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Eating Disorders :hamburger: (Anorexia Nervosa (Bulemia (Normal (Low not…
Eating Disorders :hamburger:
Separating Anorexia Nervosa (AN) from Bulemia Nervosa (BN)
Sweeping generalities, seem like mirror opposites (reality is different , many crossovers)
See them as 2 distinct diseases that do not overlap
:warning: Most people w/ these diseases die from medical complications not related to the disease nor suicide. :skull_and_crossbones:
Why :girl::skin-tone-4:, not :boy::skin-tone-4:?
ratio of eating disorder 10 :female_sign::1 :male_sign:
Eating disorder/body dysmorphia in :boy::skin-tone-2:, probably an issue w/ bodybuilding :muscle::skin-tone-3: or testosterone abuse
Occurs in teens -20's
AN : restriction
BN : purge
Methods that :girl::skin-tone-4: might use
Restriction (AN)
reducing caloric intake
diet/fasting
increasing caloric expenditure
exercise to excess
:pencil2:highest risk for eating disorder is a young teen :girl::skin-tone-4:, who might be a healthy athlete :woman-running::skin-tone-4: :hard to tell, easy to hide
Purge (BN)
ingested nutrients don't get into body
emesis/laxative abuse
emesis = acid burns (teeth erosions, dorsal hand :hand::skin-tone-3: scars, parotid swelling)
emesis = metabolic derangement (K loss, H loss, Mg loss)
low K, low Mg, Metabolic Alkalosis
Laxatives :poop:
Met acidosis
(loss of Bicarb)
chief complaint of diarrhea :poop:
Anorexia Nervosa
Underweight
Woefully decreased
unrealistic image, even when shown mirror
Fear of becoming/being Fat
Anxiety not about weight
no insight, can't see she's hurting self
Restriction
Malnourished
"hypothyroid but thin"
Lanugo
Amenorrhea
Cold intolerance
Emaciated
When anorexia extreme: defined…
BMI <16
<85% ideal body weight
Leukopenia, Electrolyte disorder, bradycardia :<3:, Hypotension
Tx: force feeds
replete fluids/electrolytes
may begin outpatient Rx/therapy
F/u: Antipsychotics (1st line)
CBT
2 more items...
Bulemia
Normal
Low
not the trigger for anxiety
Binge
uncontrolled eating, can't stop eating whats in front of you :hamburger::unamused:
has insight = feels bad
Purge
Can be normal
Might see…
signs of purge
Nope, rarely hospitalize. Not as extreme
Tx: SSRI, SNRI
CBT
1 more item...
Binge eating disorder
Path: Binge w/o purge
likely to be Obese
Body weight
Self Image
Anxiety trigger
Method
S/s
Hospitalize?
Tx
f/u