Exam 4 Eating Disorders Flashcards
**What BMI is considered anorexia?
<18.5 kg/m^2
What is the most common comorbid condition with anorexia?
Depression
What are the 2 types of anorexia?
Restricting type
Bing-eating/Purging Type
What classifies the Restricting Type of anorexia?
-In the last 3 months, the person has not binge eaten or purged
-Weight loss is accompanied by dieting, fasting, and/or excessive exercising
What classifies the Binge-Eating/Purging Type of anorexia?
In last 3 months, patient has had recurrent episodes of binge eating or purging behavior
What is the difference between Binging/Purging anorexia and Bulimia?
Anorexia has a low body weight associated with it but bulimia does not
What are the severity levels of anorexia based on weight?
Mild: BMI > or = 17
Moderate: BMI= 16-16.99
Severe: BMI= 15-15.99
Extreme: BMI <15
What are the health effects of anorexia?
-Slow HR
Low BP
-Decreased bone density (osteoporosis)
-Weakness
-Electrolyte abnormalities
-Hypoglycemia
-Dry skin
-Hair loss
-Severe dehydration
-Downy layer of hair (lanugo)
-Cold intolerance
-Delayed gastric emptying
-Constipation
What is the inpatient treatment focus?
Treatment of acute risks
(suicidality, psychosis, electrolyte abnormalities, cardiac irregularities)
What is the outpatient treatment focus?
Treat chronic symptoms and prevent relapse
What is re-feeding syndrome?
Re-feeding results in shift from fat metabolism to glucose metabolism
**Rapid reuptake of electrolytes into the cells (especially phosphate)
This causes hypokalemia, water retention, and severe edema
**Can lead to multiple organ failure
What is the treatment for anorexia?
-SLOWLY increase calories
-Correct electrolytes like thiamine
-Cognitive behavioral therapy (best outcome)
No FDA approved drugs
What drugs may be helpful in anorexia treatment?
Olanzapine (modest weight gain)
SSRIs (comorbidities)
Which drug is contraindicated with anorexia?
Bupropion
(because of seizure risk)
How often must binge eating occur to be diabnosed with binge eating disorder?
at least once weekly for 3 months
True or False: Binge eating disorder is associated with the recurrent use of inappropriate compensatory behavior
False
What are the severity categories of binge eating disorders?
Mild: 1-3 episodes/week
Moderate: 4-7 episodes/week
Severe: 8-13 episodes/week
Extreme: > or = 14 episodes/week
What are the health consequences of binge eating disorder?
-Hypertension
-Elevated cholesterol
-CV disease
-Type 2 diabetes
-Gallbladder disease
**similar to obesity
Which medication is FDA approved for binge-eating disorder?
Lisdexamfetamine (Vyvanse)
*want to decrease episodes of binging, not necessarily focused on weight loss
Which treatment provides the best outcome for patients with binge eating disorder?
CBT (cognitive behavioral therapy) + Medication (Vyvanse)
What are the defining characteristics of bulimia nervosa?
Recurrent episodes of binge eating and recurrent inappropriate compensatory behaviors in order to prevent weight gain (vomiting, laxatives, exercise, etc)
-Occurring at least once a week for 3 months
What are the severity categories for Bulimia Nervosa?
Mild: 1-3 episodes/week
Moderate: 4-7 episodes/week
Severe: 8-13 episodes/week
Extreme > or = 14 episodes/week
*same as binge eating
What are the health consequences of bulimia nervosa?
Mallory Weiss tears (esophageal rupture from frequent vomiting)
Tooth decay, staining, and permanent loss of enamel
Irregular bowel movements and constipation (laxative abuse)
Physical sores (over exercising)
Diabetic ketoacidosis (withholding insulin in Type 1 patients) (“diabolemia”)
What are Russel’s signs?
Callouses on knuckles on the dominant hand that appear in bulimia from using the hand to induce vomiting
Which medication is used to treat bulimia?
Fluoxetine
(FDA approved)
*note that medication+ CBT works best
