Feeding / Eating Disorders Flashcards
______ (feeding/eating) disorders are more present in infants and children
Feeding Disorders = Infants/Children
______ (feeding/eating) disorders are more present in adults.
Eating Disorders = Adults
T/F: Feeding/Eating Disorders can be present at any age
True
The following are all examples of ______ (feeding/Eating) Disorders…..
Pica Disorder
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Feeding Disorders
____ disorder occurs when an individual consumes a non-nutritional substances on a persistent basis for at least 1 month
Pica Disorder
What age must a patient be to be diagnosed with Pica Disorder?
> 2 y.o.
T/F: A child mouthing a non-food object is considered Pica Disorder
False
it is not
T/F: Iron deficiency may be an underlying cause of pica disorder
True
it is also seen in pregnant women and patients with developmental delays
What are some GI manifestations of Pica?
Obstruction
Constipation
Ulcerations
Perforations
What is the most effective management of Pica?
Behavioral strategies and therapy…..
- Discriminate between edible and non-edible
Should you refer patients with Pica to a dentist?
Yes because there are many dental manifestations and complication of pica
________ disorder is defined as a repeated regurgitation of food WITHOUT nausea, heartburn, abdominal pain, or retching for at least 1 month.
(The regurgitation is effortless)
Rumination Disorder
T/F: You must rule out GERD and other GI disorders before a patient can be diagnosed with rumination disorder
True
What is the most effective management of rumination disorder?
Behavioral Therapy and Strategies
ie; rewarding non-rumination behaviors - also remember this is common in children with developmental delays
__________ disorder can be defined by the three following types….
Little Interest in Eating
Avoiding food based on sensory characteristics
Rejecting food due to adverse experiences
These all must result in a failure to meet basic nutritional needs (weight loss, mal-nutrition)
Avoidant/Restrictive Food Intake Disorder
T/F: Patients with Avoidant/Restrictive Food Intake Disorder may progress to the point of needing nutritional supplements or even feeding tubes
True
Is Avoidant/Restrictive Food Intake Disorder associated with anorexia nervosa or bulimia?
No
When is Avoidant/Restrictive Food Intake Disorder most common?
A) Adulthood B) Infancy C) Children D) Both B and C E) Neither, its equally prevalent
D) Both B and C
T/F: Children who are picky eaters can be considered to have Avoidant/Restrictive Food Intake Disorder
False
What is the most beneficial treatment for Avoidant/Restrictive Food Intake Disorder?
Behavioral Therapy (Exposure)
The following are all examples of ______ (feeding/Eating) Disorders…..
Anorexia Nervosa
Bulimia Disorder
Binge-Eating Disorder
Eating Disorders
Up to __% of female teens diet regularly
60%
About __% of female teenagers smoke cigarettes to control weight
45%
T/F: Most female teens are preoccupied with their food intake
True
Rank the following eating disorders from most prevalent to least prevalent….
Bulimia
Anorexia Nervosa
Binge-Eating Disorder
Binge Eating Disorder (Most Prevalent)
Bulimia
Anorexia Nervosa (Least Prevalent)
Are eating disorders more prevalent in males or females?
Females
What is the most common ‘time’ for eating disorders to onset?
A) Infancy
B) Adolescence
C) Late Adulthood
B) Adolescence
T/F: Eating disorders are more common in African American populations
False
Anorexia Nervosa is more common in patients with a ________ personality
Perfectionistic
Which is more common during transitional times (ie: going to college, break-ups)….
Anorexia -OR- Bulimia
Bulimia
Which is more common during times of stress (ie: abuse, leaving home)…..
Anorexia -OR- Bulimia
Anorexia
_______ is defined as restriction of energy intake which produces a significantly low body weight, the intense fear of gaining weight, and a disturbance in one’s perception of self.
Anorexia nervosa
What is the ‘key’ to diagnosing anorexia nervosa?
discrepancy between a patient’s actual weight and their perceived weight
What are the two “sub-types” of anorexia nervosa?
Restricting Type
Binge-Eating/Purging Type
What are examples of “eating” behaviors seen in patients with anorexia nervosa that promote weight loss?
Extreme Diets
Developing Unusual Diets
Refusal to eat with family
T/F: Patients with anorexia nervosa my stat to abuse laxatives, diuretics, and stimulants
True
Would you expect a patient with anorexia nervosa to be……
Bradycardic -OR- Tachycardic
Hypertensive -OR- Hypotensive
Diarrhea -OR- Constipation
Low Sex Hormone levels -OR- High Sex Hormone levels
Bradycardic
Hypotensive
Constipation
Low Sex Hormone Levels
______ is described as an episode of binge-eating (typically to relieve tension/stress) followed by weight gain prevention behaviors such as self-induced vomiting (due to guilt/disgust).
These behaviors are typically done in private
Bulimia Nervosa
What are some unique physical examination findings in a patient with bulimia nervosa?
Calluses on the dorsum of the hands Dental Erosions/Carries Esophageal Erosions Hypocalcemia Hypokalemia Alkalosis
__________ disorder is described as eating in a discrete period of an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances, and feeling a lack of control during the episode…..
Also including THREE or more of the following….
Eating much more rapidly than normal
Eating until feeling completely full
Eating large amounts of food when not feeling physically hungry
Eating alone because of feelings of embarrassment
Feeling disgusted with oneself, depressed, or very guilty afterwards
Binge Eating Disorder
T/F: Weight and body shape concerns are required for a diagnosis of binge-eating disorder
False
They are not required
What physical examination ‘sign’ is described as calluses on the knuckles as a result of self-induced vomiting?
Russell Sign
Why may patients with eating disorders get lower extremity edema?
Lack of protein intake
Would patients with eating disorders progress normally through puberty?
No, it may be delayed or interrupted
What is a common ‘co-morbidity’ of eating disorders?
HINT: Its not a ‘medical condition’
Body Dysmorphia
At the time of 30-year follow up for anorexia nervosa….
It has the ______ (highest/lowest) mortality rate in psychiatric disorders
Highest Mortality
__-__% of patients with eating disorders have a good psychological outcome
25-40%
What THREE things would indicate a poorer prognosis in an eating disorder?
Longer Duration
Prior Hospitalizations
Comorbid Personality Disorders
Which has a better prognosis….
Anorexia -OR- Bulimia
Bulimia
rule of 1/3 –> 1/3 doing well, 1/3 still affected, 1/3 doing poorly
Onset of anorexia prior to the age of 12 has a ____ (good/poor) prognosis
Poor Prognosis
Anorexia nervosa with bulimic/purging symptoms has a _____ (good/poor) prognosis
Poor Prognosis
What are the THREE main goals for treating eating disorders?
- Restore Nutritional Status
- Modify maladaptive behavior
- Help changes the patient’s negative views of food/body image
In the United States….
What percent of anorexia nervosa patients that seek treatment end up hospitalized?
50%
T/F: There are life-threatening risks to refeeding
True
When treating eating disorders…..
Patients need to restore their weight to ___% of their ideal weight
85%
How much weight should a patient with an eating disorder gain per week during therapy?
0.25-1 kg/week
What is the ‘goal’ amount of nutritional intake a day for a patient undergoing treatment of an eating disorder?
2000-3000 kcal/day
T/F: CBT is NOT useful in adults with bulimia or binge-eating disorder
False
It is useful
Are there FDA approved medications for anorexia nervosa?
No
What medication was FDA approved in 2015 for binge-eating disorder?
Vyvanse
