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12 eating disorders

12 eating disorders






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    12 eating disorders 12 eating disorders Presentation Transcript

    • Anorexia nervosaBulimia nervosaBinge-Eating disorder
    •  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
    •  Amenorrhea Electrolyte abnormalities Arrhythmias Hypotension Dry skin Hypercholesterolemia Lanugo Melanosis coli
    •  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.
    •  Mood disorders Anxiety disorder Personality disorders Substance abuse
    •  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.
    • Thank you