Disordered Eating Screening For Physical Therapy

What is PICA?

Eating of non-nutritive non-food

What is the classification of PICA in the DSM-5?

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

• The eating of nonnutritive, nonfood substances is inappropriate to the developmental level of the individual

• The eating behavior is not part of a culturally supported or socially normative practice

• If the eating behavior occurs in the context of another mental disorder, it is sufficiently severe to warrant additional clinical attention

How long must a person experience persistent eating of nonnutritive, nonfood substances to be considered PICA?

at least 1 month

T/F: The eating of nonnutritive, nonfood substances is appropriate to the developmental level of the individual to consider PICA.

False, it is not appropriate to the developmental level of the individual

What GI complications are associated with PICA?

• Intestinal obstruction

• Acute weight loss

• Poisoning

• Infection

• Nutritional Deficiency

What is Rumination Disorder?

Repeated regurgitation of food over a period of at least 1 month (re-chewed, re-swallowed, or spit out)

Is Rumination disorder associated with a GI or co-medical condition like GERD or plyoric stenosis?

No

Does Rumination Disorder occur with anorexia nervosa, bulimia nervosa, binge-eating, or avoidant-restrictive disorder?

No

Can Rumination Disorder occur throughout the lifespan?

Yes

What are the risk factors associated with Rumination Disorder?

• Lack of stimulation

• Neglect

• Stress

• Parent-Child Relationship

What are 3 complications of rumination disorder?

Malnutrition, avoidance of eating prior to social situations, and impact on social functioning

Which complication is associated with growth delay for Rumination Disorder?

Malnutrition

Which complication is associated with low weight and weight loss for Rumination Disorder?

Avoidance of eating prior to social situations

Which complication is associated with avoidance of social activities for Rumination Disorder?

Impact on social functioning

What is avoidant / restrictive food intake disorder?

Eating disturbances with persistent failure to meet nutritional and / or energy needs

What must be present from the DSM-5 to consider avoidant / restrictive food intake disorder?

• Significant weight loss

• Significant nutritional deficiency

• Dependence on enteral feeding or oral nutritional supplements

• Marked interference with psychosocial functioning

When does avoidant / restrictive food intake disorder develop?

Infancy / Childhood

Can avoidant / restrictive food intake disorder continue to adulthood?

yes

Is avoidant / restrictive food intake disorder impacted by perception of body weight / shape?

No

What are the complications associated with avoidant / restrictive food intake disorder?

• Malnutrition

• Growth delays

• Need for artificial nutrition

• Social difficulties

What is a screening to detect eating disorders?

SCOFF

What does S stand for in the SCOFF screening tool?

Sick: Do you make yourself Sick because you feel uncomfortably full?

What does C stand for in the SCOFF screening tool?

Control: Do you worry you have lost Control over how much you eat?

What does O stand for in the SCOFF screening tool?

One: Have you recently lost more than One stone (6.35 kg) in a three-month period?

What does F stand for in the SCOFF screening tool?

Fat: Do you believe yourself to be Fat when others say you are too thin?

Food: Would you say Food dominated your life?