Eating Disorders Flashcards
True or False - EDs have the highest mortality rate out of all mental illness
True
what is the gender split for eating disorders
F>M 10:1
When is the peak age for eating disorder presentation
adolescence
Aetiology for eating disorders
hypothalamic dysfunction perfectionism decreased self-esteem early sexual development history of abuse personality disorder parental overprotection
How do you assess a suspected eating disorder
Establish eating behaviour - method of weight loss, daily intake, relationship with body image, binge eating
Medical history - specifically: menstrual history, sexual dysfunction, starvation complications, digestive complications, known physical illness
Personal /social history - past abuse + context, bullying, bereavements, major change at home or school, and the effect of the behaviour on school, home life, relationships, socialising, hobbies and careers
How do you Diagnose anorexia
<15% expected weight OR BMI <17.5
Weight loss is self-induced via avoidance of ‘fattening’ foods, as well as 1 or more of: purging, excessive exercise, use of appetite supplements, diuretics
Body image distortion with an intrusive, overvalued idea of becoming/being fat, resulting in the patient imposing a low weight barrier on themselves
Widespread endocrine disorder involving the hypothalamic-pituitary-gonadal axis resulting in: amenorrhoea in women and sexual impotence in men
if pre pubertal: delayed development
How do you diagnose Bulimia
Persistent occupation with eating and irresistible craving for food resulting in binge eating sessions
Patient attempts to counteract with one or more of self induced vomiting appetite suppressants voluntary starvation in diabetics - insulin neglect
Morbid dread of obesity
Differentials for an eating disorder
Hyperthyroidism Depression OCD Body dysmorphic disorder Psychosis
Prognosis for anorexia
slow
1/3 in 3 years
2/3 in 3-6 years
>15 years of no recovery = far less likely to recover
What is the 10-year mortality for anorexia
10%
Poor Prognosis indicators for anorexia
very low weight bulaemic features family difficulty personality diffiulty longer illness duration
Prognosis for bulimia
70% recover in 10 years
1% mortality
Poor prognostic indicators for bulimia
low weight and depression
What are some common comorbidities for eating disorders
Anxiety
Depression
Self-harm
What are some hair-related consequences of anorexia
brittle-thin hair lanugo hair (fine baby hair) on face/body
