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Eating disorders (Personal Hx (Living arrangements/ environment,…

- - - - Solid foundation for eating pattern
      - 3 meals and 3 snacks
    - - Adequate nutrition
        
        Medical stability
        
        Wt restoration
        
        Nutritional rehab
      - Quality: food groups
      - Quantity: energy intake
    - - Step outside of safe food list
      - Challenge eating behaviours
      - Eat across the food groups
    - - Eating with others
      - Challenge social isolation and eating fears
      - Social re-engagement with friends and family
    - - Flexibility in thinking
- - - - Persistent energy restriction
      - Intense fear of gaining wt
      - Disturbance in self perceived wt or shape
    - - Repeated episodes of binge eating
      - Compensatory behaviours
        
        Self-induced vomiting
        
        Excessive exercise
        
        Laxatives
      - Excessive emphasis on body shape or wt
    - - Repeated episodes of binge eating
      - Pts are often overwt/ obese
    - - Pts may present with AN, BN, or BED symptoms
      - Do not meet full diagnostic criteria
      - Pts may present with a combination of:
        
        Distorted body image
        
        Extremely disturbed eating habits
        
        Overevaluation of shape and wt
        
        An intense fear of gaining wt
  - - - Re-feeding syndrome
        
        High-risk of developing re-feeding if...
        
        BMI <16kg/m2
        
        Unintentional wt loss >15% within the last 3-6 months
        
        Little or no nutritional intake for more than 10 days
        
        Low levels of potassium, phosphate or magnesium prior to feeding
        
        Supplement with thiamine and MVI
    - - Medical stabilisation
      - Prevention (and treatment) of re-feeding syndrome
      - Weight restoration
      - Reversal of cognitive starvation
    - - Malnutrition
      - Thiamine deficiency
        
        Symptoms:
        
        Muscle weakness
        
        Muscle wasting
        
        Cardiomegaly
        
        Oedema
        
        Tachycardia
      - Cessation of menstrual cycle
      - Oseteoporosis
      - Hair loss or excessive hair gross
      - Irregular HR
      - Kidney and liver damage
      - Low BGLs
      - Infertility
      - Anaemia
    - - Psychiatrists
      - Drs
      - Nurses
      - Dietitians
  - - - Medical ward
      - Mental health ward
    - - HR <40 or >100
      - BP <90/60 or >10mm postural drop with standing
      - Electrolyte disturbance
      - Failure of outpatient treatment
      - BMI <14kg/m2 (admit to medical ward if BMI is <12kg/m2)
      - Suicidality
      - Rapid wt loss