Eating Disorders Flashcards
Who tends to be affected by anorexia nervosa?
75% of cases occur before age 22
90% of patients are female
prevalence is about 1% in females, 0.5% in males
What is the SCOFF questionaire?
Method of screening for eating disorder, does the patient score 2 or more positive answers:
- do you make yourself sick bc you feel full?
- Do you worry you’ve lost control over how much you eat?
- Have you recently lost more than one stone?
- Do you believe you are too fat?
- would you say that food dominates your life?
What is anorexia nervosa?
Excessive loss of weight due to fear of fat as an over valued idea. Involves:
- Restriction of calorie intake
- Compensation for situations where food cannot be avoided in the form of: self induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants / diuretics
What are the requirements for diagnosis with anorexia nervosa?
Body weight is at least 15% below what is expected, or BMI is less than 17.5
- This must be due to fear of putting on weight and voluntary weight loss
What are some signs and symptoms of anorexia nervosa?
Delay or arrest of puberty Amenorrhoea in females Reduced libido in males Cold intolerance Constipation Dry skin Hypotension Fainting Scalp hair loss Short stature Osteopenia / osteoporosis
What is bulimia nervosa?
Episodes of binge eating followed by compensatory mechanisms of the purging type.
- Self induced vomiting, laxative abuse, diuretic abuse, excessive exercise, fasting)
Characterized by disatisfaction with body weight and a sense of loss of control during binges
What are some signs and symptoms of bulimia nervosa?
Oesophageal rupture Mouth sores Pharyngeal trauma Heartburn / chest pain Muscle cramps / weakness Impulsivity (stealing / alcohol abuse / drugs) Blood diarhhoea Irregular periods
What is binge eating disorder?
Similar to bulimia nervosa, absence of purging behaviours
Often includes rapid, excessive eating followed by feelings of shame, guilt and embarassment
What are some methods of getting rid of calories that people suffering from eating disorders may exploit?
Self induced vomiting Chewing and spitting out Overexercise Overactivity (excessive housework etc) Cooling (opening windows etc) Blood letting (not common - hectic) Medication abuse (caffeine / cigarettes / pain killers)
What are some of the psychological consequences of eating disorders?
Obsessive behaviour - can’t dissociate weight loss from other aspects of life
Reduced central coherence, ability to concentrate and narrowed focus of interest
Inability to interpret emotion in starved states
Depression is common
Feeling of isolation - other people turned into obstacles in their quest to avoid food
How effective are medications at treating comorbid depression in those with eating disorders?
Depression at very low weight rarely improves with medication
What are some of the physical consequences of prolonged states of starvation?
Reduced immunity (WBC drops to chaemo like levels)
Heart damage
Anaemia
Bone loss
Infertility
Growth / developmental arrest in youngers
What are some of the physical consequences of purging behaviours?
Neuro-chemical disruption causing damage to:
Brain - can develop seizures
Heart - arrhythmias
Are eating disorders heritable?
Studies have shown that risk factors for eating disorders include family history of:
- Eating disorder
- OCD
- Depression
- Perfectionism
May require life trauma as trigger (societal pressures)
What are some common precipitating factors that may lead to an eating disorder?
Puberty (coping with changes in body etc)
Dieting or non-deliberate weight loss
Increased exercise
Stressful life events
