Eating Disorders Lecture Powerpoint Flashcards
Pica definition and what 3 groups is it most often seen in?
Persistent eating of non-nutritive substances for a period of at least one month inappropriate for given individual’s developmental level (not including teething babies), not accounted for by ethnic/social norm, highest among pregnant women, children, adults with iron deficiency
Pica comorbidities (4)
- Intellectual development disorder
- schizophrenia
- OCD
- trichotillomania (hair pulling disorder, then sometimes ingested)
Complications of pica (3)
- Heavy metal toxicity
- GI symptoms and complications
- bowel obstruction
Rumination disorder definition
Repeated regurgitation of food for >1 month that is either re-chewed, re-swallowed, or spit out not due to a medical condition and not exclusive to anorexia, bulimia, binge eating, etc.
Complications of rumination disorder (3)
- malnutrition
- esophageal ulceration
- tooth decay
Pica and rumination disorder treatment (2)
- Pharmacologic treatment for comorbid conditions
- Psychotherapy
Avoidant restrictive food intake disorder (ARFID) definition
An eating or feeding disturbance manifested by persistent failure to meet appropriate nutritional and or energy needs associated with significant weight loss, nutritional deficiency, and marked interference with psychosocial functioning NOT*** due to disturbance in perception of body weight and shape (not anorexia or bulimia)
Binge eating disorder (BED) definition
Recurrent episodes of binge eating episodes characterized by both eating in a discrete period of time (such as 2 hours) an amount of food that is definitely larger than what most would normally eat AND individual has lack of control over eating (cannot stop eating or control what or how much one is eating), associated with eating rapidly, alone, and feeling disgusted with oneself (ego dystonic) not associated with compensatory behaviors
Binge eating disorder complications (3)
- overweight
- DM II
- HTN
Bing eating disorder treatment (3)
- Psychotherapy
- group therapy in or outpatient
- pharmacotherapy for psychiatric comorbidities
Anorexia nervosa definition and epidemiology
- Persistent restriction of energy intake leading to significantly low body weight and intense fear of gaining weight or becoming fat regardless of own weight as well as disturbance in way ones body weight or shape is experienced
- 90% of cases of females primarily affecting adolescent girls and young women
Anorexia nervosa 2 subtypes
1) Restrictive - restricted food and compulsive exercise
2) binge eating/purging - restricts food with intermittent episodes of binging OR** purging
Bulimia nervosa definition
Recurrent episodes of binge eating episodes characterized by both eating large portions of food in discrete period of time and a sense of lack of control as well as reucrrent inappropriate compensatory behavior in order to prevent weight gain such as self induced vomiting, laxatives, diuretics, fasting, etc.
Bulimia nervosa 2 subtypes
1) purging - use of vomiting or misuse of laxatives, diuretics, etc
2) non purging - person has used other inappropriate compensatory behavior but has not engaged regularly in self induced vomiting, diuretics, laxatives, etc. but rather things like excessive exercising and fasting
Atypical anorexia nervosa
All criteria met despite significant weight loss, individuals weight is within or above normal range
Binge eating disorder or bulimia nervosa of low frequency and or limited duration
All criteria of respective diseases are met but have occurred for less than 3 months
Purging disorder difference from bulimia
It lacks binge eating
Night eating disorder
Recurrent episodes of eating food after the evening meal
Unspecified feeding or eating disorder
-Used when individual fails to meet full criteria of any of the feeding or eating disorder categories, may be used by clinician when there is insufficient info to make more specific diagnosis
Most deadly psychaitric disease
anorexia nervosa
2 most common age groups for eating disorders
13-14 (menarche)
17-18 (entering college)
Genetics dysfunction in eating disorders
Serotonergic system dysfunction
Body image dissatisfaction is significantly related to perception of their ___’s body dissatisfaction
mother’s
Lab evals in eating disorder patients are limited to provide evidence because…
….the body is very efficient at compensating for condition even at extremely low weights for prolonged periods of time
Red flags on physical exam for eating disorder (5)
- Bradycardia
- hypotension
- low BMI
- lanugo
- russel’s sign (abrasions on knuckles of hand from purging)
What makes eating disorders hard to treat?
Lots of denial, secrecy, and deception around the illness
Electrolyte features of eating disorder with vomiting abuse
Hypokalemia, hypochloremia, metabolic alkalosis
Electrolyte features of eating disorder with laxative abuse
Metabolic acidosis due to bicarb losses in the stool
Refeeding syndrome
Significant risk in malnourished patients with anorexia nervosa because patients are in an adjusted homeostatic state (catabolic), too rapid of refeeding can upset this balance putting at risk of edema/CHF as well as abdominal pain because of decreased motility of gut as well as profound reduction in serum phosphate that enters cells upon refeeding to be used as ATP putting at risk of hypophosphatemia
4 commonly used medications in treatment of eating disorders
- Antidepressants
- antipsychotics
- anxiolytics
- antiepileptics
