Peds Eating Disorders Flashcards
what is the definition of body image
perception that a person has of their own physical self
what are the two main factors that influence body image
- individual factors
- environmental factors
what are perceptual factors of body image
how we see ourselves
what are affective factors of body image
how we feel about how we look
what are cognitive factors of body image
our thought and beliefs about out body
what are behavioral factors of body image
what we do in relation to how we look
body dissatisfaction is strongly tied to (…)
chronic negative perception about ones body
what makes body dissatisfaction different from an eating disorder?
morbid fear of weight gain and the thoughts are all-consuming in an eating disorder
what are risk factors for body dissatisfaction
- female
- teen/adolescent
- low self esteem
- participation on activities that focus on being thin
t/f eating disorders may have a possible genetic link
true
mother/sisters of anorexic patients are (…)x as likely to also have an eating disorder
8
what neurotransmitters does anorexia affect?
serotonin and dopamine mostly. possibly norepinephrine
what neurotransmitters do bulimia affect?
serotonin
people with eating disorders have a hard time recognizing what ques
hunger and satiety
what psych problems are associated with eating disorders?
- OCD
- Anxiety
- Depression
- body dysmorphia
what type of family are anorexic patients are more likely to come from?
rigid, controlling, and organized
what type of family are bulimic patients are more likely to come from?
chaotic, critical and conflicted
what type of ineffective parenting can lead to eating disorders in the future
feeding kids at time of anxiety rather than hunger, making it hard for them to differentiate hunger from feelings as an adult
how do we tell the difference between normative and abnormal dieting?
- patient weight
- patient health status
- body perception
- healthful or harmful diet?
what are the screening tools for eating disorders
- SCOFF
- ESP
- EAT
- PHQ
when does Avoidant/Restrictive Food Intake Disorder begin?
infancy or early childhood
what is the classic presentation of Avoidant/Restrictive Food Intake Disorder
underweight child with a BMI of 16 or less
diagnostic criteria of Avoidant/Restrictive Food Intake Disorder
- Avoiding or restricting food intake
- failure to meet nutritional or energy needs
- not due to lack of resources or other medical condition
anorexia is (…)x more common in women
3 times
what is the peak onset of anorexia
early adolescence and late adolescence/early adulthood
what is the average age of onset for anorexia
18
classic anorexia patient
adolescent white female
what characterizes anorexia
- restricted energy intake-> low body weight
- intense fear of weight gain
- distorted perception of weight
what is binge eating anorexia
when someone engage in small binges and purges (less frequent than bulimia)
what is restrictive anorexia
anorexic tendencies with no purging behaviors
what are abnormal food behaviors in anorexia
- reduction in food intake
- food related obsessions
- claim distaste for food or epigastric pain
common behavioral disturbances in anorexia
- distorted perception of part or all of body
- perfectionist
- limited social activities
what are the clinical findings of anorexia
- depression
- fatigue
- bone pain
- amenorrhea
- GI
- hair loss
- russell’s sign
what are severe clinical signs of anorexia
- emaciation
- sallow complexion
- bradycardia
- severe hypotension
- osteoporosis
- lanugo
what is lanugo
fine, soft hair, especially that which covers the body
what is Russell’s sign
calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time
what is the cause of 50% of deaths in anorexic patients
complications of the disease
what is included in the workup of all suspected anorexia patients?
- EKG
- UA
- serum labs
when should you admit an anorexia patient?
- unstable vitals
- cardiac complications
- organ failure
- suicide
- weight less than 70% IBW
what is refeeding syndrome
metabolic alterations that may occur during nutritional repletion of starved patients
what is the management of anorexia
- multimodal approach including:
- nutritional rehabilitation
- psychotherapy
- medical management
what are the goals of anorexia treatment
- medical stability
- weight stabilization
- heathy eating patterns
- treat underlying psychopathology
- prevent relapse
t/f psych meds are first line for anorexia
false: psychotherapy is first line
if psych meds are needed for anorexia treatment, what should be given?
- olanzapine to help with weight gain
- SSRI can also be used. (fluoxetine preferred d/t lower risk of relapse after restored weight)
(…)% of anorexia patients have a good prognosis
50%
(…)% of anorexia patients eventually relapse
35-55%
bulimia is (…)x more common in women
3x
what is the classic bulimia patient
adolescent white female
what is purging bulimia
patients who engage in self induced vomiting or misuse of laxatives, diuretics, and enemas
what is nonpurging bulimia
patients who engage in other inappropriate compensatory behaviors such as fasting, excessive exercise
what is the typical pattern of behavior for bulimia
- caloric restriction
- binge
- compensatory mechanism (purge)
t/f bulimia patients have slightly more control over their condition than anorexia
true
what are the clinical findings of bulimia
- lethargy
- hypotension
- tachycardia
- hair loss
- GI
what are the severe clinical findings of bulimia
- dehydration
- hypokalemia
- hyperchloremia
- metabolic alkalosis
hypertrophy of what gland is related to bulimia?
parotid gland
what is the workup for all suspected bulimic patients
- UA
- Serum labs
- if severely ill: EKG
when should you admit a bulimia patient?
- unstable medical condition
- suicidal ideation
- refusal of treatment with potential to become unstable
what is the management of bulimia
- multimodal approach:
- nutritional rehabilitation
- psychotherapy
- medical management
what is the best form of therapy for bulimia
cognitive behavioral therapy
1st line medication for bulimia
Fluoxetine (prozac)
what medications are contraindicated in bulimia and other eating disorders?
bupropion (wellbutrin)
what is the prognosis of bulimia
- 50-70% short term reduction of symptoms
- 28% relapse rate
binge eating disorder is more common in which population
women
what is the median age of onset for binge eating disorder
23
what is binge eating disorder
recurrent binge eating without compensatory behaviors
how do you rate severity of binge eating disorder
- Mild: 1-3x weekly
- Moderate: 4-7x weekly
- Severe: 8-13x weekly
- Extreme: 14+ weekly
common reported symptoms with binge eating disorder
- food is coping mechanism
- shame, guilt, hopelessness
what are the typical comorbidities of binge eating disorder
- obesity
- psychological factors.
How do you manage binge eating disorder
psychotherapy
what pharmacotherapy is available for binge eating disorder
