Eating Disorders Flashcards
What screening tool is used for eating disorders?
SCOFF questionnaire
SCOFF questionnaire features
If score 2 or more positive answers, then an eating disorder is more likely
- 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 in a three month period?
- do you believe yourself to be FAT when others say you are too thin?
- would you say that FOOD dominates your life?
Key features of obsessive weight losing disorders
Obsessive fear of fatness with avoidance of food and other sources of calories
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
ICD-10 classification for anorexia nervosa
Body weight < 15% of expected
Body image distortion
Self induced
(amenorrhoea)
Who gets anorexia nervosa?
75% occur before age 22
90% in females
Presentation of anorexia nervosa
Restriction of intake to reduce weight Relies on compulsive compensatory behaviours when food cannot be avoided fear of weight gain cold intolerance blue hands and feet constipation bloating delayed puberty primary / secondary amenorrhoea dry skin fainting hypotension lanugo hair scalp hair loss early satiety weakness, fatigue short stature osteopenia and osteoporosis loss of muscle (including cardiac muscle) Infertility
Examples of compensatory behaviours
Self induced vomiting/purging excessive exercise abuse of appetite suppressants / diuretics / laxatives strict diet fasting
How can constipation of anorexia nervosa relate to the psychological aspect of it?
Gut slows down - reduced peristalsis and so this can lead to e.g. a tight tummy which can contribute to the psychological aspect
What is bulimia nervosa?
Binges and the resulting compensatory behaviour - which must occur a minimum or two times per week for 3 months
Presentation of bulimia nervosa
Episodes of binge eating with a sense of loss of control
Binge eating with a sense of loss of control
Binge eating is followed by a compensatory behaviour of the purging type or non purging type
Dissatisfaction with body shape and weight
mouth sores
Hoarse voice
pharyngeal trauma
dental caries / damaged teeth
heartburn
chest pain
oesophageal rupture
impulsivity (stealing, alcohol abuse, drugs/tobacco)
muscle cramps
weakness
bloody diarrhoea
irregular periods
fainting
swollen parotid glands (Parotid enlargement)
hypotension
Electrolyte abnormalities
Dehydration
Why do upper GI problems occur in bulimia nervosa?
Due to vomiting and gastric acid in the upper GI
What is a particular worry in bulimia nervosa?
Electrolytes - especially potassium as this can cause cardiac arrhythmias
What is binge eating disorder?
Similar to bulimia nervosa but in the absence of purging behaviours
Presentation of binge eating disorder
ongoing and/or repetitive cycles often including
- unusually fast eating, usually alone
- unusually large amounts consumed
- uncomfortably full; often buzzed after eating
- embarrassment, shame, guilt
- depression
Methods of avoiding calorie intake
Diets - veggie / vegan
Not touching food or grease
Developing dislikes, pickiness or even ‘allergies’
Interpreting all the symptoms as allergy or ingestion
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 the least
rules about finishing last etc
medication abuse
- appetite suppressants (gum, cigarettes)
- alternative, OTC and www medications
Methods of getting rid of calories
Self induced vomiting Chewing or spitting it out Over exercise - often secret Overactivity - obsessive housework - fidgeting / twitching - never sitting down - fetching one item at a time - carrying heavy loads Cooling making the body shiver - inadequate dress - open windows Blood letting - cutting themselves and letting blood out Medication abuse - alternative, OTC and www medications - excessive caffeine and stimulant consumption - laxatives, ipecac - pain killers to allow exercise despite damage
Presentation of body checking
Repeated weighting mirror gazing self measurement self photographing trying on particularly tight clothes
