Eating Disorders Flashcards
what is the criteria for anorexia nervosa
1 - weight <85% of predicted or BMI < 17.5kg/m2
2 - fear of weight gain, even when underweight, leading to dieting, induced vomiting or excessive exercise
3 - feeling fat when thin
4 - amenorrhoea or decreased libido (due to hypothalamic-pituitary-gonadal dysfunction)
what happens if the onset of anorexia nervous is pre-puberty
sequence of pubertal events is delayed or even arrested
(growth ceases; in girls the breasts do not develop and there is a primary amenorrhoea; in boys the genitals remain juvenile)
what happens after anorexia nervous is recovered in pre-puberty
puberty is often completed normally
menarche is late
what are the sub-types of anorexia
restricting
binge-eating/purging
what is the criteria for bulimia
1 - recurrent episodes of binge eating characterised by uncontrolled overeating
2 - preoccupation with control of body weight
3 - regular use of mechanism to overcome the fattening effects of binges e.g. starvation, vomit-induction, laxatives, over-exercise
4 - BMI > 17.5 = self perception of being too fat, with dread of fatness
what are psychological risk factors for developing an eating disorder
Low self-esteem Perfectionist/obsessional Black and white thinking Adolescence Childhood sexual abuse Bullying
what co-morbidities are often seen in ED
Depression
OCD
Substance misuse
what effects does starvation have on the brain
Loss of grey and white matter
Increased compulsive behaviour
Reduced social skills
Focus on food
Poor concentration and decision making
New learning stunted
what causes re-feeding syndrome
Caused by depletion of already inadequate stores of nutrients e.g. magnesium, potassium, phosphate which are quickly used up as body starts to repair itself.
how is re-feeding syndrome prevented
frequent blood monitoring slow pace of initial refeeding
what are metabolic complications of ED
Hypothermia
Dehydration
Electrolyte disturbance (low potassium, magnesium, calcium, phosphate)
Hypoglycaemia
Raised LFTs
