8- eating disorders

disordered eating definition

variety of atypical eating behaviors used to reduce weight

eating disorder definition

psychiatric condition involving extreme body dissatisfaction + long term eating patterns that harm the body, must meet DSM-V criteria

eating disorders are very common in which population

white females

4 main eating disorders

1. anorexia nervosa (AN)

2. binge eating disorder (BED)

3. bulimia nervosa (BN)

4. purging disorder (PD)

2 types of anorexia nervosa

1. restricting: diet, fasting, excessive exercise

2. binge eating/purging: diet + binge eating/purging behavior

purging behaviors definition

attempt to rid the body of unwanted food through means like vomiting, laxatives, diuretics, enemas

symptoms of anorexia nervosa

1. cold intolerance

2. amenorrhea (no periods)

3. hair loss/languno (thin hair)

4. fainting

5. muscle wasting

6. edema

7. cyanosis

8. bruising

9. constipation

10. insomnia

health risks of anorexia nervosa

1. hypothermia

2. infertility

3. hypotension

4. osteopenia/osteoporosis

5. organ wasting

6. macro/micronutrient deficiency/malnutrition

7. dehydration + electrolyte imbalance

8. cardiac arrhythmias + bradycardia

9. anemia

inpatient intervention for anorexia nervosa

1. correct starvation

2. correct fluid + electrolyte imbalance

3. correct bradycardia/hypotension

4. 2-3lb/week weight gain

outpatient intervention for anorexia nervosa

1. psychotherapy

2. promote healthy eating habits

3. achieve normal menstrual cycle

4. 0.5-1lb/week weight gain

via team of physician/PA, psychologist, RD, family

foods to avoid for anorexia nervosa pts

high volume + fiber, can slow gastric emptying

safe foods for anorexia nervosa pts

1. fruits + veggies

2. tofu

3. low fat/fat free foods

4. plain tuna + chicken

anorexia nervosa pts should slowly add small amount of what into their diet

higher calorie foods

what’s refeeding syndrome

occurs in malnourished pts that initially consume a concentrated carbohydrate → insulin release → rapid depletion of phosphorus, potassium, magnesium

who’s at significant risk for refeeding syndrome

1. <16 BMI

2. weight loss of 7.5% in 3 months or >10% in 6 months

3. no calorie intake for >7 days

4. <50% of energy requirement for >5 days during illness/injury

5. <50% of energy requirement for >1 month

6. low levels of K, P, Mg

7. severe fat + muscle mass loss

who’s at moderate risk for refeeding syndrome

2 criteria needed:

1. BMI 16-18.5

2. weight loss of 5% in 1 month

3. no calorie intake for 5-6 days

4. <75% of energy requirement for >7 days during illness/injury

5. <75% of energy requirement for >1 month

6. low levels of K, P, Mg

7. moderate fat + muscle mass loss

bulimia nervosa definition

binge eating followed by an attempt to rid the body of unwanted food by vomiting, laxative, diuretics, enemas, fasting, excessive exercise

symptoms of bulimia nervosa

1. disappearance of large amounts of food

2. eating quickly

3. jaw/cheek swelling

4. frequent bathroom trips

5. Russell’s signs (cuts on knuckles)

6. dental decay

7. sore throat

8. constipation

9. withdrawal from friends/family

health risks of bulimia nervosa

1. anemia

2. electrolyte imbalance

3. cardiac arrhythmias

4. esophagitis

5. Mallory-Weiss tears

2 warning signs of bulimia nervosa

1. erosion + decay on teeth

2. Russell’s signs (cuts on knuckles)

what’s the female athlete triad

1. disordered eating

2. menstrual dysfunction (amenorrhea)

3. osteoporosis

recognizable behaviors of the female athlete triad

1. restrictive eating patterns

2. significant weight loss

3. no periods/irregular periods

4. fatigue + decreased ability to concentrate

5. stress fractures unrelated to significant injury

6. muscle injuries

7. low body fat