Patients with anorexia or bulimia have a disturbed bodyimage and use extensive methods to avoid gaining weight. Binge eating may occur in all of the eating disorders.
It’s psychiatric illness that describesan eating disorder characterized byextremely low body weight and bodyimage distortion with an obsessivefear of gaining weight. Patients are highly concerned withtheir weight, body image, and beingthin.
Patients are known to control body weight commonly through themeans of voluntary starvation, excessive exercise, or otherweight control measures such as diet pills or diuretics drugs. 2 main subdivisions:A-Restrictive type: eat very little amount and may vigorouslyexercise. More often have obsessive-compulsive traits.B-Binge eating/purging type: eat in binges followed by purging,laxatives use and excessive exercise. Associated with increasedincidence of major depression and substance abuse.
Family history. Psychiatric illness. Obesity. Chronic medical illness. History of sexual abuse. Homosexuals.
10-20 times more common in women than men. In 4% of adolescents and young adults. Onset b/w ages 10 & 30. Increased incidence of comorbid mood disorders.
More common in developedcountries and professionsrequiring thin body. Etiology involvedenvironmental, social,psychological and geneticfactors.
Body weight at least 15% below normal Have intense fear of gaining weight orbecoming fat. Disturbed body image. Amenorrhea.
Major Depression Obsessive compulsive disorder Alcohol or substance abuse
Leukopenia Hypothermia and cold intolerance Lethargy Osteoporosis Patients are often preoccupied with food rituals,intensely fear becoming fat, and judge themselvesby their weight.
Medical conditions Major depression Mental disorders Bulimia.
Variable… Mortality rate…
Early treatment centers on monitoring caloric intake to stabilizeweight and then focuses on weight gain. Treated as outpatients- unless; their weight is more than 20%below ideal body weight, or in severe cases to restore nutritionalstatus and/or correct electrolyte imbalances. Later treatment includes individual, family, and grouppsychotherapy. SSRIs may help treat comorbid depression such as Paroxetine.
An eating disorder which is characterized by recurrent bingeeating, followed by compensatory behaviors. Patients areusually ashamed of their eating behaviors, tend to keep themsecret, and often maintain normal body weight. Has a 3-5% prevalence rate among late adolescent girls. Can be classified into; purging & nonpurging types.
Recurrent episodes of binge eating. Recurrent inappropriate attempts to compensate forovereating and prevent weight gain. These behaviors occur at least twice a week for 3 months. Perception of self-worth is excessively influenced by bodyweight and shape.
Dental enamel erosion Salivary glands hypertrophy Calloused knuckles Menstrual irregularities Electrolyte imbalance (hypochloremic hypokalemic alkalosis) Laxative dependencePatients’ self-esteem is overly dependant on body weight.
Affects 1-3% of adolescents andyoung females. More common in females than males. More common in developedcountries. High incidence of comorbid mooddisorders, impulse control disordersand alcohol abuse/dependence
Better prognosis than anorexia nervosa. Symptoms exacerbated by stressful conditions. One half fully recover with treatment. One half have chronic course with fluctuating symptoms.
Individual psychotherapy, cognitive-behaviortherapy, group therapy. Pharmacotherapy: SSRIs as a first linetreatment then TCAs
An eating disorder characterized byperiods of extreme over-eating, but herethey DO NOT try to control their weight bypurging or restricting calories as doanorexics or bulimics. Patients with this disorder suffer emotionaldistress over their binge eating. So they are obese.
Recurrent episodes of binge eating ( excessive amounts of food in a2 hour period associated with lack of control). Sever distress over binge eating. Bingeing occurs at least 2 days a week for 6 months and NOTassociated with compensatory behaviors.
Three or more of the following:1. Eating very rapidly.2. Eating until uncomfortable full.3. Eating large amounts when not hungry.4. Eating alone.5. Feeling disgusted, depressed, or guilty after overeating.
Dysphoric mood Interpersonal stressors Intense hunger after dietary restrain
People with binge eating disorder may become ill due toa lack of proper nutrition. People with binge eating disorder are usually very upsetby their binge eating and may become very depressed. Obesity has many adverse effects on health Depression, sometimes called post binge anguish, oftenfollows the episode.
Individual psychotherapy and behavioral therapy with strict dietand exercise program. Comorbid mood disorders or anxiety disorders should betreated. Pharmacotherapy: used adjunctively to promote weight loss.Include:-Stimulants: phentramine and amphetamine.-Orlistat (Xenical).-Sibutramine.