ED: Bulimia Flashcards
What is bulimia?
ED characterised by uncontrolled binge eating with vomiting/laxative abuse. Preoccupation with BW and shape.
What is the aetiology of bulimia?
Personal and family hx of eating disorder, affective disorder, substance misuse. Half have previous anorexia.
What is the epidemiology of bulimia?
High prevalence of depression, self harm and substance abuse comorbidity. 3% young females. Age 18y.
What may you find in the history and exam of someone with bulimia?
Persistent preoccupation with eating and craving food. Binge eating up to 20k Kcal per session may occur. Followed by vomiting, starvation etc.
O/E weight may be normal. Dental erosion, finger calluses, callus on dorsum of hand (Russel sign), parotid swelling. Menstrual abnormalities, low mood, self loathing.
More insight than anorexia and keen for help.
What investigations do you do for someone with bulimia?
FBC, UE, Amylase, Ca, FLT, TFT, Mg, P. ECG.
What is the management of someone with bulimia?
Nearly all OP management, Medical stabilisation, CBT, psychotherapy.
SSRI may be useful (fluroxetine) can be antibulimic separately from antidepressant.
What are the complications and prognosis of someone with bulimia?
Arrhythmias, MW tears, renal failure, osteoporosis, pancreatitis, oesophagitis, endocrine.
Most patients make full recovery.
