Understanding Eating Disorders

Question 1

20 million women and 10 million
men suffer from a clinically
significant eating disorder at
some time in their life
----An estimated 10 – 15% of people with anorexia or bulimia are \_\_\_\_\_\_

Answer 1

males

Question 2

“________ _________” is a disorder uniquely male—–Obsess about having a small and underdeveloped build, even
if they have good muscle mass

Answer 2

Muscle Dysmorphia

Question 3

Anorexia Nervosa
—Patient typically does not recognize that problem exits
—Body Image Distortion
— Having _______, physical wasting with loss of weight and muscle mass due to
disease
—–Controlling weight appears to
offer 2 advantages:
1. Taking control of one’s own
body = gain control over something in life
2. Gaining approval from others

Answer 3

cachexia

Question 4

Medical Complications–Anorexia Nervosa
1—Osteopenia - Irreversible bone loss rate of 15%/year
2–Visceral protein loss - can be life threatening
3–_______ _______LOSS – susceptible to sudden cardiac death
4–Heart failure leading to DEATH -precipitated by electrolyte imbalance, dehydration and malnutrition
5—Bradycardia (and Hypotension)
6— Dry scaly skin, brittle hair
7—Hypothermia
8—_____________ = metabolism and conversion of carotenoids to retinol is slowed, lead to decreased clearance and increased plasma levels (2ndry to hypothyroidism)
9—-___________= decrease in amount of oxygen delivered to extremities - hands and feet turn blue due to lack of oxygen

Answer 4

Myocardial protein

Hypercarotenemia

Acrocyanosis

Question 5

A study by the National Association of Anorexia Nervosa and Associated Disorders reported that:
 5 -10% of anorexics die within 10 years after
contracting the disease
18 - 20% of anorexics will die after 20 years
only ___-____% ever fully recover

Answer 5

30 - 40%

Question 6

Bulimia Nervosa

Recurrent episode of ____ _____ followed by 1 or more compensatory behavior to prevent weight gain

• – MORE common than anorexia
• – MORE challenging to cure than anorexia
• —- Preoccupation with weight and fear of weight gain
• —Distinguishing feature is that dietary control is strict in anorexia but VERY POOR with bulimia..

Answer 6

binge eating

Question 7

Bulimia Nervosa

Purge can manifest in various ways:
Induced vomiting
Use of laxatives
Use of diuretics
Excessive \_\_\_\_\_\_\_\_
Or a combination of some or all of the above
----- Unlike anorexics, that generally appear un well, patients with bulimia often appear well and KNOW their behavior is pathological
-----Often conceal the condition

Answer 7

exercise

Question 8

Medical Complications–Bulimia Nervosa

Medical complication results from trauma to
GI tract and electrolyte imbalances:
Binging can lead to _____ ________
______________ may occur
Enlargement of the parotid gland can be induced by binge
Purging can result in esophageal tear or rupture
Enamel can erode, lead to tooth loss
Other complications can include shock,
myocarditis and dysrythmia
Bruised knuckles resulting from self-induced
vomiting may be an early diagnostic clue

Answer 8

gastric rupture

Pancreatitis

Question 9

Binge Eating Disorder (BED)

• Relatively new diagnosis
• Similar to bulimia – loss of impulse control leads to a binge (may be 2,000 - 3,000 kcal)
• Distinction: NO extreme form of _____
• Also, MC among middle aged, and up to 25% are_______
• Binge tends to take place in PRIVATE with normal or subnormal food intake in public
• Contributes to development of OBESITY
• Rise in prevalence attributed to societal and
environmental influences

Answer 9

purging

male

Question 10

Night Eating Syndrome (NES)

• Binging condition – evening hyperphagia,
nocturnal snacking resulting in _______ _________
• Consumption of over ½ of daily calories after the last evening meal
• Tends to be 400 kcal per episode with multiple episodes throughout the night
• Very common among obese individuals

Answer 10

morning anorexia

Question 11

Treatment

Multidisciplinary approach required
—Psychiatric or psychological care is key
—Medical
—-Nutrition interventions
—-May be inpatient hospitalization, day treatment, intensive outpatient treatment or outpatient treatment
— Depends on _________
—Refeeding after prolonged starvation must be gradual to avoid Refeeding Syndrome
—Starting to eat again after a period of prolonged starvation can precipitate_____ _______
—Patients with anorexia nervosa, cancer,
alcoholism, neurological dysphagia and some
patients after operations are at risk
—Eating disorders are most successfully
treated when diagnosed EARLY

Answer 11

severity

cardiac failure