Eating Disorders Flashcards
What is the epidemiology of anorexia?
90% are females
Affects 0.1-0.9% of someone at some point
5-10% of young woman will have an eating disorder
Type 1 diabetes makes it more likely (20% of Young patients)
Mid teens to mid twenties
How do you screen for disordered eating in those with diabetes?
DEPSR-16 questionnaire (16 questions)
How do you screen for an eating disorder?
SCOFF questions (2 or more indicative)
Do you make yourself sick if you feel uncomfortably full
Do you worry you have lost control over how much your eat
Have you recently lost more than 1 stone (6.35kg)
Do you believe yourself to be fat when others say you’re thin
Does food dominate your life?
How do you classify anorexia nervosa?
Restriction of intake to reduce weight
Relies on compulsory behaviours when canntonbe avoided, self induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants
BMI<17.5 or 15% below ideal body weight
Fear of weight gain
Absence of menstraul cycle or amnerrhoea greater than 3 cycles
Late menarche
What are the symptoms of anorexia nervosa?
Cold intolerance Blue hands and feet Constipation Bloating Delayed puberty Primary or secondary ammenorrhea Dry skin Fainting Hypotension Hair loss Weakness/fatigue Short stature Osteopenia and osteoporosis (DEXA SCAN) Early fullness
Can reverse all of this with healthy BMI (20-25)
What is bulimia nervosa?
Episodes of binge eating with a sense of loss of control
Followed by compensatory behaviour of the purging type (vomiting, laxative abuse, diuretic abuse) or nonourging type (excessive exercise, fasting or strict diets)
Big es and the resulting compensatory behaviour must occur a minimum of two times per week for three months
Dissatisfied with body shape and weight
What are the symptoms of bulimia?
Mouth sores Pharyngeal trauma Dental cares Heartburn, chest pain Esophageal rupture Impulsivity (stealing, alcohol, abuse, drugs/tobacco) Muscle cramps Weakness Bloody diarrhoea Irregular periods Fainting Swollen parotid glands Hypotension
What is the most dangerous aspects of bulimia nervosa
Metabolic alkalosis leading to reduced potassium. This leads to arrhythmias and seizures.
Why do people with bulimia present with sore lumps
Parotid glands get swollen, with food leads to salivary stimulating
What are binge eating disorders?
Similar to bulimia nervosa without the purging behaviours
This includes
Eating fast and alone
Unusually large amounts
Uncomfortably full, buzzed after food
Leads to low mood, guilt, depression
What symptoms might people present with who are trying to avoid calorie intake
Becoming veggie, vegan
Not touching food or grease
Developing pickiness and allergies
Interpreting all symptoms as allergies or indigestion
Eating very slowly, only eating at certain times
Avoiding parties and social occasions
Smoking of messing food, bizarre combinations
Refusing to ear more than the person who eats last, rules surrounding food
Medication abuse- gum, cigarettes.
How do people get rid of calories?
Self induced vomiting Chewing and spitting out Overexercise Oferactivitu-obsessive housework, fidgeting, twitching, never sitting down, fetching one item at a time Cooling- inadequate dress, open widows Blood letting Medication abuse
What are some other eating disorder behaviours?
Respected weighing, mirror hazing, self measurement, self photographing, trying on tight clothes
Displacing emancipation to elicit reassuringly shocked attention
Emailing fellow sufferers
Competing with self and others to attain lower and lower targets
Compulsive browsing of gossip magizines, thinspirations
What are the psychological consequences of eating disorders
Extreme overvaluation of low weight and thin/lean shape- almost religous following, giving up other things they love
Obsessive weight losing feels like a solution, not a problem
Cognitive style shows a reduced central coherence and narrowed focus of interest
Starved person struggles to interpret emotion
What other other consequences are there in the psychological aspect of eating disorders
Depression, anxiety, obssionality and loss of concentration on anything except food
Depression at low weight rarely responds to medication
People who rely on earring do refer behaviours fail to cope with life and struggle to feel rewarded or fulfilled
What are the social consequences of eating disorders?
Turn other people into obstacles to eating disorder- become isolated
What are the physical consequences of eating disorders
Heart damage, reduced immunity to infections anaemia bone loss seizures arrhythmia
How is growth shown in woman
Height growth slows down before weight growth
What causes anorexia?
Genes- OCD, anxiety, disorders, perfectionism
Perinatal factors
Life events and traumas
Perpetuating consequences of starvation and of avoidance
What precipitate eating disorders
Hormonal changes of puberty
Dieting or non deliberate weight loss
Increased exercise
Stressful life events (deaths, transitions, stress, bullying)
What are the perpetuating factors of eating disorders
Delayed gastric emptying
Narrowing focus
Obsessional
High expressed emotion by family colleagues or clinic staff may delay recovery
How common is death and anorexia nervosa?
Highest mortality rate of any eating disorder
Die from starvation or self harm which may or may not be suicide
Modern specialised units are associated with lower mortality rates
Increased risk of death by 10 fold
How do you treat and eating disorder
No one size fits all Estimated recovery takes 6-7 years Re- feeding CBT-ED IPT or fluoxetine Olanzapine Specialised family work for anorexia nervosa, particularly young patients
What is key to remember during treating anorexia?
Diagnosis, not acccusation
Patients are obliged to defend their weight loss defendants
What the patient says they will do is not the same as what they will do
Patience is needed as psychological recovery will take ages
Empowerment of parents and family fighting illness together
