Eating Disorders Flashcards
what is the lifelong prevalence of anorexia nervosa?
0.1-0.8%
at what age do 75% of anorexia nervosa occur by?
22
in developed countries children are more likely to suffer from an eating disorder than?
Meningococcal disease
incidence of anorexia nervosa in adolescence is greater in those with what conditions?
T1DM
IBS
Describe the SCOFF questionnaire
If patients score 2 or more positive answers, then an eating disorder is likely:
• Do you make yourself Sick because you feel uncomfortably fully?
• 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 dominated your life?
what is anorexia nervosa?
There is an obsessive fear of fatness with avoidance of food and other sources of calories and a range of compulsive “compensatory” behaviours when food cannot be avoided. In time, these behaviours are the only way to avoid the experience of anxiety and there are secondary physical and psychological consequences of starvation
what are the F50.0 criteria for anorexia?
Restriction of intake to reduce weight
• Relies on compulsive compensatory behaviours when food cannot be avoided, Self-induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants / diuretics
• Considered anorexic if he/she is 15% below ideal body weight/BMI 17.5 or <
• Fear of weight gain
• [In postmenarchal females, absence of the menstrual cycle or amenorrhoea (greater than 3 cycles)]
symptoms of anorexia nervosa
Cold intolerance – core body temperature, and low HR • Blue hands and feet • Constipation – gut wall becomes thinner and slower • Bloating • Delayed puberty • Primary or secondary amenorrhea • Dry skin • Fainting • Hypotension • Lanugo hair • Scalp hair loss • Early satiety • Weakness, fatigue • Short stature • Osteopenia & osteoporosis
what are the F50.2 criteria for bulimia nervosa
- Episodes of binge eating with a sense of loss of control
- Binge eating is followed by compensatory behaviour of the purging type (self-induced vomiting, laxative abuse, diuretic abuse) or nonpurging type (excessive exercise, fasting, or strict diets).
- Binges and the resulting compensatory behaviour must occur a minimum of two times per week for three months
- Dissatisfaction with body shape and weight
signs and symptoms on bulimia nervosa
• Mouth sores • Pharyngeal trauma • Dental caries • Heartburn, chest pain • Oesophageal rupture • Impulsivity: o Stealing o Alcohol abuse o Drugs/tobacco • Muscle cramps • Weakness • Bloody diarrhoea • Irregular periods • Fainting • Swollen parotid glands • Hypotension
what is binge eating disorder?
Binge eating disorder is similar to bulimia nervosa; but with absence of purging behaviours. Ongoing and/or repetitive cycles also include:
- Unusually fast eating, usually alone
- Unusually large amounts consumed
- Uncomfortably full; often buzzed after eating
- Embarrassment, shame, guilt, depression
how do people with eating disorders avoid calorie intake?
- Diets – becoming vegetarian, vegan
- Not touching food or grease
- Developing dislikes, pickiness, even ‘allergies’
- Interpreting all symptoms as allergy or indigestion
- Eating very slowly, only eating at certain times
- Avoiding parties and social occasions
- Spoiling or messing of food, bizarre combinations
- Refusing to eat more than the person who eats least, rules about always finishing last etc
- Medication abuse - appetite suppressants – including gum, cigarettes - alternative, otc & www medications
how may people with eating disorders get rid of calories?
- Self-induced vomiting
- Chewing & spitting out
- Overexercise – often secret
- Overactivity – obsessive housework, fidgeting, twitching, never sitting down, fetching one item at a time, carrying heavy loads
- Cooling – inadequate dress, open windows etc
- Blood letting
- Medication abuse – including alternative, OTC & www medications, excessive caffeine and stimulant consumption – laxatives, ipecac, pain killers to allow exercise despite damage
describe some eating disorder behaviours
- ‘Body-checking’– repeated weighing, mirror gazing, self-measurement, self-photographing, trying on particular tight clothes
- Displaying emaciation to elicit reassuringly shocked attention
- Cruising ‘pro-ana’ websites/facebooking/emailing fellow sufferers
- Competing with self and others to attain lower and lower targets
- Compulsive browsing of gossip magazines and websites – celebrities, ‘thinspirations’
- Deliberate self-harm if ‘rules’ are broken
describe the psychological consequences of eating disorders
The core psychopathology resembles religious belief, with the adherents willing to sacrifice even other
highly values things to the cause. These include extreme overvaluation of low weight and thin/lean
shape. Obsessive weight-losing feels like a solution, not a problem. Cognitive style shows reduced
central coherence and narrowed focus of interest – a difficulty in seeing the bigger picture. A starved
person is unable to interpret emotion as in Asperger’s, but this does improve with better nutrition.
Malnourished brains experience depression, anxiety, obsessionality and loss of concentration on
anything but food. Depression at low weight rarely responds to medication. People who rely on eatingdisordered
behaviour to “solve” their problems fail to develop other ways to cope with life, tolerate
distress or feel rewarded and fulfilled. Anxiety eating in company, followed by guilt after eating.
