eating disordesr Flashcards
what is an eating disroder
complex mental illness not just about food
screening tool
SCOFF
Do you make yourself Sick because you feel uncomfortably full?
o Do you worry you have lost Control over how much you eat?
o Have you recently lost more than One stone in a three month period?
o Do you believe yourself to be Fat when others say you are too thin?
o Would you say that Food dominates your life?
causes of an eating disorder
- high achievers/goal orientated families
- previous bulling/teasing related to appearance
- broken families
- peer/family/social pressures
- genetic (esp in anorexia)
- hormonal/neurotransmitters
- hobbies/sports
- physical/sexual abuse
healtjy BMI
18.5-24.9
orthorexia
obcession with eating pure or clean food
feelings of extreme gulit if unhealty eating
judge others
clinical featues of orthorexia
- fatigue
- poor immune response
- malnutrition due to not eating enough (angular chelitis (sore areas on the corner of mouth) and recurrent apthous ulceration)
anorexia nervosa
body image disorder- sufferers often believe they are fat, even when severely underweight
- disproportionate concerns about weight gain (eg from oral contraceptive pill)
- rapid weight loss
- secretive behaviours and social withdrawal
clinical features of anorexia nervosa
- muscle wasting
- hair loss
- complications for bone density
- growing ‘fur’
consequences of anorexia
- faltering growth
- delayed puberty (infertility and amenorrhea)
- dehydration (kidney failure)
- cardiac (heat failure/death)
managment of anorezia
- psychoeducation about anorexia
- mental heath (family therapy for children, GBT/group therapy)
- monitoring physical heath (no blame approach, weight gain key for recovery, meal planning and vitamin supplements)
dentla considerations for hallitosis
- halitosis (pear drops smell, ketosis when body runs out of glucose)
- dry mouth (TCAs antidepressant drug causes this)
- drug dosages
- Reduced immune response (PDD, angular chelitis malnutrition)
bulima nervosa
cyclical binge eating and purging behaviours
medical consquences of bulim
- normal/slightly overweight
- laxative abuse (lazy colon/increased risk of colon cancer)
- vomiting (barretts oesophagus occurs with prolonged vomiting is also precancerous)
- diabulimia (hyperglycaemia will purposely withhold their insulin, want to burn excess glucose)
- Cardiac (arrhythmias and heart failure/death)
managment of bulimia
- multidisciplinary and long term
- educate re harmful effects of purging
- mental health (family therapy for children and CBT)
- monitoring physical health inc risk factors (no blame approach, meal planning and vitamin supplements)
- support for family
oral/dental considerations for bulim
parotid enlargment a
acne
regular dental rewies needed for erosion
teeth erosion preventative for bulima
- education
- 2800ppm/5000 ppm fluoride varnish
- fluoride varnish 4x per year
- fissure sealants
- mouthwash after vomiting
- no brushing for at leat 1 hour
- CPP-ACP (tooth mousse)
- Saliva substitutes
cliical presentation of binge eating disorder
- binges similar to bulimia but without purging
- buying lots of food and hoarding it
- secretive eating- rapid until overfull
- social withdrawal
- more common in adults
- may have had another ED previously or go on to develop one
consequences of binge eating
- weight gain
- bad skin
- bloating and constipation
- stomach rupture
Longer term - obesity
- type II diabetes
- sleep apnoea
- heart disease
mangament of bindge eating
Mental health
- CBT/group CBT
- outpatient care unless self harm/suicide risk
Monitoring physical health inc risk factors
- daily food intake plan – avoid dieting
- weight monitoring
dental considerations for binge eating
caries
weight
GA airway risks
medical emergencies for binge eating
hypoglycaemia
MI cardiac arrest
obesity
BMI 30 or above
obestity managment
Management tailored to the underlying cause
- exercise on prescription
- healthy living classes
- CBT/counselling
