Eating Disorders

Question 1

What group most often gets eating disorders?

Answer 1

Young (>22) women

Question 2

How can we screen for eating disorders?

Answer 2

SCOFF questionnaire

Question 3

What are the questions in the SCOFF questionnaire?

Answer 3

2+ yes answers = ED likely:

• do you make yourself SICK?
• do you worry you’ve lost CONTROL of how much you eat?
• have you lost >ONE stone in any 3 months?
• do you think you’re too FAT when others say you’re too thin?
• does FOOD dominate your life?

Question 4

What are the criteria for anorexia nervosa?

Answer 4

An obsessive fear of weight gain
+ Restriction of intake
+ Compulsive compensatory behaviours

A BMI <17.5 is also required

Question 5

What signs can you spot in an anorexic patient?

Answer 5

Hypotension, bradycardia & Fainting

Cold intolerance

Constipation & bloating

Delayed puberty, amenorrhoea, impotence & decreased libido

Lanugo hair

Weakness/fatigue

Risk of osteopenia & osteoporosis

Question 6

What compensatory behaviours are common in AN?

Answer 6

Excessive exercise
Vomiting
Drug abuse - Laxatives, diuretics & appetite suppresants

Question 7

What make’s bulimia different to AN?

Answer 7

BN has obsessive fear of fat
+ compensatory mechanisms
+ Binge eating (vs AN’s restriction of intake)

BN can present at any weight

Question 8

How often do BN suffers binge eat?

Answer 8

They must have a binge eating + compensation “Cycle” atleast twice/wk for atleast 3 months to be diagnosed

Question 9

What signs would suggest BN?

Answer 9

Mouth sores, dental caries etc.

Heartburn/chest pain

Impulsive behaviour

Hypotension & fainting

Muscle cramps & weakness

Bloody diarrhoea

Irregular periods

Swollen parotids

Question 10

Binge Eating Disorder is different to BN, how so?

Answer 10

IT involves binge eating but without the purging.

Instead they have cycles of binge eating followed by embarrassment, shame & guilt

Question 11

What are the common forms of compensatory behaviours in eating disorders?

Answer 11

Restrictive - Diets, “allergies”, obsessed with gut symptoms, avoiding social occasions & med abuse

Purging - Vomiting, spitting out, overactivity, cooling, blood letting & med abuse

Others - Body checking, self-harm, competing in thinness, displaying emaciation & seeking out pro-ana sites

Question 12

We split the aetiology of eating disorders into predisposing, precipitating and perpetuating factors. List some predisposing ones?

Answer 12

• Genetic
• Perinatal complications
• Life events/traumas

Question 13

List some factors that precipitate an eating disorder?

Answer 13

Puberty
Dieting/non-deliberate weight loss
Increased exercise
Life events e.g. loss, abuse or moving

Question 14

What factors will perpetuate an existing eating disorder?

Answer 14

Delays gastric emptying
Narrows focus (avoiding other interests)
Obsessionality (phobia worsens with avoidance)

Question 15

How can we manage someone with an eating disorder?

Answer 15

If dangerously thin –> Admit and do re-feeding/dietary support

Otherwise:

• CBT/IPT
• Antidepressants
• Olanzapine
• Family interventions