[ Psychiatric ] Eating & Sexual Disorders 3

Binge-eating disorder: Definition of an episode

Eating an objectively large amount of food within a discrete period (= 2 hours).

Binge-eating disorder: Diagnostic criteria requirement during binges

≥3 of the following: Eating much more rapidly than normal, Eating until uncomfortably full, Eating large amounts when not hungry, Eating alone due to embarrassment, Feeling disgusted, depressed, or guilty afterward.

Binge-eating disorder: Diagnostic criteria for frequency and duration

≥1 episode/week for ≥3 months.

Binge-eating disorder: First-line psychotherapy

CBT: 1st line.

Binge-eating disorder: Indication for SSRIs

Helpful for binge frequency + comorbid depression/anxiety.

Binge-eating disorder: Effects of Topiramate/Zonisamide

Weight loss + reduced binge behavior.

Binge-eating disorder: Mechanism and indication for Orlistat

Blocks pancreatic lipase → ↓ fat absorption, useful if obesity is prominent.

Binge-eating disorder: FDA-approved medication for moderate–severe BED

Lisdexamfetamine.

Pica: Diagnostic criteria for duration

Recurring episodes of eating non-food substances over ≥ 1 month.

Pica: Most common populations

Common in children and during pregnancy.

Pica: Associated clinical conditions

Associated with malnutrition, IDA, developmental disabilities, emotional trauma.

Avoidant/restrictive food intake disorder: General definition

Eating or feeding disturbance.

Avoidant/restrictive food intake disorder: Associated complications (must have + 1)

• 1: weight loss, nutritional deficiency, dependence on oral nutritional supplements or tube feeding.

Avoidant/restrictive food intake disorder: Key negative symptom distinguishing from anorexia/bulimia

No disturbance in body image (no fear of fatness).

Avoidant/restrictive food intake disorder: First-line management

CBT: 1st line.

Eating disorders: Most common demographic group

Most common in young women.

Eating disorders: Location of the stop-eating center in the brain

Stop-eating center is present in the ventromedial hypothalamus.

Eating disorders: Location of the hunger center in the brain

Hunger center is present in the lateral hypothalamus