Eating disorders Flashcards
What screening tool is used for eating disorders?
SCOFF questionnaire
What is the SCOFF questionnaire?
Male self Sick because uncomfortably fill
Worry they’ve lost Control over eating
Lose more than One stone in 3 months
Believes self to be Fat when others think they are thin
Food dominates life
What is anorexia nervosa?
Restriction of intake to reduce weight
Relies on compensatory behaviours when food cannot be avoided
What are some compensatory behaviours used in anorexia nervosa?
Self induced vomiting
Laxative abuse
Abuse of appetite suppressants/diuretics
Excessive exercise
What are the risk factors for anorexia nervosa?
Female Adolescence and puberty Dieting, non deliberate weight loss Increased exercise Stressful life event
What are some clinical features of anorexia nervosa?
Fear of weight gain Body checking Cold intolerant Constiation and bloating Amenorrhoea Dry skin Fainting Hypotension, Bradycardia Scalp hair loss Weakness, fatigue Osteopenia, osteoporosis Short stature, delayed puberty
How is anorexia nervosa diagnosed?
Restriction of intake relative to requirements leading to significantly low body weight in context
Intense fear of gaining weight or becoming fat
Body dysmorphia
What is the management of anorexia nervosa in children?
Physical
- Structured eating plan with oral/enteral/parenteral nutritional
- Careful monitoring of fluids and electrolytes
1. Anorexia focused family therapy
2. CBT
What is the management of anorexia nervosa in adults?
Physical
- Structured eating plan with oral/enteral/parenteral nutritional
- Careful monitoring of fluids and electrolytes
1. Eating disorder focused CBT
2. Add SSRI or olanzapine
What are some complications of anorexia?
Heart damage Reduced immunity Osteopenia and osteoporosis Fertility issues Slowed development Seizures and arrythmias- vomiting and laxative aduse Refeeding syndrome
What is refeeding syndrome?
Severe fluid and electrolyte shifts and related metavbolic complications in malnourished patients undergoing refeeding
What causes refeeding syndrome?
Primarily due to phosphate depletion, caused by shift intracellularly to produce ATP
Prescribe Pabrinex with refeeding
What is bulimia nervosa?
Episodes of binge eating with a sense of loss of control, followed by compensatory behaviour, of purging or non purging type
>1 episode a week for 3 months
What is purging type behaviour?
Self induced vomiting
Laxative or diuretics abuse
What is non purging behaviour?
Excessive exercise
Fasting
Strict diet
What are the risk factors for bulimia nervosa?
Female 20-35yo Childhood obesity Early onset puberty FH mental health problems Impulsivity
What are th clinical features of bulimia nervosa?
Body checking Dissatisfaction with weight and body shape Dental issues, Swollen parotids, Mouth sores Pharyngeal trauma, Oestophageal rupture Russel's sign Bloody diarrhoea Muscle cramps Fatigue, weakness Fainting Hypotesion
What is Russel’s sign?
Teeth marks on knuckles
How is bulimia diagnosed?
Recurrent episodes of binge eating, associated with lack of control
Recurrent inappropriate compensatory behaviour
At least once a week for 3 months
What is the management of bulimia nervosa in adults?
Nutritional and meal support
- CBT
- Add SSRI/SNRI or use as firstling where CBT not appropriate/available
What is the management of bulimia nervosa in children?
Nutritional and meal support
Bulimia nervosa focused family therapy
What are some complications of bulimia?
Volume depletion Electrolyte abnormalities Seizures, arrythmias Heart damage Fertility issues Dental issues
