Eating Disorders Part 2 Flashcards
1
Q
Binge-Eating Disorder
How is it similar to Bulimia Nervosa?
How is it different?
A
- 3-5% of the population
- Similar features to BN
- Recurrent episodes of binge eating
- Marked distress regarding binge eating
- Occurs 1X/wk for 3 mo
- Same severity scale as bulimia nervosa
- Distinguishing features
- Not associated w/ recurrent use of inappropriate compensatory disorder
- Not exclusively during BN or AN
2
Q
**Avoidant/Restrictive Food Intake Disorder **
How is it similar to Anorexia Nervosa?
How is it different?
A
- Similar features to AN
- Persistant failure to meet appropriate nutritional/energy needs
- Not better explained by lack of food or cultural practice
- Not attributable to a concurrent medical condition or other mental disorder, or beyond what one would expect for another condition/disorder
- Distinguishing features
- Not associated w/ a disturbance in the way one’s body weight/shape is experienced
- Not part of AN or BN
3
Q
Other Specified Eating Disorders
A
- Atypical anorexia nervosa (i.e. normal weight)
- Bulimia nervosa of low frequency or limited duration
- Binge-eating disorder of low frequency or limited duration
- Purging disorder
- Night eating syndrome
4
Q
Unspecified Eating Disorders
A
Other feeding & eating symptoms that cause clinically significant distress or impairment in social, occupational or other important areas of functioning, or having insufficient information to make a more specific diagnosis
5
Q
Fill in the blanks
A
6
Q
Definition of Obesity (IBW & BMI)
A
- Weighting >20% IBW or BMI 30+
- Overweight (BMI) = 25-29.9
- Not an eating disorder
7
Q
**Epidemiology of Obesity **
Adults
Children
A
-
US Adults
- Upwards of 2/3 of US adults are considered overweight/obese
- >1/3 of US adults are obese
-
Children
- Rates in children who are overweight/obese were increasing for many years, but are leveling off
- Decreasing for very young children (<5)
- 25% preschool & 35% school-aged children are overweight/obese
8
Q
Etiology of Obesity
- Environmental
- Genetic
- Biological
- Psychological/Social
A
Balance energy IN > energy OUT
-
Environmental
- Increased availability of high calorie foods
- Decreased requirement for physical activity
- 78% of Americans don’t meet activity level requirements
- 25% completely sedentary
- Genetic – identical twins have the greatest risk
- Biological – set point/satiety, development, medical issues, medications
- Psychological/Social – culture, family habits, psychiatric comorbidity (binge-eating disorder), low SES
9
Q
Obesity Risks
- Cardiovascular
- Psych
- Repro
- Lungs
- Memory
- Musculoskeletal
- Other
A
- Cardiovascular: Type II DM, HTN, CAD, stroke, CV death
- Cancer
- Depression, quality of life
- Reproduction & sexual function
- Lung function: respiratory disease, asthma, obstructive sleep apnea
- Memory/Cognitive function: Alzheimer’s disease
- Musculoskeletal: osteoarthritis, hip replacement, chronic back/limb pain
- Other: gallstones, gout, kidney, fatty liver, mortality
10
Q
How is obesity treated?
A
- Commercial dieting & weight loss programs: regain weight in 5 yrs
-
Bariatric surgery
- Including banding, gastrectomy, gastric bypass
- BMI >40 or >35 w/ life-threatening condition
- Initially effective, but questionable regarding long-term weight loss
- Pharmacologic agents: variable efficacy & safety
- Sensible diet & exercise
11
Q
What type of pharmacotherapy is used to treat obesity?
A
- Prescribed pharmacological agents
- Other: antidepressants, anti-seizure, metformin (not FDA approved)
- OTC: ephedra, chromium, diuretics, herbal laxatives, hoodia (not considered safe or effective)
12
Q
What are the 4 prescribed drugs used to treat obesity?
A
-
Orlistat (Xenical & Alli)
- Pancreatic lipase inhibitor limits breakdown of dietary fats
- 5-10 lb weight loss in first 6 mo, maintained at 24 mo
-
Phentermine (Ionamin)
- Sympathomimetic amine that decreases appetite
-
Sibutramine hydrochloride (Meridia)
- Blocks monoamine reuptake that decreases appetite
- Off the market: heart attack & stroke risk
-
Lorcaserin hydrochloride (Belviq) & Qsymia
- BMI >30 or >27 w/ weight-related condition
13
Q
What is the gold standard for weight loss in obesity?
A
- Sensible diet & exercise
- Calorie intake < calories burned = most effective way to maintain long-term weight loss
14
Q
What are some reasonable methods of weight loss in adults & children?
A
-
Adults
- 5-10% loss of initial body weight over 6 mo or 1-2 lb weight loss per week
- Cutting back calorie intake by 500-1000 calories/day
- Women: 1000-1200 calories/day
- Men or women who exercise routine: 1200-1600
- After 10% body weight lost & kept off for 6 mo, consider future weight loss if still overweight
-
Children & Teens
- Initial goal: maintain weight or slow weight gain by healthy eating & physical activity
- Obesity: maintenance for 3 mo, then slow weight loss
- Slower weight loss than w/ adults: from 1 lb/mo
- ½ weight loss from diet, ½ from exercise
15
Q
What are some reasonable dietary changes?
A
- Diet
- Limit portion size, cut out second helpings
- Limit high calorie foods, high sugar, sugar additives, fast food, high fat
- Behavioral modification (MOST SUCCESSFUL): recognize external cues, keep food diary, develop new eating patterns (eat slowly, chew food well, stay seated, etc.), use rewards/reinforcements
- Group therapy
