Eating disorders Flashcards
Biological RFs for eating disorders
F
FH
Age - Adolescence
Early menarche (bulimia nervosa)
Psychological RFs for eating disorders
Adverse parenting - eg. high expectations
Abuse
Perfectionism
Low self esteem
Social RFs for eating disorders
Adolescence - social media
Western culture
Bullying
Occupation
Common eating disorders
Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Anorexia nervosa features
BMI < 17.5
Amenorrhoea
Excess in higher social class
Overvalued idea of dread of fatness
Definition of anorexia nervosa
Person tries to keep weight low
Eg. Starving, Excessive exercise
Bulimia nervosa features
BMI > 17.5
Mostly young adults
Bulimia nervosa definition
Periods of binge eating and then deliberate purge (eg. vomiting, laxatives) to control weight
Binge eating disorder age? BMI?
BMI > 30
Pts usually present in 40s
Binge eating disorder definition
Compelled to overeat large food quantities in short space of time in absence of weight control behaviour
Overvalued idea vs delusion
Overvalued idea may be challenged
Delusion cannot
Diabulimia
Diabetic and reduce calorie intake by modifying insulin regime
Very dangerous
Binge-purge subtype of anorexia vs Bulimia nervosa
BMI < 17.5 vs BMI > 17.5
Binge eating disorder criteria
Pt distressed by their behaviour
Binge eating > 2 days per month
Binge definition
Eaten in discrete amount of time ( < 2 hrs)
Associated with lack of control
BMI level for concerns over capacity
BMI < 15
Brain daily calorie requirements
500 kcal per day
Physical Sx
Increased sensitivity to cold GI Sx Syncope Amenorrhoea Low sexual appetite Lanugo Stunted growth Dry skin
Physical signs of eating disorders
Hypercarotenaemia Russel's sign Parotid and submandibular swelling Perimylolysis Bradycardia / Arrhythmias Orthostatic hypotension
Lanugo
Fine downy hair
Perimylolysis
Erosion of inner surface of teeth
Due to frequent vomiting
Common complications of eating disorders
Hypokalaemia - ‘U’ have no Pot and no T but a long PR and a long QT
Thyroid dysfunction
Osteoporosis
Assessment of eating disorders
Medical
Patterns of eating - changes over time
Psychological
Medical assessment of eating disorders
BMI
Physical Sx
Psychological assessment of eating disorders
Body image disturbance
Why now?
Motivation to change?
Hypercarotenaemia
Orange pigmentation of skin
Russel’s sign
Calluses on back of hand over knuckles
Due to repeated self induced vomiting
