In ANOREXIA, what 4 electrolyte disturbances are classically seen?
What three vitamin and mineral deficiencies are classically seen?
Hypo K, Ca, Mg and Ph
B1, B12, and iron.
Ipecac abuse as a means of purging can cause this horrible medical SE?
Irreversible Cardiomyopathy.
In an individual with AN…who would you consider a Dexa bone scan for?
Those with amenorrhea for >6 months should get DEXA.
What is the role of medications in the treatment of AN?
No FDA approved medications to treat AN…only comorbidities like depression, anxiety, substance abuse ext.
What are the 9 indications for hospitalization of AN?
- Weight 40% below normal
- > 30lb loss in 3 months
- Weight is that of previously associated with medical issues.
- Severe metabolic/electrolyte issues.
- Severe binging and purging.
- Autonomic instability
- Risk of suicide or severe MDD
- Need for brief weight restoration
- Treatment failure at lower level.
What is the weight goal for the end of hospitalization for Anorexia?
Near normal weight !!!!
What are the electrolyte abnormalities in Refeeding Syndrome.
Hypo Phos
Hypo K
Hypo Mg
Psychotherapy has “modest” outcomes during acute phase treatment in the hospital for AN…but during maintenance phase psychotherapy has good evidence for efficacy…What are the 4 therapies that have been found to be helpful?
- CBT
- Family treatment-behavior FT-B (family gets involved and healthy eating is non-negotiable)
- 12 step groups - addition model
- Adolescent focused therapy
Anorexia and bulimia have high commodities with what 4 other diseases?
- Mood disorder
- Anxiety disorder
- Substance use disorder
- Personality disorder
What FDA approved medication for Bulimia (but not AN) helps reduce core symptom of binge eating and purging?
Fluoxetine.
