Eating Disorders

what is orthorexia?

unhealthy focus on healthy eating (OCD behavior)

what are complications of extreme caloric restriction?

bradycardia, anemia +/- leukopenia, hypothermia, orthostasis, edema, etc.

what are complications of purging behaviors?

dental caries, parotid hypertrophy, Russell's sign, arrythmias, or melanosis coli

what is Russell's sign?

calluses of metacarpals/phalanges

what is melanosis coli?

mucosa w/ dark brown hyperpigmentation due to misuse/abuse of Senna-containing laxatives

what does pica have an association with?

pregnancy

what is rumination disorder?

regurgitating food after eating on a daily basis and persists for >1 month

how is rumination disorder treated?

diaphragmatic breathing to prevent abdominal contractions

what usually causes avoidant/restrictive food intake disorder?

lack of interest/distaste of food or marked impairment in psychosocial functioning

is avoidant/restrictive food intake disorder equally prevalent in males and females?

yes

what is the treatment for avoidant/restrictive food intake disorder?

refer to occupational therapy

what is the diagnostic criteria for anorexia nervosa?

1. restriction of energy intake relative to requirements

2. intense fear of gaining weight

3. disturbance in the way body weight or shape is experienced

what are the subtypes of anorexia nervosa?

restrictive & binge eating/purging

what is the extreme BMI specifier for anorexia nervosa?

<15 kg/m2

what labs can be done for anorexia?

CBC, CMP, thyroid studies, ESR, UA, EKG

what is the diagnostic criteria for bulimia nervosa?

recurrent episodes of *binge eating at least once a week for ≥3 months* AND have *compensatory behaviors*

what is the diagnostic criteria for binge eating disorder?

recurrent episodes of *binge eating at least once a week for ≥3 months*

what is a binge eating episode defined as?

1. eating in discrete period of time ex. 2 hours an amount of food larger than what others would eat in similar time period

2. sense of lack of control while eating during episode

what are the severity specifiers for bulimia nervosa and binge-eating episodes?

-mild: 1-3 times/week

-moderate: 4-7 times/week

-severe: 8-13 times/week

-extreme: ≥14 times/week

what is considered overweight in children & adults?

85th-95th percentile; BMI ≥25 to <30 kg/m2

what is considered obese in children & adults?

≥95th percentile; BMI ≥30 kg/m2

what is considered severe obesity in children & adults?

120% of 95th percentile; BMI ≥40 kg/m2

which conditions are more likely to seek treatment on their own?

bulimia nervosa & binge eating disorder

what is the #1 goal in treating BN & BED?

restore nutritional state w/ multidisciplinary approach

what is atypical anorexia nervosa?

individuals meet criteria for anorexia nervosa but are not underweight (falls under OSFED disorder)

what are subtypes of BN?

purging & non-purging

what are related OSFEDs to BN?

bulimia nervosa of limited duration or purging disorder

what is bulimia nervosa of limited duration?

all BN criteria met except they occur less than once per week and/or <3 months

what is purging disorder?

purging to influence weight in absence of binge eating

what is the non-pharmacologic therapy for eating disorders?

CBT

what is the MC pharmacologic therapy for eating disorders?

fluoxetine

what is a medication that is a stimulant and first med FDA-approved specifically for BED?

lisdexamphetamine

what medication is CI in eating disorders?

buproprion

which condition has the highest mortality rate amongst all psychiatric diseases?

anorexia nervosa