Psychological Aspects of Eating Disorders Flashcards
Who is functional GI disease more common in?
Younger people
What are psychological problems caused by GI disease?
Conditioning Nausea and vomiting Loss of appetite / weight loss Diarrhoea Sexual problems Stress
What psychological problems can present as GI disease?
Stress Anxiety Depression Somatisation Eating Disorders
Definition of somatisation
Mental disorder characterised by recurring, multiple and current clinically significant complaints about somatic symptoms
When do somatic symptoms occur?
When a patient feels extreme anxiety about physical symptoms such as pain or fatigue
How do you assess nutritional risk?
BMI <20 = 1 BMI < 18 = 2 Weight loss 5% = 1 Weight 10% = 2 Have you eaten anything for 5 days 1. yes 2. no Score > 2 significant risk off malnutrition
Definition of refeeding syndrome
If you have been starving for a long period of time then get fed normally - can get very ill very quickly
Pathology of refeeding syndrome
Major electrolyte shifts - Ca - K - P - Mg Giving rise to MI
Definition of adapted starvation
The body enters this state to shut down as much as it can to reduce the energy it needs
Pathology of adapted starvation
Reduced intake of carbohydrate
Reduced secretion of insulin
What are the major energy sources?
Fat
Protein
How does the body have low expenditure of energy?
Lethargy
Lack of physical activity
How do you determine if someone is at high risk of developing refeeding problems?
Patients has one or more of the following
- BMI < 16
- Unintentional weight loss greater than 15% within the last 3 - 6 months
- little or no nutritional intake for more than 10 days
- low levels of potassium phosphate or magnesium prior to feeding
Patient has two or more of the following
- BMI < 18.5
- Unintentional weight loss > 10% within the last 3 - 6 months
- Little or nutritional intake for more than 5 days
- A history of alcohol abuse or drugs including insulin, chemotherapy, antacids or diuretics
Treatment of malnutrition / eating disorder
Start slow - correct fluid depletion (cautiously) - thiamine (Vit B12) at least 30 mins before feeding starts Feed at 5-10kcal/kg over 24 hours - VERY SLOW Replace - Phosphate (IV) < 0.3 - K < 2.5 - Mg < 0.5 Thiamine
What are the eating disorders?
Binge Eating Disorder
Bulimia nervosa
Anorexia nervosa
