Hill: Eating Disorders and Treatment

Question 1

What is the most important aspect of the evaluation for a patient being seen regularly for bulimia and anorexia nervosa?

Answer 1

Discuss suicidality

Question 2

What is the criteria for restricting type vs. binge-eating/purging type of anorexia nervosa?

Answer 2

• Restricting type: 3 months of no binging or purging, but excessive exercising, fasting, dieting
• Binge/purge type: 3 months of binging and purging behaviors: self-induced vomiting, misuse of laxatives, diuretics, enemas

Question 3

What are some of the cardiac complications associated with Anorexia Nervosa?

Answer 3

Bradycardia, HYPOtension, QT dispersion, Cardiac atrophy, and Mitral Valve Prolapse

Question 4

Which type of anxiety disorder is most often seen in assoc. w/ anorexia nervosa?

Answer 4

Obsessive compulsive disorder

Question 5

Which 2 drugs should be avoided in bulimia nervosa and anorexia nervosa (binge-purge subtype) and why?

Answer 5

• Buproprion –> ↑ seizure risk w/ binging and purging
• TCA’s –> Cardiotoxicity

Question 6

What is the only adjunctive medication shown to help with weight gain in pt with Anorexia Nervosa?

Answer 6

Olanzapine

Question 7

What is the tx of choice for Bulimia Nervosa?

Answer 7

CBT Psychotherapy

Question 8

What is the first-line drug for treating Bulima Nervosa?

Answer 8

Fluoxetine (Prozac)

Question 9

How many episodes and for what duration must they occur for diagnosis of Binge Eating Disorder?

Answer 9

Occur on average 1x/week for ≥3 months

Question 10

What is the first line tx for Binge Eating Disorder and what is the only medication approved for tx?

Answer 10

• Psychotherapy: CBT –> especially self-help forms and interpersonal therapy (IPT)
• Vyvanse (Lisdexamfetamine dimesylate)