Eating Disorders-Sweeny Flashcards
What is a normal BMI range? Overweight? Obese?
Normal: 20-24.9
Overweight: 25-30
Obese: 30+
How do you calculate BMI?
(weight X 703)/(height in inches)2
What is Diabulimia?
Diabetes and bulimia:
-people with Type 1 Diabetes do not adhere to their insulin administration, for the sole purpose of weight loss.
What does the psychological profile for Anorexia include?
- Low self-esteem
- knowledgeable about nutrition
- delayed sexual psychosocial adjustment
- perfectionism
- family conflict
- terrified of embarrassment
- always “good” in family system
What is the DSM IV criteria for Anorexia Nervosa?
- Body weight <85% of normal expected weight (equal to or below BMI of 17.5)
- intense fear of gaining weight
- disturbed body image
- Amenorrhea: missed 3 consecutive periods (removed in DSM V)
What are the 2 types of Anorexia Nervosa?
What are some common comorbid disorders?
- Restricting Type: not regularly engaged in binge eating or purging. s), obsessive compulsive,
- substance abuse
- social phobias
What is the best treatment for Anorexia Nervosa?
Cognitive Behavioral Therapy in the context of a multi-disciplinary approach
-family therapy, cognitive therapy
What is the 10 year outcome for full recovery in anorexia?
only 25% recover completely
50% improve and function fairly well
other 25% function poorly, chronic weight issues
What are the differences between Anorexia and Bulimia?
Anorexia: intense fear of obesity, denial of symptoms, lack of sexual interest, denies depression
Bulimia: worry about gaining weight, feel “out of control”, weight can be normal or overweight, DISTRESS about symptoms, normal sexuality, depression
What are some physical signs associated with anorexia?
- Russell’s signs: metacarpal-phalangeal calluses from inducing vomiting
- kidney stones
- high cholesterol
- late stages: hypothermia, dependent edema, bradycardia, lanugo (baby fine hairs on trunk), amenorrhea, dehydration, EKG changes (K+ imbalance–> T wave flattening or ST depression and lengthening QT interval)
- abnormal electrolytes, increased liver enzymes and serum urea nitrogen, mild anemia and leukopenia
What are the immediate and long term treatment goals for anorexia nervosa?
- immediate: restore body weight to save pt’s life
- long term: strategies to prevent relapse!!
-hospitalize if body weight 20% below normal
What are some common symptoms seen in purging eating disorders?
- Esophageal varices (repeated vomiting)
- Enamel erosion-dental caries (gastric acid)
- Swelling or infection of parotid glands.
- Metacarpal-phalangeal calluses (Russell’s sign)
- EKG Changes: long QT and ST depression
What is the common psychological profile for Bulimia?
- Compassionate, empathetic, social
- Prone to peer pressure
- Get bored easily
- Low self-directedness
- High harm avoidance
- Impulsivity temperament
What is the DSM IV criteria for Bulimia Nervosa?
A. Recurrent binge-eating episodes coupled with
1. 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. 2. a sense of lack of control over eating
B. Recurrent inappropriate compensatory behavior (vomiting; laxatives, diuretics, enemas or other medications; fasting; or excessive exercise
C. Binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa
What are the two types of Bulimia?
Purging: vomiting or laxatives, diuretics, enemas
Non-purging: other inappropriate compensatory behaviors (fasting or excessive exercise)
What is the best treatment for Bulimia?
CBT with pharmacological treatment (anti-depressants, MAOIs, SSRIS)
What are some comorbid disorders of Bulimia?
- Mood Disorders - Dysthymic Disorder Major Depressive Disorder
- Anxiety Disorders: Social Anxiety, Panic D/O, GAD, PTSD
- Personality D/O’s: Borderline PD (most frequent)
- Substance Abuse or Dependence
What medication is contraindicated in Bulimia?
Buproprion
can increase seizure risk
What is the DSM IV criteria for Eating Disorder NOS?
-Used for disorders of eating that do not meet criteria for any specific Eating Disorder.
- Examples include
1. For females, all of the criteria for AN are met except that the individual has regular menses.
2. All criteria for AN met except that, despite significant weight loss, current weight is in the normal range.
3. All criteria for BN are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week OR for a duration of less than 3 months.
4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g. self-induced vomiting after the consumption of two cookies).
5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
6. Recurrent episodes of binge eating in the absence of regular use of inappropriate compensatory mechanisms.
