Eating Disorders Chapter 22

Question 1

Amenorrhea

Answer 1

Absense OF

Period

Due to Weight loss onset happens befores severe loss of weight.

Question 2

Anorexia Nervosa

Answer 2

Prolonged loss of Appetite

Question 3

What contains the appetite regulation center in the brain ?

Answer 3

Hypothalamus

Question 4

What neurotransmitter play a role in regulating eating behaviors in

the hypothalmus ?

Answer 4

Serotonin and Norepinephrine

Question 5

What age group is associated with anorexia nervosa ?

Answer 5

Females 12 to 30 years of age.

Question 6

Bulimia nervosa

Answer 6

* Excessive,insatiable appetite

* This is more prevalent than

Anorexia

* Occurs late adolescence or early adulthood

1.

Question 7

Biological factors

Answer 7

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)

Question 8

Binge eating disorder (BED)

Answer 8

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

Question 9

Obesity

Answer 9

1.BMI of 30 or greater

2.Higher in African Americans and Latino’s

3. Low income-women

4.Low level of education-women

Question 10

Body Image

Answer 10

A subjective concept of one’s physical appearance based on the personal perceptions of self and the reactions of others.

Question 11

Anorexia Symptoms

Answer 11

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

Question 12

Are there hunger pains with Anorexia ?

Answer 12

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.

Question 13

Emaciaited

Answer 13

Excessively thin

Question 14

Anorexia

How weight loss is accomplisheds

Answer 14

1. Reduction of food

2.Extensive exercise

3.Self induced vomiting

4.Abuse of laxitives

5.Abuse of laxitives

Question 15

Anorexia

Effects on the Body

Answer 15

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)

Question 16

What is Binging ?

Answer 16

Rapid ingestion of large quanities of food over a short period of time.

Question 17

What is Bulimia Nervosa ?

Answer 17

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.

Question 18

What is purging ?

Answer 18

Self induced vomiting

Question 19

Diagnostic

Criteria for Anorexia Nervosa

Answer 19

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

Question 20

What is Restricting type of Anorexia ?

Answer 20

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.

Question 21

What is Binge-Eating/Purging Type ?

Answer 21

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.

Question 22

Severity of Anorexia

Answer 22

Mild BMI >17

Moderate BMI 16-16.99

Severe BMI 15-15.99

Extreme BMI < 15

Question 23

Excessive Vomiting and laxitive or diuretic abuse can led to ?

Answer 23

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)

Question 24

Common Comorbidities in Bulimia

Answer 24

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

Question 25

Binge eating disorder

(BED)

Difference between this and bulimia

Answer 25

Absence of compensatory purging.

Rate of improvement is higher

Question 26

Binge eating disorder (BED)

Answer 26

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

Question 27

What is the normal BMI range ?

Answer 27

BMI 20-24.9

Question 28

Over weight is defined as what BMI ?

Answer 28

BMI 25.0-29.9

Question 29

What is the etiolgy of BED ?

Answer 29

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.

Question 30

Some studies have shown high levels of this in the spinal fluid of clients with Anorexia.

Answer 30

Endogenous opiods

(may contribute to denial of hunger)

Naloxone ,opioid antagonist is given which helps in weight gain.

Question 31

Treatment modalities for eating disorders include ?

Answer 31

1.Behavior modification

2.Individual psychtherapy

3.CBT

4.Family treatment

5.Psychopharmacy

Question 32

Prozac

Answer 32

1 fluxetine (Prozac) weight gain , comorbid depression

black box warning risk for suicide in adolescents

2. Anticholinergic side effects of tricyclic antidepressants orthstatic hypotension.
3. useful in tx of bulimmia.
4. 60 mg most effective.
5. may decrease craving of carbs