Eating Disorders Flashcards
What is the epidemiology of anorexia nervosa?
Incidence is 1%
10 times more common in women
Usually begin in teens
What are the symptoms of anorexia nervosa?
Refusal to maintain body weight (BMI <=17.5) Intense fear of weight gain Disturbance of body image Denial of seriousness of low weight Amenorrhoea
What is subclincal anorexia nervosa?
Not all diagnostic criteria met = more prevalent, may be precursor to complete syndrome
What is the mortality of anorexia nervosa?
Highest mortality of any psychiatric condition = 5% per decade
What are some common co-morbidities of anorexia nervosa?
Anxiety, depression, OCD, alcohol misuse
What are some of the behaviours seen in anorexia nervosa?
Food restriction, over-exercising, obsession with self-weighing, misuse of laxatives or diet pills, lying about eating, calorie counting
What is the genetic influence in anorexia nervosa?
10 times higher risk if first degree relative affected
Heritability may be up to 70%
What are some general complications of anorexia nervosa?
Hypokalaemia, hyponatraemia, dehydration and rebound water retention, oedema, enlarged parotid glands, indigestion, bloating, constipation, delayed gastric emptying
What are some CV and CNS complications of anorexia nervosa?
CV = low heart rate and BP, prolonged QTc interval, arrhythmia, cardiac arrest CNS = peripheral paraesthesiae, tetany, seizures, reduced grey matter, enlarged ventricular spaces
What are some of the MSK complications of anorexia nervosa?
Muscle wasting, weakness, osteopenia, dry skin, lanugo hair, poor peripheral circulation, hair loss
What are some haematological complications of anorexia nervosa?
Raised LFTs, low WBC, anaemia, bone marrow suppression, thrombocytopenia
How does anorexia nervosa affect people psychologically?
Low mood, anxiety, irritability, narrowed range of interests, rigid thinking, social withdrawl, poor concentration, impaired decision making, drowsiness
What are the treatment options for anorexia nervosa?
Family based therapy, cognitive behaviour therapy, interpersonal therapy, specialist supportive clinical management, medication
How is family based therapy used to treat anorexia nervosa?
1st line in children and teens = parents guided to appropriately feed child calmly but persistently
How is cognitive behaviour therapy used to treat anorexia nervosa?
Focuses on recognising unhelpful thoughts about eating then challenging them and learning healthier ways of thinking
What is the focus of interpersonal therapy?
Various roles that different relationships have in someone’s life and how they can be used in a more supportive way
What is specialist supportive clinical management of anorexia nervosa?
Combines clinical management with supportive therapeutic style = aims to get patients to make a link between their symptoms and their eating behaviour
What medications are used in anorexia nervosa treatment?
Calcium and vitamin D supplement for bone thinning
Oestrogen patches for amenorrhoea
Antidepressants for low mood
What are the symptoms of bulimia nervosa?
Recurrent binges associated with compensatory behaviours = vomiting, excessive exercise, fasting
Pre-occupation with body shape and weight
What is a binge?
Consumption of unusually large amounts of food within a short interval associated with loss of control
How often do binges need to occur to diagnose bulimia nervosa?
At least once a week for three months
What is Russel’s sign?
Calluses on back of hand from self inducing vomiting = seen in bulimia nervosa and sometimes anorexia nervosa
What are associated conditions of bulimia nervosa?
Usually have co-morbid depression an dental caries
Risk of oesophageal or gastric rupture = can be fatal
What are the treatment options for bulimia nervosa?
Individual and group cognitive behaviour therapy
High dose fluoxetine may reduce food cravings