EATING DISORDERS Flashcards
What is the prevalence of eating disorders in males vs females?
They are 10 times more common in females
Which has a higher incidence: anorexia or bulimia?
The exact incidence of bulimia is difficult to know because many sufferers never present. However, it is estimated that the incidence of bulimia is approximately 5 times higher than that of anorexia.
Are eating disorders associated with a particular social class?
Classically, anorexia was considered to be more prevalent in higher socioeconomic classes, however, recently this seems to have changed and prevalence is pretty equal across all classes. Bulimia also has equal prevalence across all socioeconomic classes.
What are the biological factors that may provide a cause for someone developing anorexia?
Genetics play a big part - MZ twins (55%) DZ twins (5%)
Abnormalities of serotonin metabolism
What are the environmental and psychological factors that may provide a cause for developing anorexia?
Western culture - ideal body image
Relationship difficulties - both parental (overprotection, conflict avoidance, enmeshment) and peer to peer (boyfriend splitting up with patient)
Exam stress
What are the personality traits that increase someone’s chance of developing anorexia?
Inhibition
Perfectionism
Obsessionality
Harm avoidance
What are the biological factors that may provide a cause for someone developing bulimia?
Genetic component is a big part
Serotonin, noradrenaline and plasma endorphins have all been implicated (however, these could be secondary to weight loss)
Family history of depression
Early menarche
What are the environmental and psychological factors that may provide a cause for developing bulimia?
Past exposure to dieting History of childhood obesity Conflictual relationships with family Alcohol and substance misuse Personality disorders Depression
What is the cut-off BMI for anorexia in adults?
A BMI of less than 17.5 kg/m2 is characterised as anorexia.
How do you calculate a person’s BMI?
Weight (kg) / height (m) x height (m)
If an anorexic patient begins to binge eat and purge, are they now classified as bulimic?
No. The key diagnostic difference is the weight and the significant generalised endocrine abnormalities. By the DSM-V they would now be classified as ‘anorexia nervosa, binge eating/purging type’.
What other psychiatric symptoms other than those specifically related to eating, might someone with an eating disorder report?
Anxiety
Depression
What are the physical complications of starvation in a patient with an eating disorder?
- Emaciation (wasting of flesh)
- Amenorrhea; infertility; reproductive system atrophy
- Cardiomyopathy
- Constipation; abdominal pain
- Cold intolerance; lethargy
- Bradycardia; hypotension; cardiac arrythmias; heart failure
- Lanugo (fine, downy hair on trunk); loss of head hair
- Peripheral oedema
- Proximal myopathy; muscle wasting
- Osteoporosis; fractures
- Seizures; impaired concentration; depression
What are the physical complications of purging (vomiting) in a patient with an eating disorder?
- Permanent erosion of dental enamel; dental cavities
- Enlargement of salivary glands (especially parotid)
- Russell’s sign - calluses on back of hands from repeated trauma from teeth during induction of vomiting.
- Oesophageal tears; gastric rupture
What might the blood tests of an eating disorder patient show as a result of their starvation?
- Normocytic anaemia
- Leucopenia
- Abnormal LFTs
- Raised urea
- Raised cortisol
- Raised growth hormone
- Reduced T3
- Reduced FSH and LH
- Hypercholesterolaemia
- Hypoglycaemia
- Hypercarotenaemia
