wamss notes eating disorders Flashcards
anorexia nervosa
Eating disorder characterised by low weight, fear of gaining weight & strong desire to be thin, many see themselves as overweight even though they are underweight.
criteria of anorexia nervosa
A. Restriction of energy intake relative to requirements leading to a significantly low body
weight
B. Intense fear of gaining weight or becoming fat even though at a significantly low weight
C. Disturbance in the way ones body weight/shape is experienced (undue influence of weight
on self-evaluation or persistent lack of awareness of seriousness of current low body weight)-
body image distortion
physiological effects anorexia nervosa
Low BMI
Amenorrhoea
OP
Thin brittle hair
Cardiac Damage
Lanugo
risk factors for anorexia nervosa
Genetics
Obstetric complications or GI diseases
Childhood sexual abuse or dysfunctional families
Social environment- social pressure
treatment for anorexia nervosa
Restore pt to a healthy weight
- Nutritional support
- Manage Refeeding syndrome
Psychotherapy; CBT, Family Based Therapy (FBT)
prognosis for anorexia nervosa
20% never completely recover
Relapse in 1/3
bulimia nervosa
Eating disorder characterised by binge eating followed by purging
classification of bulimia nervosa
A. Recurrent episodes of binge eating
- Eating in a period of time an amount of food that is greater than what most ppl would
eat in similar timeframe under similar circumstances
- Sense of lack of control of overeating during the episode
B. Recurrent inappropriate compensatory behaviours in order to prevent weight gain
C. At least 1 per week for 3 months
D. Self-evaluation is unduly influenced by body shape & weight
E. not due to anorexia
physiological effects of bulimia nervosa
Reflux
Russel’s Sign: calluses on knuckles
Oesophagitis
Mallory-Weiss tears, Boerhaave syndrome
Dehydration
Hypochloraemia & Hypokalaemia
Electrolyte abnormalities
Cardiac conduction abnormalities
Dental erosion
Swollen salivary glands
Loss of teeth enamel & thickening of skin of fingers
Dehydration & hypokalaemia due to vomiting
Tx for bulimia nervosa
Psychotherapy; CBT, Family Based Treatments (FBT)
Limited utility for medications
binge eating disorder
Recurrent episodes of binge eating
- Eating in a discrete period of time an amount of food that is more than what most ppl
would eat in that time
- Sense of lack of control of eating during the episode…
avoidant/restrictive food intake disorder
A. Eating or feeding disturbance (apparent lack of interest in eating food; concern about the
aversive consequences of eating) manifested by persistent failure to meet appropriate
nutritional needs:
- Weight loss (failure to meet expected weight)
- Nutritional deficiency
- Dependence on enteral feeding or nutritional supplements
- Interference with psychosocial functioning
bulimia nervosa of low frequency or limited duration
<3 months
binge-eating disorder of low frequency or limited duration
<3 months
purging disorder
recurrent purging in the absence of binge eating
night eating syndrome
recurrent episodes of night or after dinner eating
unspecified feeding or eating disorder
Symptoms characteristic of an eating disorder that cause clinically significant distress or
impairment areas of functioning, but do not meet the full criteria for any of the disorders in
the feeding and eating disorders diagnostic class.
Pica
A. Persistent eating of a non-nutritive, non-food substance for a period of >1 month
B. Inappropriate to the developmental level of the pt
C. Not culturally or socially accepted practice
D. Does not occur in the context of another mental disorder or intellectual disability
special names for Pica
Trichophagia- hair
Ice- pagophagia
Paper- xylophagia
Paint or metal- metallophagia
Stones- Lithophagia
Dirt- Geophagia
Faeces- coprophagia
rumination disorder
Pt repeatedly regurgitates food & re-chews, swallows or spits out
For at least 1-month
