Eating Disorders

Question 1

What are the 3 eating disorders to know?

Answer 1

Anorexia, bulimia, and binge eating

Question 2

Bulimia and anorexia are often accompanied by what?

What is an indication for hospitalization in these patients?

Answer 2

Suicidality

If they have a specific suicide plan

Question 3

What are the two types of anorexia?

Answer 3

Resistive, 3 months of no binging or purging. Excessive exercising, fasting, dieting.

Binge eating/purging, 3 months of binging and purging. Vomiting, laxatives, diuretics.

Question 4

Most common medical complication leading to death in patients with anorexia?
What is another body system he mentioned being messed up as well?

Answer 4

Cardiac

GI, gastroparesis and constipation

Question 5

What is a serious complication of treatment of anorexia?

Answer 5

Re feeding syndrome. Do not rehydrate or feed patients beyond their current capacity

Question 6

2 most common comorbidities with anorexia?

Answer 6

OCD and borderline personality disorder

Question 7

Treatment requires what kind of team?

2 things first line treatment for anorexia at minimum?

Answer 7

Interdisciplinary team

Nutritional rehab and psychotherapy

Question 8

What does the psychotherapy for anorexia patients focus on?

Answer 8

Helping the patients confront their disorder and change their eating habits and thoughts about weight gain

Question 9

4 types of psychotherapy for anorexia?

Answer 9

CBT
Specialist support clinical management
Motivational learning
Family therapy

Question 10

What medicines to avoid in anorexia patients and why?

Answer 10

Bupropion because of seizure
TCA because of cardiac
Antipsychotics and antidepressants because of QT prolongation

Question 11

What two meds to give to anorexia patients and why?

Answer 11

Olanzapine 2.5 -10 mg per day as adjunct which can help with weight gain

Lorazepam .5 mg before eating to help with the anxiety associated with eating

Question 12

Definition of bulimia for the purposes of diagnosis?

Answer 12

Binge eating that they cant control and inappropriate compensatory mechanisms at least 2 times per week for 3 months

Question 13

What is the big difference between anorexia and bulimia?

Answer 13

Anorexia they are way underweight

Bulimia can be normal weight, overweight or just slightly underweight. They aren’t so concerned with being thin, just not fat.

Question 14

5 clinical signs of bulimia when you see the patient?

Answer 14

Mallory Weiss syndrome, esophageal rupture, parotid glands are huge, teeth suck, callus on hands which is called russel sign.

Question 15

Best standard treatment for bulimia and which os the three is treatment of choice?

Answer 15

Combo of nutritional rehab, CBT psychotherapy, and pharmacotherapy.

Treatment of choice is CBT

Question 16

Avoid which drug in bulimia?

Answer 16

Bupropion because of seizure

Question 17

As far as meds used for bulimia, what are the three lines?

Answer 17

First line: fluoxetine

Second line: SSRIs, sertraline and fluvoxamine

Third line: tricyclics, topiramate, trazodone and MAOIs

Question 18

Good definition of binge eating disorder and how it is different from anorexia and bulimia?

Answer 18

Binge eating episode of a discrete amount of time once a week for at least 3 months.

No inappropriate compensatory mechanisms like the other two

Question 19

What is the first line treatment for binge eating disorder?

What is the only medication approvals for Binge eating disorder?

Answer 19

Psychotherapy, CBT or IPT

Vyvanse, also indicated for ADHD

Question 20

What drugs are not recommended in binge eating disorder?

Answer 20

Anti obesity drugs