Eating Disorders Flashcards
Prevalence of anorexia nervous
90% of cases are female
75% before 22
0.1-0.9% prevalence in life time
SCOFF questionnaire
If scores 2 or more positive answers, then eating disorder is 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 3 month period
Do you believe yourself to be Fat when others say you are too thin?
Would you say that Food dominates your life?
Define Anorexia Nervosa
Eating disorder characterised by ICD-10 by 4 key points:
1-BMI <17.5
2-Self-induced weight loss
3-Morbid fear of weight loss
(4-Endocrine dysfunction (e.g amenorrhoea)
Symptoms of Anorexia Nervosa
Cold intolerance Blue hands and feet Constipation Bloating Delayed puberty Primary or secondary Amenorrhoea Dry skin Fainting Bradycardia Hypotension Lanugo hair Scalp hair loss Early satiety Weakness Fatigue Short stature Osteopenia and osteoporosis
Signs of induced purging
Russell’s sign (calluses on knuckles or back of hands)
Tooth enamel that is pitted/ eroded
Enlarged parotid glands
What is Bulimia nervosa?
Eating disorder characterised by ICD-10 as 3 key points:
1-Patient engages in binge eating
2-Evidence of purgative behaviour
3-Morbid fear of fatness
Must occur a minimum of 2 times per week for 3 months
Signs and symptoms of Bulimia nervosa
Mouth sores, Pharyngeal trauma Dental caries Heartburn Chest pain Eosophageal rupture Muscle cramps Weakness Bloody diarrhoea Irregular periods Fainting Swollen parotid glands Hypotension Impulsivity- stealing, alcohol abuse, drugs/ tobacco
What is binge eating disorder
Similar to bulimia nervosa but with absence of purging behaviours Repetitive cycles often include: -unusually fast eating -unusually large amounts consumed -uncomfortably full -often “buzzed” after eating -embarrassment, shame, guilt, depression
Ways people avoid calorie intake
Diets,
Developing dislikes, pickiness, “allergies”,
Eating very slowly or only at certain times,
Avoiding parties and social occasions,
Spoiling or messing of food,
Refusing to eat more than the person who eats the least,
Medication abuse
Appetite suppressants- gum, cigarettes
How people get rid of calories
Self induced vomiting,
Chewing and spitting out,
Overactivity,
Cooling- inadequate dress, open windows,
Blood letting,
Medication abuse-excessive caffeine and simulate consumption eg laxatives, ipecac, pain killers (allow exercise despite damage)
Other eating disorder behaviours
Body checking ,
Checking “pro-ana” websites/facebooking/ emailing fellow sufferers,
Competing,
Compulsive browsing of gossip magazines and websites,
Deliberate self arm if “rules” broken
Psychological and social consequences of eating disorders
Psychological: Depression, Anxiety, Obsessionality, Loss of concentration
Social:
Isolation
What damage can starvation cause?
Heart damage, Immunosuppresion, Anaemia, Bone loss, Fertility problems
What are the consequences of purging behaviour?
Causes neuro-chemical disruption resulting in…
Seizures,
Arrhythmias,
QT prolongation (can lead to sudden death)
Overall physical complications of eating disorders?
Death, Endocrine dysfunction, Metabolic acidosis (laxative abuse), Metabolic alkalosis (excessive vomiting), Cardiac complications (arrhythmias, QT prolongation leading to death), Refeeding syndrome, Electrolyte abnormalities Anaemia, Proximal myopathy
