Eating Disorders - Schlafman

Question 1

What are the diagnostic criteria for anorexia?

Answer 1

Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.
Intense fear of gaining weight or becoming fat, even though under weight.
Disturbance in the way one’s body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.
Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.

Question 2

What are the physical and lab features of anorexia?

Answer 2

Bradycardia
Low blood pressure
Hypothermia
Postponed sexual development
Arrythmias
Extra skin and stretch marks, self mutilation, lanugo (soft hair all over body), lose hair
Can see partotid and salivary glands enlarged d/t vomiting
Brain shrinks- in severe cases not reversible
Cardiac muscles catabolized

  Elevated TSH (don't treat with thyroxin- metabolism will increase)
   Anemia and low WBC
   Can lose bone mass from calcium deficiency
   Check LH/FSH to see if normal hormonal changes

Question 3

What are the diagnostic criteria for bulimia?

Answer 3

Recurrent episodes of binge eating characterized by both:
Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating
Recurrent inappropriate compensatory behavior to prevent weight gain
Self-induced vomiting
Misuse of laxatives, diuretics, enemas, or other medications
Fasting
Excessive exercise
The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.
Self evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of anorexia nervosa.