Eating Disorders Chapter 22 Flashcards
Amenorrhea
Absense OF
Period
Due to Weight loss onset happens befores severe loss of weight.
Anorexia Nervosa
Prolonged loss of Appetite
What contains the appetite regulation center in the brain ?
Hypothalamus
What neurotransmitter play a role in regulating eating behaviors in
the hypothalmus ?
Serotonin and Norepinephrine
What age group is associated with anorexia nervosa ?
Females 12 to 30 years of age.
Bulimia nervosa
* Excessive,insatiable appetite
* This is more prevalent than
Anorexia
* Occurs late adolescence or early adulthood
1.
Biological factors
1.Genetic factor,particular personality type or a general susceptibility to psychiatric disorders.
2. Family HX of mood or anxiety orders,places a person at reisk for an eating disorder
3. Neurochemical changes (norepinephrine,serotonin)
Binge eating disorder (BED)
1. Most common eating disorder
2.Episodes occur at least once a week to 3 months
3. Weight gain and Obseity are major health risks.
4. Affects woman twice more than men
5. Identified as a mental illness
Obesity
1.BMI of 30 or greater
2.Higher in African Americans and Latino’s
3. Low income-women
4.Low level of education-women
Body Image
A subjective concept of one’s physical appearance based on the personal perceptions of self and the reactions of others.
Anorexia Symptoms
1. Morbid fear of obesity.
2. Gross distortion of body image.
3.preoccupation with food.
4.Refusal to eat
5 .Feelings of depression and anxiety
Are there hunger pains with Anorexia ?
They do experience pangs from hunger with food, and it is only with food intake of less than 200 calories per day that hunger sensations actually cease.
Emaciaited
Excessively thin
Anorexia
How weight loss is accomplisheds
1. Reduction of food
2.Extensive exercise
3.Self induced vomiting
4.Abuse of laxitives
5.Abuse of laxitives
Anorexia
Effects on the Body
1. Weight loss is excessive
2.hypothermia
3.bradycardia
4.hypotension with orthostatic changes
5.peripheral edema
6.lanugo (fine neonatal-like hair growth)
7. Amenorrhea
8.Compulsive behaviors (excessive handwashing)
What is Binging ?
Rapid ingestion of large quanities of food over a short period of time.
What is Bulimia Nervosa ?
1.This is an episide,uncontrolled,compulsive, rapid ingestion of large quanities of food over a short period of time.
2.Food consumed is often high calorie content, sweet tast and often a soft texture.
3. Binging often occurs in secret.
4. Episodes are usually stopped by abdomen discomfort ,sleep or socail interruption or self induced vomiting.
5. Eating binges bring pleasure but aftereffects are self degradation and depressed mood
5.
What is purging ?
Self induced vomiting
Diagnostic
Criteria for Anorexia Nervosa
A. Restriction of energy intake - low body weight..
B. Intense fear of gaining weight
C. Disturbance in way individual thinks about body weight or shape
What is Restricting type of Anorexia ?
During the last 3months, the individual has not engaged in recurrent episodes of binge eating or purging behaviors.(self induced vomiting,misuse of laxitives,diuretics or enema’s)
This subtype descibes presentations in which weight loss is accomplished through dieting,fasting and or excessive exercising.
What is Binge-Eating/Purging Type ?
During the last 3 months, The individual has engaged in recurrent episodes of binge eating or purging behavior. ( Self induced vomiting or the misuse of laxitives,diuretics or enemas.
Severity of Anorexia
Mild BMI >17
Moderate BMI 16-16.99
Severe BMI 15-15.99
Extreme BMI < 15
Excessive Vomiting and laxitive or diuretic abuse can led to ?
1.Dehydration
2.Electrolyte imbalance
3.Erosion of teeth enamel
4.Tears in gastric or esophageal mucosa
5. Callus on the dorsal surface of hands typically on knuckles ( Russell’s sign)
Common Comorbidities in Bulimia
1. Mood disorders
2. Anxiety
3. Substance abuse
Most frequently involving the CNS (stimulants or alcohol)
About 50 % of those with bulemia have HX of Anoxrexia nervosa
Binge eating disorder
(BED)
Difference between this and bulimia
Absence of compensatory purging.
Rate of improvement is higher
Binge eating disorder (BED)
There is a risk of weight gain
Episodes occur over discrete period of time, usually less than two hours until individual become uncomfortably full.
Eating is out of control
Interpersonal stressors,low self esteem,boredom
50 % have hx of depression
What is the normal BMI range ?
BMI 20-24.9
Over weight is defined as what BMI ?
BMI 25.0-29.9
What is the etiolgy of BED ?
1. UNKNOWN
2.Brian imaging reveal increased activity in orbitofrontal cortex which is associated wuth reward and pleasure like those seen in response to substances of abuse.
Some studies have shown high levels of this in the spinal fluid of clients with Anorexia.
Endogenous opiods
(may contribute to denial of hunger)
Naloxone ,opioid antagonist is given which helps in weight gain.
Treatment modalities for eating disorders include ?
1.Behavior modification
2.Individual psychtherapy
3.CBT
4.Family treatment
5.Psychopharmacy
Prozac
1 fluxetine (Prozac) weight gain , comorbid depression
black box warning risk for suicide in adolescents
- Anticholinergic side effects of tricyclic antidepressants orthstatic hypotension.
- useful in tx of bulimmia.
- 60 mg most effective.
- may decrease craving of carbs
