Eating Disorders

Question 1

What is the DSM-5 criteria for anorexia nervosa?

Answer 1

• Restriction of energy intake in relation to requirement leading to a low weight
• Intense fear of weight gain
• Disturbed view of weight/shape, self evaluation based on weight/shape or denial or seriousness of weight loss

(BMI and amenorrhoea no longer part of diagnostic criteria)

Question 2

What are some risk factors for anorexia nervosa?

Answer 2

Female
Occupational eg dancer
Perfectionism
OCPF personality disorder
Young dieting behaviours

Question 3

What blood test results might you expect in anorexia nervosa?

Answer 3

Low K
Low T3
Low LH, FSH, oestrogen and progesterone

High cholesterol
High cortisol

Question 4

What are some signs and symptoms of anorexia nervosa?

Answer 4

Dizziness/ syncope 
Lanugo hair 
Cheek swelling (enlarged salivary glands)
Hypotension 
Bradycardia 
Hypothermia 
Constipation 
Osteoporosis 
Recurrent miscarriage

Question 5

How is anorexia nervosa managed? How is this different in children?

Answer 5

CBT-ED
MANTRA
SSCM
ED focussed psychodynamic psychotherapy

Children: Family therapy

Question 6

What bloods test results characterise refeeding syndrome?

Answer 6

Low phosphate, magnesium and potassium
Low thiamine
High glucose

Question 7

What is bulimia nervosa characterised by? (DSM-5)

Answer 7

1x/week for 3 months:

• Recurrent episodes of binge eating in which the patient feels out of control
• Compensatory behaviour in an attempt to prevent weight gain

+ self evaluation based on weight/shape

Question 8

Describe the cycle patients with bulimia nervosa go through

Answer 8

1 Tension and cravings
2 Binge eating
3 Purging to avoid weight gain
4 Shame and disgust
5 Strict dieting

Question 9

What are some signs and symptoms of bulimia nervosa?

Answer 9

• Dizziness
• Swollen cheeks
• Tooth erosion and gum disease
• Oesophageal tears and rupture
• Stomach ulcers
• Irregular bowel movements, bloating
• Arrhythmias, HF
• Knuckle abrasion
• Dehydration, low K, Mg and Na

Question 10

How is bulimia nervosa managed? How is it managed in children?

Answer 10

4 weeks of guided self help programme
If no improvement then CBT-ED
+/- Fluoxetine (licensed for bulimia)

Children: Bulimia nervosa focussed family therapy (BN-FT)