Eating Disorders

Question 1

What are the features of Anorexia Nervosa?

Answer 1

Phobia of normal body weight, weight loss due to emaciation, endocrine disorder, secondary amenorrhoea/absent libido/emotional immaturity.

Question 2

What are the behaviours causing weight loss?

Answer 2

Dietary restriction, over-activity, self-induced vomiting, laxative misuse, diuretic misuse.

Question 3

What are the keys points of the outcome of Anorexia Nervosa?

Answer 3

Character of illness changes after 7 years to a severe and enduring AN:

• Persistent
• Resistant to treatment
• Severity (of AN an it’s effects on life)
• Unemployment, medical complications, hospital admissions

Question 4

What are the potential medical consequences of Anorexia Nervosa?

Answer 4

• Neurological (cortex shrinks)
• Dermatological (teeth marks on knuckles)
• Reproductive (amenorrhoea, difficulty conceiving)
• Bone (osteoporosis)
• GI (oesophageal tears and dysplastic changes in mucosa)
• Oral (absence of enamel on back of teeth from acid)

Question 5

What is the treatment for Anorexia Nervosa?

Answer 5

• 6 months psychological therapy (CBT-ED, then MANTRA, SSCM for sever and enduring Anorexia Nervosa)
• Dietetic counselling should be offering in conjunction
• Family therapy
• Do not delay inpatient treatment for stall in weight gain

Question 6

What are the features of Bulimia Nervosa?

Answer 6

No fear of normal body weight, food binges, later onset, compensatory behaviour to stop weight gain, major fluctuations, low self-esteem.

Question 7

What is the major endocrine/gynaecological condition related to Bulimia Nervosa?

Answer 7

Polycystic Ovarian Syndrome

Question 8

What is multi-impulsive Bulimia?

Answer 8

Associated with alcohol and drug abuse, overdosing, self-damaging behaviour, sexual disinhibition - behaviours are interchangable.

Question 9

What is the three layered structure of Bulimia Nervosa?

Answer 9

• Behaviours (binges, vomiting, over-exercise, risk-taking behaviours)
• Mood changes
• Dynamic/social core (life events)

Question 10

What is the treatment for Bulimia Nervosa?

Answer 10

Should be in community, 15-20 sessions of psychotherapy, CBT/interpersonal therapies, fluoxetine good for mood changes.

Question 11

What are the risk factors for Bulimia Nevrosa?

Answer 11

Female (more adipose as energy store for pregnancy), adolescence and early adulthood, western cultures.

Question 12

What are the key differences between Anorexia Nervosa and Bulimia Nervosa?

Answer 12

• Weight (low AN, normal BN)
• Age of onset (mid-teens AN, adults BN)
• Age of presentation (mid-teens AN, mid-20s BN)
• Psychopathology (phobia present in AN not in BN)