Term
| *DMS criteria for anorexia nervosa (AN)* |
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Definition
*refusal to maintain body weight; weight loss resulting in <85% expected weight*
intense fear of gaining weight/being fat
disitubed body image
*amenorrhea (when applicable) for 3+ cycles/months |
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Term
| *DSM criteria for bulimia nervosa (BN)* |
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Definition
recurrent episodes of binge eating
recurrent compensatory behavior
*binge eating twice a week/3 months*
self-evaluation unduly influenced by body image/shape
disturbance does NOT occur exclusively during episodes of AN
(NO weight criteria) |
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Term
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Definition
| includes *binge-eating disorder |
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Term
| eating disorder prevalence/distribution |
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Definition
no sex difference for AN
white adolescents - most AN
hispanic adolescents - most BN
BN: F>M
*parental education, household income, parent marital status were not significantly associated with any eating disorder presentation |
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Term
| epidemiological trends in ED |
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Definition
gloabd distribution rate
higest %age (57) of adolescent ED are EDNOS
100+% increase in hospitalizations from ED under age 12 |
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Term
| current ED rate estimates |
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Definition
AN lifetime prevalence - 0.9%F 0.3%M
BN lifetime prevalence - 1.5%F 0.5%M |
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Term
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Definition
higher lifetime prevalence among relatives
MZ>DZ twins
genetic predisposition to behaviorally rigidity, perfectionism, or harm avoidance may be more salient than genetic influences on eating, hunger, or satiety |
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Term
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Definition
*6th -7th grade* median onset
~95% cases of AN before age 25
rare in younger children |
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Term
physical, psychological, social changes with AN/starvation
as shown by the Minnesota Starvation Experiment of 1944 |
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Definition
-increasing irritability and impatience
-decreased cold tolerance
-introversion, less energy and motivation
-increased preoccupation with food
-men: libido loss first symptoms to occur; decline in interest in women
**even after 12-week refeeding phase, most of the abnormal attitudes and behaviors in regard to food persisted |
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Term
| permanent medical complications of AN |
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Definition
growth disturbance
osteoporosis
brain changes/atrophy
(suicide)
*eating disorders affect nearly EVERY ORGAN and may lead to LIFE THREATENING situations* |
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Term
| medical complications of BN |
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Definition
(many)
fluid and electrolyte imbalances
significant strain on GI system |
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Term
|
Definition
-potentially lethal combo or fluid/metabolite shift
-risk related to degree of starvation
mech:
-decreased heart mass, lower CO
-insulin-->glucose load with food introduction causes P and K to move intracellularly
-limits ATP production
-hypophosphatemmia-->diaphragmatic fatigue, respiratory failure
-HF from starvation impaired cardiac status of low ATP |
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Term
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Definition
| 32 times highers than expected in general population |
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Term
| presenting symptoms of AN |
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Definition
| weight loss, amenorrhea, irritalbiltiy, lability, sleep disturbances, fatigue, weakness, dizziness, nonfocal abdominal pain, constipation, feeling of "fullness", polyuira, cold intolerance, detachment |
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Term
|
Definition
| emaciation, lanugo (peach fuzz), hyperactivity or psychomotor retardation, bradycardia, hypotension, dry skin, brittle hair, hair loss on scalp, brittle nails, cyanotic and cold hand/feet, ankle edema |
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Term
| presenting symptoms of BN |
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Definition
| irregular menses, esophageal burning, nonfocal abdominal pain, abdominal bloating, lethargy, fatigue, headache, constipation/diarrhea, swelling of hands/feet, frequent sore throat, depression, *swollen cheeks* |
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Term
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Definition
dental erosions, salivary gland hypertrophy, periodontal disease, petechiae, perioral irritation, *Russell's sign - calluses on the back of the hand*, mouth ulcers, henatemesis, edema, abdominal bloating
often unnoticed because body weight appears normal |
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Term
| AN differential diagnosis |
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Definition
DM
colitis
thyroid disease
Addison's (adrenal insufficiency)
brain tumors |
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Term
| BN differential diagnosis |
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Definition
neurologic disorder (appetite regulation, eating patterns)
GI conditions
hormonal disorders (metabolism) |
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Term
| psychiatric comorbidity with ED |
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Definition
*RULE, not the exception
3/4 have other Axis I/II disorders
affective, anxiety, substance abuse, personality |
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Term
AN prognosis
from meta-analysis of German and English ED studies |
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Definition
20% remain chronically ill
1/3 intermediate outcomes
<1/2 recovered |
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Term
BN prognosis
from meta-analysis of German and English ED studies |
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Definition
23% chronic protracted illness
27% improved
45% full recovery |
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Term
|
Definition
-restore weight and menses
-follow closely for refeeding syndrome in AN
-AN: family therapy
-BN: CBT
-psychotropics generally NOT helpful |
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