extreme bulimia nervosa
What is the female athlete triad?
Nutritional: Eating disorder
Endocrine: Amenorrhea
Musculoskeletal: Osteoporosis
Russell’s sign (calluses on the back of hand or knuckles) is a medical complication that arises from?
Vomiting
If you have a patient with an eating disorder and they are suffering from a life threatening cardiomyopathy, what drug should you suspect that they are abusing?
Ipecac
What is the difference between bulimia and binge eating disorder?
With binge eating disorder there is NO compensatory behavior after binge eating – leads to weight gain
- Eating very rapidly
- Until uncomfortably full
- Large amounts when not hungry
- Eating alone due to embarrassment over the amount
- Feeling disgusted with oneself, depressed, or very guilty afterwards
- Marked distress regarding the binge eating
Binge eating episodes must be associated with 3 or more of the following to be binge eating disorder
In order to diagnose a patient with binge eating disorder, how frequent must the episodes be?
At least once a week for three months
1-2 binge eating episodes/week
Mild binge eating disorder
4-7 binge eating episodes/week
Moderate binge eating disorder
8-13 binge eating episodes/week
Severe binge eating disorder
14 or more binge eating episodes/week
Extreme binge eating disorder
What type of therapy is the cornerstone of treatment for eating disorders?
Cognitive behavioral therapy
What is the initial goal weight for patients who are underweight and have an eating disorder?
90% of healthy BMI
Should SSRIs be sole therapy in patients with eating disorders?
NO! In bulimia it may decrease frequency of binging in addition to CBT
What drugs may help with binge eating disorder?
SSRIs, TCAs, Antiepileptics (topiramate), appetite suppressants (orlistat)
