Eating disorders Flashcards
what screening tool is used for eating disorders?
SCOFF Questionnaire
what is the SCOFF Questionnaire?
If patients score 2 or more positive answers, then an 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 (14 pounds or 6.35 kg) in a three 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
Restriction of intake to reduce weight, Relies on compulsive compensatory behaviours when food cannot be avoided, Self induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants / diuretics, Considered anorexic if he/she is 15% below ideal body weight/BMI 17.5 or
sy/sx of anorexia
cold intolerance, blue hands and feet, constipaiton, bloating, delayed puberty, primary or secondary amenorrhea, dry skin, fainting, hypotension, lanugo hair, scalp hairloss, early satiety, weakness, fatigue, short, osteopenia, osteoporosis
Define Bulimia Nervosa
Episodes of binge eating with a sense of loss of control
Binge eating is followed by compensatory behaviour of the purging type (self-induced vomiting, laxative abuse, diuretic abuse) or nonpurging type (excessive exercise, fasting, or strict diets).
Binges and the resulting compensatory behaviour must occur a minimum of two times per week for three months
Dissatisfaction with body shape and weight
sy/sx of Buliimia
Mouth sores, Pharyngeal trauma, Dental caries, Heartburn, chest pain, Esophageal rupture, Impulsivity: Stealing, Alcohol abuse, Drugs/tobacco. Muscle cramps, Weakness, bloody diarrhoea, irregular periods, Fainting, Swollen parotid glands, hypotension.
what electrolytes do you need to monitor if a patient is constantly vomiting and has diarrhoea?
Potassium
what is Binge easting disorder?
Similar to bulimia nervosa; absence of purging behaviours. Ongoing and/or repetitive cycles often include, unusually fast eating, usually alone, unusually large, amounts consumed. uncomfortably full; often “buzzed” after eating. embarrassment, shame, guilt, depression.
methods to avoid calories and get rid of calories…
diets, not touching food, slow eatinng, spoiling food, medication abuse, self induced vomiting, overexercise and activity, cooling, blood letting
what are the psychological consequences of eating disorders?
The core psychopathology - extreme overvaluation of low weight & thin/lean shape – resembles religious belief, with the ‘adherents’ willing to sacrifice even other highly valued things to the cause. Obsessive weight-losing feels like a solution, not a problem, Cognitive style shows reduced central coherence & narrowed focus of interest – a difficulty in seeing the ‘bigger picture’. And a starved person is unable to interpret emotion – as in Aspergers - but this does improve with better nutrition. Malnourished brains experience depression, anxiety, obsessionality and loss of concentration on anything but food.
Depression at low weight rarely responds to medication. People who rely on eating-disordered behaviour to ‘solve’ their problems fail to develop other ways to cope with life, tolerate distress or feel rewarded and fulfilled. Anxiety eating in company, followed by guilt after eating.
what are the social consequences of eating disorders?
Eating disorders turn other people into mere obstacles to the eating disorder! Normally honest people are forced to lie and cheat, even to steal about eating disorder concerns. Sufferers withdraw from friendships and lose interest in sexual relationships. ‘I could summarise my experience of anorexia in a single word – ISOLATION’
what are the physical consequences of eating disorders?
Starvation causes physical damage, poor repair and resistance, heart damage, reduced immunity to infections, anaemia, bone loss, fertility problems
Purging behaviours cause neuro-chemical disruption with special damage to brain (seizures) and heart (arrhythmias). Potassium is only one crude measure of the problem. Young people need good nutrition to allow growth – height, pubertal development, brain growth and development (especially frontal lobe growth), so re-nutrition is more urgent the younger the patient
Predisposinng factors of ED
genetic, perinatal, lifeevetns, perpetuating consequences of stravation annd of avoidance.
precipitating factors of ED
puberty, dieting, increased exercise, stressful life events
Perpetuating factors of ED
consequences of ‘starvation syndrome’: delayed gastric emptying, narrowing focus, obsessionality, families, school, clinnical staff
