Eating Disorders Flashcards
What is the screening tool used to determine if a patient may have an eating disorder?
SCOFF Questionnaire
do you make yourself Sick because you feel uncomfortably full?
do you worry you have lost Control over how much you eat?
have you recently lost more than One stone (14 pounds or 6.35kg) in a 3 month period?
do you believe yourself to be Fat when others say you are too thin?
would you say that Food dominates your life?
What are features of anorexia nervosa?
- restriction of intake to reduce weight
- relies on compulsive compensatory behaviours when this cannot be avoided
- self induced vomiting
- laxative abuse
- excessive exercise
- abuse of appetite suppressants/ diuretics
- fear of weight gain
When would someone be considered anorexic?
if their BMI 17.5 or less (they are 15% below ideal body weight)
What are features of bulimia nervosa?
- episodes of binge eating with a sense of loss of control
- binge eating is followed by compensatory behaviour of purging type (vomiting, laxatives, diuretic abuse) or non purging type (excessive exercise, fasting or strict diets)
- dissatisfaction with body shape and weight
What about the features will lend a diagnosis of bulimia nervosa?
binges and resulting compensatory behaviour occurring a minimum of two times per week for 3 months
What might be examples of ways patients may avoid calorie intake in anorexia nervosa?
- diets such as becoming vegan or vegetarian
- not touching food or grease
- developing dislikes, pickiness or ‘allergies’
- interpreting all symptoms as allergy or indigestion
- eating very slowly, only eating at certain times
- avoiding parties and social occasions
- spoiling or messing food or bizarre combinations
- refusing to eat more than the person who eats least (competitive eating)
- medication abuse e.g. smoking or drinking lots to feel full
What are ways patients with anorexia nervosa or bulimia nervosa might try to get rid of calories?
- self induced vomiting
- diabetic patient may eat lots of calories but omit to take insulin so purge the calories
- chewing and spitting out
- overexercise
- overactivity e.g. obsessive housework
- cooling - open windows, inadequate dress etc
- blood letting
- medication abuse e.g. laxatives, diuretics etc
What are the psychological consequences of having an eating disorder?
- willing to sacrifice things they value to stay thin
- obsessive weight losing feels like a solution rather than a problem
- cognition reduced
- inability to interpret emotion if starved - as in aspergers
- malnourished brains experience depression, anxiety, obsession, loss of concentration on anything but food
What are social consequences of eating disorders?
- social isolation
- competitive exercise may induce them to see other people as rivals not friends
What are physical consequences of eating disorders because of starvation?
- poor repair and resistance in body
- reduced immunity
- anaemia
- bone loss
- fertility problems
- growth problems
What are physical consequences of eating disorders because of purging behaviours?
neurochemical disruption with special damage to brain (seizures) and heart (arrhythmias). Potassium crude measure of the problem.
What are though to be precipitations or causes of anorexia?
- genetic predisposition - OCD, anxiety disorders, perfectionism
- perinatal factors
- life events and traumas
- perpetuating consequences of starvation and avoidance
- puberty
- dieting or even non-deliberate weight loss
- increased exercise
- stressful life events
What are perpetuating factors of anorexia?
consequences of ‘starvation syndrome’
- delayed gastric emptying (sensations of fullness are interpreted as fatness)
- narrowing focus- with avoidance of interpersonal interest, change of values so that food becomes the most salient stimulus
- obsessionality. Phobia of ‘fat’ increases as avoidance increases. Body checking amplifies body image concern
- high emotional expression in family and other acres may delay recovery
What are possible outcomes of anorexia?
- death
- recovery
What is average time for recovery from anorexia if it occurs?
6-7 years
