Lecture 4: Eating Disorders and Treatment Flashcards
What is the most important aspect of the evaluation for a patient being seen regularly for bulimia and anorexia nervosa?
Discuss suicidality
What is the criteria for restricting type vs. binge-eating/purging ty of anorexia nervosa?
- 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
What are some of the cardiac complications associated with Anorexia Nervosa?
Bradycardia, HYPOtension, QT dispersion, Cardiac atrophy, and Mitral Valve Prolapse
Which type of anxiety disorder is most often seen in assoc. w/ anorexia nervosa?
Obsessive compulsive disorder
Which 2 drugs should be avoided in bulimia nervosa and anorexia nervosa (binge-purge subtype) and why?
- Buproprion –> ↑ seizure risk w/ binging and purging
- TCA’s –> Cardiotoxicity
What is the only adjunctive medication shown to help with weight gain in pt with Anorexia Nervosa?
Olanzapine
What is the tx of choice for Bulimia Nervosa?
CBT Psychotherapy
What is the first-line drug for treating Bulima Nervosa?
Fluoxetine (Prozac)
How many episodes and for what duration must they occur for diagnosis of Binge Eating Disorder?
Occur on average 1x/week for ≥3 months
What is the first line tx for Binge Eating Disorder and what is the only medication approved for tx?
- Psychotherapy: CBT –> especially self-help forms and interpersonal therapy (IPT)
- Vynase (Lisdexamfetamine dimesylate)
Serious complication in treating an eating disorder
Re-feeding syndrome. DO NOT rehydrate or feed patients beyond their current capacity
First line therapy anorexia nervosa
- therapy supervised by a registered dietician with focus on proper weight gain practices
- CBT or family therapy
BMI Anorexia vs. Bulimia
Anorexia: low
Bulimia: normal/obese/low
