Eating disorders

Question 1

ICD10 criteria for anorexia nervosa

Answer 1

Fear of weight gain
Endocrine disturbance e.g amenorrhoea
Emaciated (BMI <17.5kg/m^2)
Deliberate weight loss either by less intake or increased exercise 
Distorted body image

Question 2

Management of anorexia nervosa

Answer 2

Manage medical complications
Aim for weight gain of 0.5-1kg per week (monitor for refeeding syndrome)
Self help groups
CBT
Family therapy
Psycho education
Pharmacological management of comorbidities

Question 3

Indications for hospitalisation in anorexia nervosa

Answer 3

BMI <14
Severe electrolyte abnormalities
Suicidal ideation

Question 4

Differences between AN and BN

Answer 4

Bulimia nervosa - normally healthy weight or overweight, recurrent binges
Anorexia nervosa - significantly underweight, more likely to have electrolyte imbalance

Question 5

ICD10 criteria for bulimia nervosa

Answer 5

Episodes of overeating at least 2 times a week over a 3 month period
Compensatory behaviours to prevent weight gain
Fear of being fat and perception of being too fat
Preoccupation with food (cravings)

Question 6

Types of bulimia nervosa

Answer 6

Purging: self induced vomiting, laxatives, diuretics, enemas

Non-purging: excessive exercise or fasting after a binge

Question 7

Management of bulimia nervosa

Answer 7

Treat medical complications from repeated vomiting
Psycho education
CBT
Self help programmes
Food diary and eating in company to avoid binges
Fluoxetine 1st line