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Eating Disorders - Coggle Diagram
Eating Disorders
Anorexia Nervosa
Definition
Restriction of energy intake, Intense fear of gaining weight, disturbance in the way in whcih one's body weight is exerienced, or persistent lack of recognition on seriousness of current low body weihgt
Specify
Subtype: Restricting type, binge eating/purging type
Clarifiers: Partial remission, Full Remission
Severity: Based on BMI, clinical symptoms, degree disability
Symptoms
Restricting intake, exercising, standing, moving, restlessness, self-induced vomiting, diet pills, social withdrawal
Risk Factors
Female, preterm birth, low self esteem, eagernes ot please, perfectionism, Family Hx of anxiety, internalitization of thin ideal
Comorbidity
Depression, anxiety disorder, perfectionism
Prognosis
High morbility and mortality (suicide and medical complications)
Better prognossi with early onset/treametn, early treatment with onset of illness, and early weight recovery
Bulimia Nervosa
Definition
Recurrent episodes of bing eating
Recurrent inappropriate compensatory behaviours to prevent weight gain (i.e vomiting or excessive exercise)
Self evaluation due to body shape and weight
Severity
Mild: 1-3 episodes of innapropriate compensatory behaviours per week
Moderate: 5-7 episodes of compensatory behaviours
Severe: 8-13 episodes of inappropriate compensatory behaviours per week
Extreme: 14+ more epsiodes
Bulimic Cycle
Restrict -> Binge -> Compensatory behaviour (repeat)
Binge: Almost always result of dieting and food restriction
Purging/Compensatory: Shame caused by loss of control over-eating, fear of weight gain
Risk Factors
Low self esteem, critical commentas, volatime family enviornment, idealization of thinnness
Comorbidity
Depression, anxiety, impulsivity substance abuse, personality disorder, PTSD, bipolar spectrum
Prognosis
Most recover with treament, some have intermediate outcome, and some contnue to do poorly
Treatment
Medical and nutritional
Food is medicine, and reversal of effects of startnation
Multidisciplinary team with physiican dietician/therapist
Anorexia Nervosa
FBT in children/adolescent, and CBT in adults
Olanzapine
Bulimia nervosa
CBT, FBT, DBT in adolescent, and CBT-E in adults
high dose SSRIs
Binge eating disorder
CBT-E in both adolescents and adults
SSRI, Vyvanse
ARFID
FBT/CBT/OT in child/adolescent, CBT in adult
Olanzapine, cyproheptadine, Mirtazapine
Binge Eating Disorder
Definition
Recurrent episodes of binge eating characterized by both
Eating in a discrete period of time that is larger than what most individuals would eat in a similar period of time under similar circumstances
Sense of lack control overeating during the epsiodes
Binge Eating episodes are associated with three or more of the following
Eating much more rapidly than normal
Eating until uncomfortably full
Eating large amounts when not physically hungry
Eating alone due to embarrassment of amoutn of eating
Feelign disgusted with oneself, depressed or guit
Severity
Mild: 1-3 episodes per week
Moderate: 4-6 episodes per week
Severe: 8-13 binge eating episodes per week
Extreme: 14+ episodes per week
Outcomes
Associated with obesity and medical morbidity
Unspecified feeding/eating disorder
Catch all for presentation of symptoms characteristic of feeding and eating disorders, but do not fit into other diagnostic categories
ARFID
Eating disturbance as manfested by persistent failure to met appropriate nutritional or energy needs associated with 1+
Significant weight loss, nutritional deficiency, depends on eneteral feeding, marketed interference
Disturbance is not better explained by lack of available food, or by an associated culturally sanctioned practice, no evidence of a disturbance in way in which one's body weight/shape is expeirences
Disturbance not attributable to a concurrent medical condition or not explained by another mental disorder
Subtypes
Lack of interest in eating food
Avoidance based on sensory characterisitcs of food
Concern about aversive conseuquences of eating
Investigations
BUN (dehydration), amylase (vomiting), cholesterol (starvation) all increase
Na,K, Cl, LH, FSH, estrogen, RBC, WBC, T3 all decrease
Higher Risk Patients
Low weight, bradycardia, longer duration of illness, multile purging, chronic self-harm or attempts, amphetamine,cocaine, or alcohol abuse