Module 10: Eating Disorders Flashcards
What is the DSM-5 criteria for anorexia nervosa?
A. Significantly low body weight due to restricted energy intake that is not enough for a person’s age, sex, developmental stage, and health
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight
C. A distorted view of body weight or shape, overemphasis on weight in self-evaluation, or failure to recognize the seriousness of being underweight
What are physiological characteristics of anorexia nervosa?
- Bradycardia
- Hypothermia
- Hypotension
- Bizarre behavior
- Cardiac arrhythmias
- Constipation
- Dehydration
- Delayed gastric emptying
- Dry skin and lanugo
- Obsessive – compulsive disorder
- Osteopenia or Osteoporosis
- Pitting edema
- Renal damage
- Refeeding syndrome
What are psychological symptoms of anorexia nervosa?
- Decrease libido
- Depression
- Irritability
- Social withdrawal
- Obsessional symptoms
What are behaviors associated with anorexia?
- Emphasis on caloric restriction through low intake of foods
- Concern about nutritional facts, calories, ingredients
- Fear of weight gain
- Not eating for long period of time
What are complications due to anorexia?
- Bone density loss (osteopenia or osteoporosis)
- Cardiovascular problems (bradycardia, arrhythmias, cardiac arrest)
- Endocrine disturbances (amenorrhea (loss of menstrual
periods), hormonal imbalances) - GI issues (constipation, bloating, abdominal pain)
- Neurological complications (seizures and cognitive impairment)
How to treat anorexia?
- Structured meal plans (restore weight and nutritional rehabilitation)
- Psychotherapy, CBT (helps with distorted thoughts and body image)
- Family therapy (communication and support)
- Medical management (complications and health status)
- Psychiatric medication (for underlying conditions like depression)
What is the DSM-5 criteria for bulimia?
A: Recurrent binge eating episodes characterized by eating excessively in a short period and feeling a lack of control over eating
B: Recurrent inappropriate behaviors to prevent weight gain (vomiting, laxatives, fasting, excessive exercise)
C: Both binge eating and compensatory behaviors occur at least once a week for 3 months
D: Self-evaluation is heavily influenced by body shape and weight
E: The behaviors don’t occur only during anorexia nervosa episodes
How is bulimia characterized?
- have an insatiable appetite
- massive overeating is used interchangeably with binge eating or binging
- considered to be part of Anorexia Nervosa
What are signs of bulimia?
- Common foods are high calorie, high carbohydrate snack foods that are easily ingested in a short period of time
- Eat a lot of calories rapidly
- Mostly during evening/night
- Secretive about behavior
- Shoplift food
- Visits different fast-food restaurants and grocery stores
What are behaviors associated with bulimia?
- Binge eating episodes
- Self-induced vomiting
- Laxative abuse
- Excessive drinking of water/carbonated beverages
- Using high amounts of mints and gum
- Vomiting signs (calloused hands/dental)
When do bulimic episodes usually end?
- induced vomiting begins and patients are physically exhausted
- pain from abdominal distention
- interrupted by others
- have run out of food
What are complications due to bulimia?
- Dehydration
- Dental enamel erosion
- Fluid and electrolyte imbalances
- GI tract irritation/injuries
- Hypochloremia
- Hypokalemia
- Hyponatremia
- Ipecac syrup (induce vomiting) → cardiomyopathy failure
- Laxative abuse → reflex constipation and rebound edema
- Menstrual irregularities
- Metabolic acidosis and alkalosis
- Pancreatitis
- Russell sign (calluses on the knuckles of fingers used to induce vomiting) - very common*
- Salivary glands enlarged
How is bulimia treated?
- Psychological treatments (first in line)
- Fluoxetine (SSRI) helpful if patients have depression (help reduce impulse)
- Topiramate (decreases appetite) helps reduce binge-eating when used with CBT
What is the DSM-5 criteria for Binge Eating Disorder (BED)?
A: Recurrent binge eating episodes, defined by:
- Eating an unusually large amount of food in a short time (e.g., within 2 hours).
- Feeling a lack of control over eating during the episode.
B: Binge eating is associated with at least three of the following:
- Eating much faster than normal.
- Eating until uncomfortably full.
- Eating large amounts when not physically hungry.
- Eating alone due to embarrassment.
- Feeling disgusted, depressed, or guilty afterward.
C: Significant distress about binge eating.
D: Binge eating occurs at least once a week for 3 months.
E: Binge eating is not linked to compensatory behaviors (like vomiting) and does not occur exclusively with bulimia nervosa or anorexia nervosa.
What are signs of BED?
- Eating large amounts of food in a short period of time
- Eating more quickly than usual
- Emotional eating
- Hoarding or hiding food
- Social Isolation
