Eating disorders

Question 1

What are some iatrogenic causes of obesity?

Answer 1

• anti-psychotics and/or antidepressants
• block H1 –> increase appetite
• block achm –> weight gain
• block 5-HT2c –> sensitivity of leptin, increase weight

Question 2

what are 3 pharmacologic therapies for obesity?

Answer 2

• amphetamines (decreases appetite)
• orlistat (lipase inhibitor) –> can’t absorb fat; side effect: diarrhea
• topiramate and zonisamide (anti-convulsants)

Question 3

What’s is the DSM-5 diagnosis of anorexia nervosa?

Answer 3

• refusal to maintain 85% typical weight
• restriction of energy intake requirements –> low body weight
• fear of gaining
• body image disturbance (dysmorphism)
• missed menstrual cycles x 3 (DSM-IV)
• restricting type = does not eat, does not purge
• binge/purge type = does binge or purge
• severity is based on BMI

Question 4

What’s the mortality rate of anorexia nervosa?

Answer 4

18%

Question 5

What’s the personality profile of someone who has anorexia nervosa?

Answer 5

rigid and controlling and high achieving or are being rigidly controlled

Question 6

What are some comorbidities assoc with anorexia nervosa?

Answer 6

• weight loss
• suicide increase
• OCD
• anxiety disorders
• rigid and perfectionistic traits
• delayed psychosexual development
• denial
• minimization
• delusion

Question 7

What are some medical issues assoc with anorexia nervosa?

Answer 7

• weight loss
• hypothermia
• edema
• bradycardia, hypotension, syncope
• amenorrhea
• electrolyte imbalance, low K+
• cardiac changes
• lanugo hair
• osteoporosis
• delayed gastric emptying
• metabolic acidosis
• organ failure

Question 8

What is the DSM-5 diagnosis of bulimia nervosa?

Answer 8

• recurrent binge eating
• eating an atypically large amt in discrete period of time disproportionate to typical eating
• purging vs non-purging types
• no anorexia present
• loss of control
• vomiting, laxative use, enema,s diuretics, exercise
• binges 1x/wk for 3 months
• compensatory behaviors necessary for diagnosis

Question 9

Which has greater prevalence: anorexia nervosa or bulimia?

Answer 9

bulimia

Question 10

Unlike anorexia nervosa in which the affected person has a rigid, high acheiving personality, what does a person with bulimia have?

Answer 10

dysfunctional family, less rigid and more conflued, outgoing, angry, impulsive traits, borderline personality, more substance abuse & personality d/o

Question 11

What are some medical signs of someone with bulimia nervosa?

Answer 11

• poor dentition, enamel loss, cavities
• abraided knuckles (Russell’s sign)
• normal/overweight
• sexually active
• high amylase/salivary enlargement
• low PO4, low Mg

Question 12

Which meds are approved for bulimia nervosa?

Answer 12

SSRIs

Question 13

What is avoidant/restrictive food intake disorder?

Answer 13

• failure to meet diet/energy needs
• weight loss, nutritional deficiency
• supplementation needed
• psychosocial distress
• doesn’t meet full anorexia criteria

Question 14

What is binge eating disorder?

Answer 14

• binges
• lack of control
• ego dystonic
• 1x/wk for 3 months
• no purges or compensations

Question 15

What is PICA?

Answer 15

• persistent eating of non-nutritive substance for 1 month
• not developmentally or culturally appropriate
• not medical or from intell disability or autism

Question 16

What is rumination?

Answer 16

• repeated regurgitation and re-chewing of food
• no weight gain
• not medical or from intell disability or autism
• often before 6 yrs