eating disorders (ch 18) Flashcards
bmi for obesity
30+
comorbidities with eating disorders
- MDD
- BPD
- OCD
- substance abuse
- personality disorders
biological predisposing factors for eating disorder
- hypothalamus dysregulation
- reduced serotonin
- decreased dopamine (binge eating)
typical psychological profile for pt with eating disorder
- desire to control
- perfectionist
- avoids risk
- people pleasers
- alexithymia (inability to verbalize psychic experiences)
- harm avoidance
- high persistence
- feelings of shame
inability to verbalize psychic experiences
alexithymia
DSM 5 anorexia nervosa (UNDER-exia)
Underweight Nervous to gain weight Distorted perception Exercise, purging Restricting intake
physical S+S anorexia nervosa and bulimia nervosa
- bradycardia, hypoTN
- arrhythmia
- hypokalemia, hypocalcemia
- dehydration
- amenorrhea
- anemia, leukopenia
- hypoglycemia
- hypothermia
- dry skin, hair loss
- osteoporosis
- constipation
- edema
BULIMIA: +dental caries, esophagitis
DSM 5 bulimia nervosa (BOWL-emia)
Binging
Offsetting (purging)
Weekly for 3+ months
Linked to self esteem
indications for hospitalization for eating disorder
- rapid weight loss (15+ lbs in 4 weeks)
- weight below 70-75% ideal body weight
- less than 10% body fat
- hypokalemia (<2.5) from vomiting/laxative/diuretic use
- severe bradycardia (<50 bpm)
- Sbp <90
- temp less than 96
- cardiac arrhythmias
- GI bleeding/dehydration
nursing care for pt in ED for eating disorder
- set limits
- create trust
- help to identify feelings
- help to increase self esteem
- teach pt and family about eating disorder
- address the control
- teach healthy living
rules for eating on inpatient unit (5)
- begin with 1500 cal/day
- increase by 100 cal/day
- watch pt for 1.5 hrs after meal
- time limit for eating
- remaining intake given through supplement
complications of hypophosphatemia caused by refeeding syndrome (3)
heart failure
arrhythmias
resp failure
syndrome: body in state of starvation, uses electrolytes as source of energy instead of food
refeeding syndrome
indications for psych hospitalization for eating disorder (4)
- severely depressed/suicidal
- resistant to outpt treatment
- severely dysfunctional environment
- lack of local outpt tx facility
med for anorexia to prevent relapse
fluoxetine
med for bulimia for acute and maintenance tx
fluoxetine
med for bulimia to decrease binging and vomiting
TCAs
DSM 5 body dysmorphic disorder (Fix ME DOC)
Fixation on flaw
Medical care seeking
Ego-systonic
Disabling
Obsessive thoughts
Compulsive behaviors
DSM 5 binge eating
- recurrent episodes binge eating
- large amounts food
- feeling sense of being out of control - 3 or more:
- eating more rapidly
- eating until uncomfortably full
- eating large amounts when not hungry
- eating alone or feeling embarrassed
- feeling disgusted/guilty - marked distress
- atleast 1x per week for 3 months
Tx binge eating
- learn to eat in response to hunger
- eat in moderation
- avoid restrictive diets
- address hidden emotions and meet needs
- overeaters anonymous
- med: vyvanse
med for binge eating
vyvanse
eating disorder: binging food without purging
binge eating
eating disorder: binging food with purging
bulimia
eating disorder: fear of gaining weight
anorexia
