Eating Disorders

Question 1

Biology of eating disorders

Answer 1

Greater incidence if in families or if twins

Elevated opioids and endorphin levels of AN…not sure what came first

Question 2

Psychological

Answer 2

Survival mech - gives patients a sense of control

Way to cope

Question 3

Anorexia nerovsa

Answer 3

Restirction of energy intake leading to signifcantly low body weight

Intense fear of gaining weight even though weight is low

Undue self-eval given seriousness of current low weight (or lack of recog)

Question 4

Restricting and binge-eating type of AN

Answer 4

Last 3 mos no binge eating or purging

Last 3 mos recurrent episodes

Question 5

Bulimeia nerovsa

Answer 5

Recurrent episodes of binge eating

Compensatory behaviors to prevent weight gain

Binge eating and compens behavior once a week for 3 mos

Does not occur exclusivley during epsiodes of AN

Question 6

Rumination disorder

Answer 6

Repeated regurgitation of food (at least 1 month)

Food may be rechewed, reswallowed or spit out

Not due to GI

Question 7

Binge eating disroder

Answer 7

once a week for 3 mos

3 of following:
More radiply 
Large amounts when not hungry
Eating alone bc embaraeed 
Feeling disgusted with slef 

Distress regarding

Question 8

AN tx

Answer 8

Weight maintencae of BMI>18.5

Physiologic - sinus bradycardia, hypotension (orthostatic), dehydration, amenorrhea, osteopenia, electrolye

Inpatietn - if med/pscy unstable…could be high risk of depression too…abnormla EKG or metabolic alkalosis

Question 9

Pharmacotherapy

Answer 9

SSRIs may increase weight but don’t really help with climate

Question 10

What works with AN

Answer 10

Maudsley method - agnositc approach to eiology…removes need to assign blame and focus on current situtation

Family therapy is superior

100% attrition in dietary only group (get CBT)

Question 11

Physcial tx of BN

Answer 11

Dental complications - tootch erosion, salivary gland hypertropy, xerostomia

Electrolyte abnormalities - hypokalaemia, hypocalcemia, hypomag

Cardiac - ventricular arryth, sinus bradycardia, otherstatic

GI - delated gastric empytinhfg

Question 12

Psych tx of BN

Answer 12

No skipped meals

No open containers, no drive through, no eating standing up

Grade a meal - A if it is nutritionally sound

Portion control

Dessert with lunch and dinner (100 cals)

Focus on satity

Question 13

Pharma tx of BN

Answer 13

SSRIs work

Question 14

Inpaitent BN

Answer 14

Medically or emotionally unstable

Question 15

Binge eating disorder tx

Answer 15

CBT
Family therapy
Bariatric surgery

Question 16

How to define recorvery

Answer 16

Insight into disease

Need to educate families and help patients voice progress to their family

Question 17

Society
Ambivalence
Fear of recovery

Answer 17

Might see any weight as fat

Feel smothered bu fear being alone

Loss of support structure

Question 18

Prognosis four years after onset and with tx

Answer 18

44% good

5% death