Eating Disorders Flashcards
Biology of eating disorders
Greater incidence if in families or if twins
Elevated opioids and endorphin levels of AN…not sure what came first
Psychological
Survival mech - gives patients a sense of control
Way to cope
Anorexia nerovsa
Restirction of energy intake leading to signifcantly low body weight
Intense fear of gaining weight even though weight is low
Undue self-eval given seriousness of current low weight (or lack of recog)
Restricting and binge-eating type of AN
Last 3 mos no binge eating or purging
Last 3 mos recurrent episodes
Bulimeia nerovsa
Recurrent episodes of binge eating
Compensatory behaviors to prevent weight gain
Binge eating and compens behavior once a week for 3 mos
Does not occur exclusivley during epsiodes of AN
Rumination disorder
Repeated regurgitation of food (at least 1 month)
Food may be rechewed, reswallowed or spit out
Not due to GI
Binge eating disroder
once a week for 3 mos
3 of following: More radiply Large amounts when not hungry Eating alone bc embaraeed Feeling disgusted with slef
Distress regarding
AN tx
Weight maintencae of BMI>18.5
Physiologic - sinus bradycardia, hypotension (orthostatic), dehydration, amenorrhea, osteopenia, electrolye
Inpatietn - if med/pscy unstable…could be high risk of depression too…abnormla EKG or metabolic alkalosis
Pharmacotherapy
SSRIs may increase weight but don’t really help with climate
What works with AN
Maudsley method - agnositc approach to eiology…removes need to assign blame and focus on current situtation
Family therapy is superior
100% attrition in dietary only group (get CBT)
Physcial tx of BN
Dental complications - tootch erosion, salivary gland hypertropy, xerostomia
Electrolyte abnormalities - hypokalaemia, hypocalcemia, hypomag
Cardiac - ventricular arryth, sinus bradycardia, otherstatic
GI - delated gastric empytinhfg
Psych tx of BN
No skipped meals
No open containers, no drive through, no eating standing up
Grade a meal - A if it is nutritionally sound
Portion control
Dessert with lunch and dinner (100 cals)
Focus on satity
Pharma tx of BN
SSRIs work
Inpaitent BN
Medically or emotionally unstable
Binge eating disorder tx
CBT
Family therapy
Bariatric surgery
