Eating disorders Flashcards
When do eating disorders usually present?
Adolescence
OCD patients are more or less prone to eating disorders?
More
True or false: athletes less commonly have eating disorders?
False–more common
True or false: there is usually a critical sensitizing event with eating disorders
True
The average american woman is how tall and weighs how much?
5’ 4”
140
The average american model is how tall and weighs how much?
5’ 11’’
117
What are the diagnostic criteria for anorexia? (4)
- Intense fear of gaining weight or becoming fat, even at a low weight
- Disturbance in the perception of shape or size
- Restriction of energy intake
- Disturbance or undue influence of weight or shape
What are the BMI definitions of mild, moderate, severe, and extreme anorexia?
Mild less than [17-18
Moderate [16, 17)
Severe less than 16
Extreme = less than 15
What is the progression of symptoms with anorexia?
Dieting progressing to more and more reductions in intake, switching to only fruits and vegetables, and an increase in physical activity
True or false: objective hypothermia can occur with anorexia
True
What is the deadliest of all psychiatric disorders?
Anorexia
What are the diagnostic criteria for bulimia? (3)
- Recurrent episodes of binge eating
- Inappropriate compensatory behaviors to prevent weight change
- Self-eval based largely on image
- Greater than 18.5 BMI
How often do episodes of binge eating occur with bulimia?
At least once a week for 3 months
What are the drugs that are abused with bulimics?
Laxatives and diuretics
What are the two subtypes of bulimia?
Purging and nonpurging
What are the diagnostic criteria for binge eating disorders? (4)
- Frequent episodes of large quantities of food in short periods
- Feeling out of control
- Feeling ashamed or disgusted by the behavior
- Eating when not hungry or in secret
What is the difference between BED and bulimia?
BED have significantly lower level of dietary restraints
True or false: men more often have BED
True
What is the pharmacotherapy treatment for BED?
Prozac (fluoxetine)
Callouses on the back of the hand may suggest what?
Bulimia
What causes the chipmunk cheeks with bulimia?
Increase salivary secretions
True or false: cardiac impairment is a risk factor for anorexia
True
True or false: there is a loss of brain tissue with anorexia
True
What happens to bone density with anorexia?
Decreased density
What mental illness has the highest mortality rate?
Anorexia
What lab abnormality may occur with anorexia / bulimia?
Hypokalemia
What are the medical complications of BED?
- HTN
- Hypercholesterolemia
- DM II
- Gallbladder disease
What are the EKG findings that can be seen with anorexia?
QT prolongation
What are the CBC abnormality with anorexia?
Leukopenia
What happens to hormone levels with anorexia?
Lower
What metabolic disorders can be seen with bulimia? (3)
Hypokalemia
Metabolic alkalosis
Increased LFTs
True or false: there is a lowered threshold for depression with anorexia
True
What happens when starving to psych stuff?
- Depression
- Asexual
- Psych s/sx
What are the comorbidities with eating disorders? (5)
- Depression
- Anxiety
- OCD
- Substance abuse
- Personality disorders
What are the drugs that take away appetite? (2)
Opioids
Stimulants
What is the treatment for eating disorders?
- Observed refeeding
- Eliminate purging
- Exercise management
What is the multidisciplinary approach to anorexic patients? (4)
- Physician refers
- Therapist
- Dietician
- Psychiatrist
What are the two medications that may assist with weight gain and mood management?
- Atypical antipsychotics
- TCAs
What do most eating disorders start off as?
A diet
What personality types are predisposed to anorexia?
Perfectionists
Which category of men have a higher incidence of eating disorders?
homosexual
True or false: most pts with an eating disorder do not believe they are thin
False–most do, but fear of a loss of control if they eat
What is the restricting type of anorexia?
Past 3 months individual has not engaged in recurrent episodes of binge eating or purging behavior
What is the binge-eating/purging type of anorexia?
Past 3 months individual has engaged in recurrent episodes of “binge” (e.g 1 banana) eating or purging behavior
Is amenorrhea a diagnostic criteria for anorexia?
Not anymore–not reliable
What is the temperamental risk factor for anorexia?
Anxiety or obsessional
True or false: having a biological relative with an eating disorder is a risk factor to developing an eating disorder
True
What is the nonpurging type of bulimia?
Not purging, but doing other things to get rid of the calories quickly (e.g intensive exercise, etc)
What were the results of the Maudsley approach to the treatment of anorexia?
50% of anorexia pts and 30% of bulimia pts showed improvement
What are the meds that have been shown to reduce binge eating?
SSRIs
