Lecture 5--- 10/26--2nd set ED

Question 1

Mortality Rate

Answer 1

Higher than any other mental illness

—Mortality rate associated with anorexia— 12x hgiher

Question 2

Complications of Anorexia

Answer 2

Bradycardia—heart rate slows, systems shut off
Osthrostasis– drop in BP or pulse with standing
Hyothermia
Osteoporosis– lack of Ca2++

Question 3

Big study to info about anorexia

Answer 3

self starvation with healthy young men
the body starts to misfire
brain starts thinking it is healthy and normal

Question 4

Bulimia Nervosa

Answer 4

Mouth sores and dental erosion– dentist furst to diagnose

Question 5

binge eating

Answer 5

same complications as obesity

weight related hypertesnision, obesity, diabetes, abnormal lipid profile

Question 6

Cycle of ED

Answer 6

o Obsessive thinking and compulsive food rituals
 reduced stomach sitze and early satiety
muscle loss leads to stomach protrusion
 bloating and fluid retention secondary to maturation
 fears of fatness reinforced
 body image distortion worsens
 increased fixation on refusing food and weight loss

Question 7

How are ED treated?

Answer 7

Multidisciplinary Approach
Medical– heart function, bone health
psychiatric–treatment of co-exiting mood disorders
nutritional– weight restoration, normalization of eating habits, improve body image
psycho therapeutic– family therapy, acceptance commitment therapy, motivational interviewing

Question 8

Levels of Care and description

Answer 8

Inpatient Hospitalization–medically unstable, ~24 hours

Question 9

COST!

Answer 9

EXPENSIVE! CAN BE OVER 100k

under covered by insurance

Question 10

nutritional treatment goals

Answer 10

a. Weight restoration
b. Elimination or redxn of symptom use
i. Coping skills
c. Normalization of eating behavior
i. Food rituals
ii. Fear foods
iii. Establishing hunger and fullness cues
iv. Food/mood
d. Improving body image/body acceptance
e. Promoting healthy physical activity when appropriate
f. Independent meal planning
g. Shopping
h. Food prep

Question 11

Re-FEEDING SNYDROME!! GONNA BE ON EXAM!

What is it?

Answer 11

 **Rapid reduction of already depleted electolytes (k, Mg, Phos) –reduction in glucose an thiamin
• They rush in to try to deal with the nutrients available
o KEY POINT!**Basically, when body is in starved states and we are in depleted state of K(potassium),Mg, Phos,****
o When we get surge of calories, protein and fats.. Body wants to store, but the electrolytes rapidly decrease
o Cardiac arrhythmias occurs and possible death
o Heart failure due to electrolyte and fluid shifts from blood to the cells that strain the heart

o Risk of giving people in starved state too much food.
o Metabolism switchs from catabolic to anabolic state
o Metabolic changes with starvation—body working to maintain survival
 Conservation of protein—use of ketone bodies
 Depletion of intracellular minerals to maintain serum levels
 Suppressed insulin increased glucagon
 Reduced heart mass
o Metabolic changes with refeeding
 Insulin secretion in response to increased in blood sugar

Question 12

Prevention of Re Feeding Snydrome

Answer 12

Replenish Electrolytes— K, Mg, Phos
Start low, and advance slow!
Be careful with carbs
once metabolic rate increases 2/5-5k diets per day

Question 13

COVERED VITAMINS–on next set

Answer 13

g