Eating Disorders Flashcards
Eating disorder definition
unhealthy and distorted obsession with body image and food.
strong correlation with personality disorders, obsessive compulsive disorder, anxiety and other mental health disorders.
more common in girls, genetic component to the condition.
anorexia nervosa
person feels overweight despite evidence of normal / low body weight. obsessively restricting calorie intake with intention of loosing weight. excessively exercises, diet pills, laxatives.
Excessive weight loss Amenorrhoea Lanugo hair is fine, soft hair across most of the body Hypokalaemia Hypotension Hypothermia Changes in mood, anxiety and depression Solitude
cardiac: arrhythmia, cardiac atrophy, sudden cardiac death
Bulimia nervosa
- sign and symptoms
normal body weight
weight tends to fluctuate
binge eating followed by purging (vomiting, laxatives)
Alkalosis, due to vomiting hydrochloric acid from the stomach
Hypokalaemia
Erosion of teeth
Swollen salivary glands
Mouth ulcers
Gastro-oesophageal reflux and irritation
Calluses on the knuckles where they have been scraped across the teeth. This is called Russell’s sign.
Binge eating disorder
episodes where the person excessively overeats
expression of underlying psychological distress
not a restrictive condition
likely to be overweight
A planned binge involving “binge foods” Eating very quickly Unrelated to whether they are hungry or not Becoming uncomfortably full Eating in a “dazed state”
bing eating disorder management
Self help resources
Counselling
Cognitive behavioural therapy (CBT)
Addressing other areas of life, such as relationships and past experiences
severe= admission
SSRI
Re-feeding syndrome
occurs in people with severe nutritional deficit for an extended period.
higher risk if BMI <20 and had little to eat for 5 days
lower the BMI and longer the period of malnutrition, higher the risk
Metabolism in the cells and organs dramatically slows during prolonged periods of malnutrition. As the starved cells start to process glucose, protein and fats again they use up magnesium, potassium and phosphorus. This leads to:
Hypomagnesaemia
Hypokalaemia
Hypophosphataemia
These patients are also at risk of cardiac arrhythmias, heart failure and fluid overload.
Re-feeding syndrome management
Slowly reintroducing food with restricted calories
Magnesium, potassium, phosphate and glucose monitoring along with other routine bloods
Fluid balance monitoring
ECG monitoring may be required in severe cases
Supplementation with electrolytes and vitamins, particularly B vitamins and thiamine
