Eating disorders Flashcards
Is anorexia nervosa more common in males or females?
Females - 90% of cases
What condition increases risk of eating disorder?
Type 1 diabetes
When is peak onset of mental illness in general?
Mid teens to early 20s
How are eating disorders screened?
SCOFF questionnaire
What are components of SCOFF questionnaire?
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? (6.35kg)
Do you believe yourself to be FAT when others say you’re thin?
Would you say FOOD dominates your life?
What is anorexia nervosa?
Restriction of food intake to lose weight
What are psychiatric features of anorexia nervosa?
Compulsive compensatory behaviours when food can’t be avoided, self induced vomiting, laxative abuse, excessive exercise
Fear of weight gain
Abscence of menstrual cycle for over 3 months in postmenarchal females
When is someone considered anorexic?
BMI<17.5
What are physical features of anorexia nervosa?
Cold intolerance Blue hands and feet Constipation Delayed puberty Primary or secondary amenorrhoea Dry skin Fainting Hypotension Lanugo hair Scalp hair loss Early satiety Weakness/fatigue Short stature Osteopenia and osteoperosis
What is normal BMI in the UK?
20-25
What is bulimia nervosa?
Binge eating with a sense of loss of control, followed by compensatory behaviour
Binges and compensatory behaviour must occur at least twice a week for 3 months
What are physical symptoms of bulimia nervosa?
Mouth sores Pharyngeal trauma Dental caries Heartburn, chest pain Oesophageal rupture Impulsivity Muscle cramps Weakness Bloody diarrhoea Irregular periods Fainting Swollen parotid glands Hypotension
What are bulimic patients at risk of due to vomiting?
Low potassium
Metabolic alkalosis
What is binge eating disorder?
Similar to bulimia but without purging behaviours
How do people avoid intake of calories with an eating disorder?
Diets
Not touching food or grease
Developing dislikes and pickiness
Interpreting all symptoms as allergy
Eating very slowly and only at certain times
Avoid parties and social occassions
Spoiling or messing of food
Refusing to eat more than the person who eats last
Medication abuse - appetite suppressants, OTC, etc
How do people with eating disorders get rid of calories?
Self-induced vomiting Chewing and spitting out Overexercise Overactivity Cooling Blood letting Medication abuse - caffeine, laxatives, ipecac, pain killers to allow exercise despite damage
What are other behaviours in eating disorders?
Body-checking - weighing, mirror gazing, self measurement
Displaying emaciation to elicit reassuringly shocked attention
Pro-anorexia websites
Competing with self and others to achieve lower targets
Compulsive browsing of magazines - thin celebrities
Deliberate self harm if rules are broken
What is the core psychopathology of eating disorders?
Extreme overevaluation of low eight and thin/lean shape
What happens to the brain as a result of eating disorder?
Depression
Anxiety
Obsessionality
What are social consequences of eating disorder?
People lie about what’s going on
Withdraw from friendships
Loss of interest in sexual relationships
How is growth affected in eating disorders?
If disorder starts before full growth height will not reach full potential
What are predisoposing factors for aorexia?
Genetic predisposition
Perinatal factors
Life events
Trauma
What are precipitating factors of anorexia?
Puberty
Dieting or non-deliberate weight loss
Increased exercise
Stressful life events
What are perpetuating factors of anorexia?
Delayed gastric emptying make them feel full
Narrowing focus
Obsessionality
How long is it estimated to take to recover from anorexia?
6-7 years
How can we treat eating disorders?
Re-feeding CBT Fluoxetine 60mg daily Olanzapine Specialised family work, especially younger patients
