Eating disorders Flashcards
What questionnaire can be used?
Deps R
How do we pick up eating disorders?
SCOFF questionnaire
Features of Scoff questionnaire
If patients score 2 or more positive answers, then an eating disorder is likely:
Do you make yourself Sick because you feel uncomfortably full?
Do you worry you have lost Control over how much you eat?
Have you recently lost more than One stone (14 pounds or 6.35 kg) in a three month period?
Do you believe yourself to be Fat when others say you are too thin?
Would you say that Food dominates your life?
Description of anorexia nervosa?
obsessive fear of fatness…
with avoidance of food & other sources of calories..
..& a range of compulsive ‘compensatory’ behaviours when food cannot be avoided
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Features of Anorexia Nervosa
- Restriction of intake to reduce weight
- Relies on compulsive compensatory behaviours when food cannot be avoided, Self induced vomiting, laxative abuse, excessive exercise, abuse of appetite suppressants / diuretics
- Fear of weight gain
- amenorrhoea, absence of menstrual cycle
When is someone considered anorexic?
15% below ideal body weight/BMI 17.5 or <
ideal is 20-25
Anorexia - what happens when someone restricts calorie intake
- loss of fat, glycogen from liver
- break down skeletal/cardiac muscle
Symptoms of anorexia?
Cold intolerance Blue hands and feet Constipation Bloating Delayed puberty Primary or secondary amenorrhea Dry skin Fainting Hypotension hair loss weakness/fatigue
Bulimia Nervosa features
Episodes of binge eating with a sense of loss of control
Binge eating is followed by compensatory behaviour of the purging type (self-induced vomiting, laxative abuse, diuretic abuse) or nonpurging type (excessive exercise, fasting, or strict diets).
- dissatisfaction with body shape and weight
anorexia nervosa binge purge sub type is diagnosed when
BMI <17.5
Bulimia Nervosa features?
Mouth sores Pharyngeal trauma Dental caries Heartburn, chest pain Esophageal rupture Muscle cramps Weakness Bloody diarrhoea Irregular periods Fainting *Swollen parotid glands* hypotension
Binge eating disorder has the absence of?
absence of purging
Binge Eating Disorder features?
- Ongoing and/or repetitive cycles often include
unusually fast eating, usually alone.
unusually large amounts consumed.
uncomfortably full; often “buzzed” after eating.
embarrassment, shame, guilt, depression.
Binge eating disorders often get better with?
CBT
Avoidance of calorie intake?
diets – becoming vegetarian, vegan not touching food or grease pickiness eating slowly avoiding social occasions spoiling foods medication abuse
Getting rid of calories?
Self-induced vomiting Chewing & spitting out Overexercise – often secret Overactivity Cooling blood letting medication abuse
what is Diabulimia?
combination of diabetes and bulimia
- take less insulin in than needed after meals - eg carbohydrate diet but omits insulin in purging behaviour
OTHER EATING DISORDER BEHAVIOURS?
‘Body-checking’ - repeated weighing, mirror , hands around wrist, taking photos
- pro- ana websites
- competing with self and others
- self hard
Psychological consequences (4)
- extreme overvaluation of low weight
- obsessive weight losing feels like a solution not a problem
- reduced central coherence, narrowed focus of interest - don’t see the bigger picture
- unable to interpret emotions
- anxiety eating in company
- fail to find other ways to cope
malnourished brains experience?
experience depression, anxiety, obsessionality and loss of concentration on anything but food.
- depression at a low weight rarely responds to medication
Social consequences of eating disorders?
are forced to lie and cheat, even to steal about eating disorder concerns. Sufferers withdraw from friendships and lose interest in sexual relationships/ family relationships
Physical consequences
Starvation causes physical damage, poor repair and resistance, heart damage, reduced immunity to infections, anaemia, bone loss, fertility problems
- impaired white cell count
- re-nutrition is more urgent the younger the patient due to growth and pubertal development
purging behaviours causes?
neuro-chemical disruption with special damage to brain (seizures) and heart (arrhythmias). Potassium is only one crude measure of the problem
if purging goes on for many years?
oesophageal function doesn’t fully recover
