Eating Disorders

Question 1

Name the 3 eating disorders identified by the ICD 10?

Answer 1

anorexia nervosa
Atypical anorexia nervosa
Bulimia nervosa

Question 2

Anorexia nervosa

• what is it? (4 criteria)
• onset?
• risk factors? (8)
• mortality?

Answer 2

1. Weight loss at least 15% below the normal or expected weight for age and height
2. Weight loss self induced by avoidance of fattening foods
3. self perception of being too fat with intrusive dread of fatness
4. widespread endocrine disorder manifesting as amenorrhoea in women (if onset pre-pubertal then pubertal delay)

-commonest age 18, in huge SES families

-hereditary component
low self esteem
obsessional/perfectionist
Black and white thinking 
Adolescence
Childhood sexual abuse
culture expectations + school (academic pressure, bullying) 

-1 in 5 deaths is by suicide

Question 3

Bulimia nervosa

• wat is it? (4 critera)
• onset?

Answer 3

1. recurrent episodes of overeating
2. persistano preoccupation with eating and a strong desire or a sense of compulsion to eat
3. attempt to counteract the fattening effects of food by: self induced vomiting/purging
   alternating periods of starvation
4. self perception of being too fat with an intrusive drear of fatness

-20 yrs old

Question 4

What is the snowball metaphor for SEED?

Answer 4

habits formed over time and psychoscocial factor occur e.g. isolation and secondary adaption by family and friends

Question 5

Comorbidity? (4)

-medical complications? (8)

Answer 5

depression
OCD
Substance misuse
DM

-Cardiovascular
Gastro-intestinal
Renal
Endocrine
Musculoskeletal
Dental
Skin and hair
Metabolic

Question 6

starvation effects on the brain? (8)

Answer 6

loss of grey and white matter
inc compulsive behaviour
enhanced response to hedonic and nutrostat signals
Reduced social skills
Focus on food
Poor conc and decision making
New learning stunted

Question 7

refeeding syndrome

• due to?
• how prevented?

Answer 7

• depletion of already inadequate stores of nutrients e.g. MG, K, phosphate, which are quickly used up as the body starts to repair itself
• prevent by frequent blood monitoring and slow pace of initial refeeding

Question 8

Medical complications of AN? (5)

Answer 8

Metabolic:
hypothermia
Dehydration
Electrolyte disturbance
Hypoglycaemia 
Raided LFTs

Question 9

How is risk assessed in terms of BMI?

-what other inv are done to asses risk? (6)

Answer 9

Low-Moderate: 17.5-16
Moderate: 16-15
High: 14.9-13
Very High: <13

-Rate of weight loss
Blood results
Circulation
Muscle strength
Temperature
ECG abnormalities