Eating Disorders Flashcards
What is a screening tool for eating disorders?
SCOFF Questionaire;
If patent score 2 or more then an eating disorder is likely.
Do you make yourself Sick because you feel uncomfortable 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?
What are some key features of Eating disorders?
Obsessive fear of fatness.
A range of compulsive compensatory behaviours when food cannot be avoided.
Behaviours are only way to avoid anxiety.
Physiological and psychological consequences of starvation.
What are the characteristics of Anorexia Nervosa?
Restriction of food intake to reduce weight.
Relies on compulsive compensatory behaviours when food cannot be avoided e.g. self-induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants/diuretics.
Considered anorexic if 15% below ideal body weight or BMI <17.5.
Fear of weight gain
Amenorrhoea
What are some physical symptoms of Anorexia?
Cold intolerance Blue hands and feet Constipation Bloating Delayed puberty Amenorrhoea Dry skin Fainting Hypotension Lanugo hair Scalp hair loss Early satiety Weakness Fatigue Short stature Osteopenia/Osteoporosis
What are the characteristics of Bulimia Nervosa?
Episodes of binge eating with a sense of loss of control.
Binge eating then followed by compensatory purging behaviour or non-purging behaviour.
These occur a minimum of 2x per week for 3 months.
Dissatisfaction with body shape and weight.
What are some symptoms of Bulimia?
Mouth sores Pharyngeal trauma Dental caries Heartburn Chest pain Oesophageal rupture Impulsivity - stealing, alcohol abuse, drugs/tobacco. Muscle cramps Weakness Bloody diarrhoea Irregular periods Fainting Swollen parotid glands Hypotension
What is binge eating disorder?
Similar to bulimia but with the absence of purging behaviours.
Ongoing and repetitive cycles often include:
unusually fast eating
eating alone
unusually large amounts consumed
uncomfortably full after but buzzed.
Embarrassment, shame, depression and guilt afterwards.
What are some ways in which people with eating disorders avoid calories?
Diets - vegetarian/vegan Not touching greasy foods Pickiness Slow eating only at certain times Avoiding parties and social occasions Spoiling or messing food Bizarre combinations Refusing to eat more than the person who eats the least Rules about finishing last Medication abuse - appetite suppressants e.g. gum, fags, coffee.
How do people with an eating disorder get rid of calories?
Self-induced vomiting Chewing and spitting out Overexercise Overactivity Cooling Blood letting Medication abuse
What are the psychological consequences of an eating disorder?
Extreme overvaluation
reduced central coherence and narrowed focus of interest
Unable to interpret emotion.
Malnourished brain experience depression, anxiety, obsessionality and loss on concentration on anything but food.
Depression at low weight rarely responds too medication.
Social isolation
What are some physical consequences of an eating disorder?
Heart damage Reduced immunity to infections Anaemia Bone loss Fertility problems Neurochemcial disruption - seizures, arrhythmias. Height Brain growth Pubertal development
What are some precipitating factors for an eating disorder?
Puberty
Dieting or non deliberate weight loss.
Increased exercise
Stressful life events - neglect, abuse, difficult transitions etc.
What are some perpetuating factors for an eating disorder?
Delayed gastric emptying
Narrowing focus
Obsessionality
Families/School/Clinic staff
What is the average time of recovery from anorexia nervosa?
6-7years
What is the treatment for Anorexia nervosa?
Re-feeding CBT tailored to individual IPT Fluoxetine 60mg daily Olanzapine - helps block out some intrusive thoughts. Specialised family work
