Nutrition-Eating Disorders

Question 1

Psychiatric disorder with highest rate of mortality

Answer 1

Anorexia nervosa (slow death from starvation, cardiac or suicide) has a 20% mortality rate.

Question 2

Eating disorder most likely to cause sudden death?

Answer 2

Bulimia (gag reflex stops working and you choke)

Question 3

What is an eating disorder

Answer 3

Persistent disturbance of eating behavior that impairs both physical and mental health.

Question 4

Groups at risk for development of an eating disorder

Answer 4

Frequent dieters, athletes and military (stress, weigh-ins, achievement)

Question 5

Anorexia nervosa definition

Answer 5

Denial of impact of low weight, use of weight to determine happiness and disturbed perception of physique.

Question 6

How common is anorexia and bulimia nervosa?

Answer 6

1-4% lifetime prevalence. 1:10 male:female

Question 7

Distinctive features of anorexia

Answer 7

Sense of specialness, effort and competitiveness.

Question 8

Co-morbid conditions with anorexia and bulimia nervosa

Answer 8

Depression, anxiety, PTSD, OCD and substance abuse

Question 9

Physiological consequences of anorexia nervosa.

Answer 9

*

Question 10

Good prognosis for anorexia

Answer 10

Early age of onset and early intervention by family and social network.

Question 11

When do you admit someone with anorexia?

Answer 11

*

Question 12

What is commonly used to prevent relapse of anorexia after recovery?

Answer 12

SSRIs

Question 13

Role of provider in managing anorexia and bulimia

Answer 13

Recognize signs, refer to mental health and treat health complications

Question 14

Definition of bulimia nervosa

Answer 14

Binge eating w/inappropriate compensatory behavior (vomiting, laxatives, diuretics, enemas, fasting, exercise) 1x a week for 3 months. Self-evaluation is influenced by physique. **Anorexia trumps bulimia**

Question 15

Binge eating

Answer 15

Eating an amount of food larger than the average person would eat and a lack of control over eating during that episode.

Question 16

How does bulimia affect the body?

Answer 16

Chipmunk cheeks, esophageal erosions, perimylolysis (erosion of tooth enamel).

Question 17

Good treatments for bulimia

Answer 17

Psychotherapy, CBT and SSRIs

Question 18

Most prevalent eating disorder. What defines it?

Answer 18

Binge eating disorder, highly associated with obesity. Note that there are no compensatory behaviors. Marked distress from binge eating. Binges 1x a week for 3 months.

Question 19

Psychotherapy for binge eating disorders

Answer 19

Help them see that food is okay to eat, but try to prevent obesity

Question 20

Comorbid in people with binge eating disorders

Answer 20

75% have another psychiatric disorder (obesity, anxiety)

Question 21

What should you always assess for in people who present that are overweight or obese?

Answer 21

Binge eating disorder

Question 22

Treating binge eating disorders

Answer 22

Psychotherapy, appetite suppressants, antidepressants

Question 23

Definition of eating disorders not otherwise specified.

Answer 23

Anorexia w/normal weight range. bulimia less than 1x a week, compensatory behavior after eating small amounts of food, chewing and spitting out large amounts of food.

Question 24

Most prevalent eating disorders in military women?

Answer 24

Bulimia and not otherwise specified. Deployed women at higher risk

Question 25

How do weigh ins affect men in military

Answer 25

15% perform eating disorder habits around weigh ins

Question 26

Physican’s role in preventing/treating eating disorders

Answer 26

Moderation in eating/exercise, collaborate with mental health provider, don’t refer solely for nutritional counseling, monitor physical comorbidities and be supportive.