Eating Disorders

Question 1

Eating Disorders

Common Eating Disorder Types

Answer 1

Pica
- In children
- In adults
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Anorexia Nervosa
- Restricting type
- Binge-eating/purging type
Bulimia Nervosa
Binge-Eating Disorder
Other Specified Feeding or Eating Disorder
- Atypical anorexia nervosa
- Bulimia nervosa (of low frequency and/or limited duration)
- Binge-eating disorder (of low frequency and/or limited duration)
- Purging disorder
- Night eating - sertraline has some efficacy
Unspecified Feeding or Eating Disorder

Question 2

Eating Disorders

Anorexia nervosa criteria

Answer 2

• Restriction of energy intake relative to requirement
• Causing abnormally low BMI
• Intense fear of gaining weight
• Distorted perception of body weight.

Question 3

Eating Disorders

Define anorexia nervosa subtypes

Answer 3

Restricting type
- During the last 3 months, the person is not binge eating or purging. They are losing weight through dieting, fasting and/or excessive exercise.

Binge-eating/purging type
- During the last 3 months, the person is recurrently binge eating or purging.

Question 4

Eating Disorders

Anorexia Nervosa Management

Answer 4

• Family intervention
• • For adolescents is the best choice
• Nutritional rehabilitation
• CBT, Interpersonal therapy, focal psychodynamic therapy and family therapy for adults
• Psychopharmacology not indicated

Question 5

Eating Disorders

Anorexia nervosa complications

Answer 5

Cardiovascular

• Myocardial atrophy
• Mitral Valve Prolapse
• Fatal Arrhythmia (risk is high if BMI <13.5)
• Pericardial effusion
• Bradycardia

Other

• Functional hypothalamic (constitutional) amenorrhoea
• Antenatal and postpartum problems
• Osteoporosis
• Gastroparesis
• Constipation

Question 6

Eating Disorders

Bulimia nervosa criteria

Answer 6

• Recurrent episodes of binge eating
• Recurrent inappropriate compensatory behaviours to prevent weight gain.
• Both above behaviours occur on average at least once a week for 3 months.
• Self-evaluation is poorly influenced by body shape and weight
• The disturbance does not occur during anorexia nervosa

Question 7

Eating Disorders

Bulimia nervosa complications

Answer 7

• Dehydration
• Hypokalaemia
• Mallory-Weiss Syndrome
• Ipecac-induce myopathy (ipecac is used to irritate stomach mucosa and induce vomiting)
• Erosion of dental enamel

Question 8

Eating Disorders

Bulimia nervosa management

Answer 8

• CBT (Gold standard)
• Nutritional rehabilitation
• Antidepressant (SSRI)
• • Such as fluoxetine

Question 9

Eating Disorders

Define Pica Disorder

Answer 9

Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month

Question 10

Eating Disorders

Define Rumination Disorder

Answer 10

Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out.

Question 11

Eating Disorders

Define Avoidant/Restrictive Food Intake Disorder

Answer 11

An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs

Question 12

Eating Disorders

Define Binge-Eating Disorder

Answer 12

Recurrent episodes of excessive bing eating

Question 13

Eating Disorders

Define Refeeding Syndrome

Answer 13

A potentially life-threatening metabolic response to refeeding in severely malnourished patients resulting in severe shifts in fluid and electrolyte levels

Question 14

Eating Disorders

Refeeding Syndrome Complications

Answer 14

• Hypophosphataemia
• Congestive Heart Failure
• Cardiac Arrhythmias
• Delirium
• Death

Question 15

Eating Disorders

Refeeding Syndrome Prevention

Answer 15

• Slow refeeding
• Gradual increase in nutrition
• Supplemental phosphorus
• Close monitoring of electrolytes
• Cardiac Status