Eating Disorders - Hill Flashcards
Major psych emergency w/ bulimia and anorexia
Suicidality
Excessive dieting, exercise, and intense fear of gaining weight. Distorted body image. Amenorrhea, metatarsal stress fractures, osteoporosis.
Electrolyte disturbances?
Cellular disturbances?
Do NOT to what with them?
Anorexia nervosa
Hypokalemia, hypophosphatemia, hypomagnesemia
Pancytopenia
Re-feeding syndrome (insulin spike –> hypokalemia)
Anorexia – MC associated psych disorders… (2)
OCD*
Depression*
Dysthymic, personality disorders, other
Anorexia - treatments (2)
Nutritional rehabilitation
Psychotherapy
Anorexia - when is hospitalization necessary?
Starvation symptoms, resistance to food, suicidal, severe psychosocial barriers to care
Anorexia - drugs to avoid
Bupropion (seizure risk)
TCAs (cardiotoxicity)
Anorexia - drug options
Olanzapine (weight gain)
Lorazepam (anxiety reduction w/ eating)
SSRIs (depression)
Binge eating + self-induced vomiting or laxatives or diuretics, normal OR abnormal body weight, at least 2 times per week for 3 months
Bulimia nervosa
Russel’s sign
Scar/callus on dorsum of hand - Bulimia
Major medical complications of bulimia
Electrolyte issues from vomiting and not digesting (like AN)
Mallory-Weiss tears
Salivary gland hypertrophy
Tooth enamel erosion
Comorbidities of bulimia (psych)
Anxiety, mood disorder, substance use disorders
Treatments for bulimia (psych)
Psychotherapy - CBT***
Nutritional rehab
Antidepressants - FLUOXETINE
Drug to avoid in bulimia
Bupropion - seizure risk
Episodes of abnormal binge eating without the compensatory purging. Lack of control over eating.
Treatments?
Binge eating disorder
Psycotherapy (CBT, interpersonal therapy)
***Vyvanse (lisdexamfetamine)
Binge eating disorder - drugs to avoid
Anti-obesity drugs – not effective, bad side effects
