NB12-7 - Eating Disorders Flashcards
List the eating disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
- Unspecified Eating Disorder
What are the diagnostic criteria for anorexia nervosa?
- Patients restricts caloric intake to the point of being significantly underweight which is a BMI < 17 in adults or below the 5th percentile in children (2-18yo)
- Patient has an intense fear of weight gain
- Patient has a body image disturbance
Patient must have all three
List and describe the anorexia subtypes.
- Binge-eating/purging type - patient recurrently binges and/or purges (vomiting, laxatives, enemas)
- Restricting type - patient does NOT recurrently binge or purge (weight loss is primarily through dieting and/or exercise)
A
List the major indicators of excessive thinness.
- Low BMI
- Amenorrhea (cessation of menstruation)
- Loss of sex drive
- Constipation
- Hypothermia
- Lanugo (development of fine hairs to keep warm)
- Bradycardia
- Hypotenstion
- Hypercholesterolemia
- Low blood counts and bone mineral density
List the major indicators of excessive vomiting.
- Russell’s Sign (calloused knuckles)
- Dental enamel erosion
- Salivary gland inflammation (chipmunk cheeks)
- Subconjunctival hemorrhage
- Hypokalemia
What is the etiology of anorexia?
- Psychological/Social Factors
- Dieting due to cultural pressure
- Learned behaviors from parents
- Dieting as a way to feel in control
- A perfectionist personality can lead to osessive dieting
- Weight loss is reinforced internally or externally
- Biological Factors
- Genetics
What is the treatment plan for anorexia? How successful is treatment usually?
- Behavioral techniques (reinforcement/punishment), and monitoring is used to achieve the immediate goal of weight gain
- CBT can be used to change the patient’s attitude about food/weight
- Medical treatment is only used for actual medical complications and comorbidities
Treatment is usually successful in the short-term but relapses are also very common
What are the diagnostic criteria for bulimia nervosa?
- Binge eating at least once a week for 3 months
- Inappropriate compensatory behavior after a binge
- Self-evaluation is unduly influenced by body shape and weight
B
How do you distinguish between the binge-eating/purging subtype of anorexia nervosa and bulimia nervosa?
Anorexia requires a restriction of food to the point of being underweight, an intense fear of weight gain, and a body image disturbance.
Bulimia just requires extended binging and purging. Bulimics typically have normal body weight or are slightly overweight.
What is the etiology of bulimia?
- Psychological/Social Factors
- Societal pressures to be thin
- Attempt to improve self-esteem
- Failed diets often lead to binge eating followed by a fear of weight gain which leads to compensatory behavior
- Biological Factors
- Genetic predisposition to low impulse control
- Low serotonin (more impulse control problems)
What is the treatment plan and prognosis for bulimia?
- As opposed to anorexia, bulimic patients typically initiate treatment because the disorder stresses them
- Treatment is usually out-patient
- CBT is essential
- Antidepressives may be useful to help with impulse dyscontrol
Prognosis is better for bulimia than anorexia because the motivation to change is more present.
What are the diagnostic criteria for binge eating disorder (BED)? How can you distinguish between a person with BED and someone who is just obese?
- Binge eating at least once a week for three months
- No inappropriate compensatory behavior
You can be obese without binge eating and there is usually greater distress and functional impairment with people who have BED, as opposed to just being obese.
What is the etiology and treatment plan for BED? With which other eating disorders does BED often cross-over with?
The etiology of BED isn’t understood but it is thought to be different from Bulimia because dysfunctional dieting does NOT preced binging
Treated with CBT and antidepressives (SSRIs)
BED does NOT commonly cross-over with other disorders
C
