Eating disorders
Upcoming SlideShare
Loading in...5
×
 

Eating disorders

on

  • 2,156 views

 

Statistics

Views

Total Views
2,156
Slideshare-icon Views on SlideShare
2,144
Embed Views
12

Actions

Likes
0
Downloads
0
Comments
0

1 Embed 12

http://study.myllps.com 12

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Eating disorders Eating disorders Presentation Transcript

    • EATING DISORDERS
      BULIMIA
      ANOREXIA NERVOSA
    • EPIDEMIOLOGY
      Up to 4% of adolescent & young adults
      Most common age of onset bet. 14 & 18 yrs
      0.5% to 1 % of adolescent girls
      20X more common in females
      Professions requiring thinness
      COMORBIDITY
      Depression 65%;social phobia 34% OCD 26%
      ANOREXIA NERVOSA
    • BIOLOGICAL
      opiods- deny hunger
      hypercortisolemia
      Non suppression on DST
      Thyroid fxn-supressed
      Amenorrhea- low LH, FSH, GRH
      Enlarged ventricles
      Higher caudate metabolism
      Dysfunction in DA, S, NE
      Delayed release of insulin
      SOCIAL
      Close but troubled relationship with parents
      High levels of chaos, hostility, isolation
      Low levels of nurturance and empathy
      ANOREXIA NERVOSA ETIOLOGY
    • A. REFUSAL TO MAINTAIN BODY WEIGHT AT OR ABOVE A MINIMALLY NORMAL WEIGHT FOR AGE & HEIGHT(e.g. weight loss leading to maintenance of body weight less than 85% of that expected; failure to make expected weight gain during period of growth, leading to body weight less than 85% that expected).
      DSM CRITERIA FOR ANOREXIA NERVOSA
    • B. INTENSE FEAR OF GAINING WEIGHT OR BECOMING FAT EVEN THOUGH UNDERWEIGHT
      C. DISTURBANCE IN THE WAY WHICH ONE’S BODY WEIGHT OR SHAPE IS EXPERIENCED, UNDUE INFLUENCE OF BODY WEIGHT OR SHAPE ON SELF- EVALUATION,OR DENIAL OF THE SERIOUSNESS OF THE CURRENT LOW BODY WEIGHT
      DSM CRITERIA FOR ANOREXIA NERVOSA
    • D. IN POSTMENARCHEAL FEMALES, AMENORRHEA,(ABSENCE OF AT LEAST 3 CONSECUTIVE MENSTRUAL CYCLES)
      TYPES
      1. RESTRICTING- DURING THE CURRENT EPISODE OF ANOREXIA NERVOSA, THE PERSON HAS NOT REGULARLY ENGAGED IN BINGE EATING OR PURGING BEHAVIOR
      2. BINGE EATING/PURGING TYPE- SELF- INDUCED VOMITING OR THE MISUSE OF LAXATIVES, DIURETICS, OR ENEMAS)
      DSM CRITERIA FOR ANOREXIA NERVOSA
    • Onset between 10 and 30 years
      Behavior and psychopathology present for at least 3 months; HALF WILL HAVE BULIMIA WITHIN ONE YEAR
      Peculiar behavior about food
      Comorbidity with obsessive compulsive behavior, depression and anxiety
      Delayed psychosocial sexual development
      PE- hypothermia, dependent edema, hypotension, lanugo hair
      Laboratory- hypokalemia, ECG changes
      CLINICAL FEATURES
    • CLINICAL FEATURESMORTALITY 5 TO 18%
      RESTRICTING TYPE
      BINGE EATING/PURGING TYPE
      OBSESSIVE COMPULSIVE TRAITS
      LOWER SUICIDE
      LOWER RECOVERY
      SUBSTANCE ABUSE,IMPULSE CONTROL &PERSONALITY DISORDER
      HIGHER SUICIDE
      HIGHER RECOVERY
    • VERSUS DEPRESSION
      NORMAL APPETITE
      HYPERACTIVITY PLANNED & RITUALISTIC
      FEAR OF OBESITY
      VERSUS SCHIZOPHRENIA
      INVOLVE CALORIC INTAKE
      HYPERACTIVE
      DIFFERENTIAL DIAGNOSIS
    • MORE PREVALENT
      LATER ONSET
      MAINTAIN NORMAL WEIGHT
      FEMALES>MALES 10:1
      BULIMIA NERVOSA
    • BIOLOGICAL FACTORS
      NE & SEROTONIN
      RAISED ENDORPHINS
      SOCIAL FACTORS
      DEPRESSED AND MORE CONFLICTUAL FAMILIES
      Describe parents as NEGLECTFUL & REJECTING
      PSYCHOLOGICAL FACTORS
      MORE ANGRY, OUTGOING AND IMPULSIVE
      EGO DYSTONIC
      LACK OF TRANSITIONAL
      OBJECT , struggle with separation
      Ambivalent attitude
      BULIMIA-ETIOLOGY
    • A. RECURRENT EPISODES OF BINGE EATING. AN EPISODE OF BINGE EATING IS CHARACTERIZED BY both of the following:
      (1) EATING, IN A DISCRETE PERIOD OF TIME(WITHIN ANY 2 HOUR PERIOD) , AN AMOUNT OF FOOD THAT IS DEFINITELY LARGER THAN MOST PEOPLE WOULD EAT DURING A SIMILAR PERIOD OF TIME AND CIRCUMSTANCES
      (2) A SENSE OF LACK OF CONTROL OVER EATING DURING THE EPISODE
      DSM CRITERIA FOR BINGE EATING DISORDER AND BULIMIA
    • B. RECURRENT INAPPROPRIATE COMPENSATORY BEHAVIOR IN ORDER TO PREVENT WEIGHT GAIN
      C. THE BINGE EATING AND INAPPROPRIATE COMPENSATORY BEHAVIOR BOTH OCCUR ON AVERAGE,AT LEAST TWICE A WEEK FOR 3 MONTHS
      D. SELF EVALUATION IS UNDULY INFLUENCED BY BODY SHAPE AND WEIGHT
      DSM CRITERIA FOR BULIMIA
    • E. THE DISTURBANCE DOES NOT OCCUR EXCLUSIVELY DURING EPISODES OF ANOREXIA NERVOSA
      TYPE:
      1. PURGING TYPE: ENGAGED IN SELF INDUCED VOMITING OR THE MISUSE OF LAXATIVES, DIURETICS, OR ENEMAS
      2. NON PURGING TYPE- EXCESSIVE EXERCISE OR FASTING
      DSM CRITERIA FOR BULIMIA
    • MOST HAVE NORMAL WEIGHT
      SEXUALLY ACTIVE
      HIGH RATES OF MOOD AND IMPULSE CONTROL DISORDER (15%)
      HIGHER RECOVERY THAN ANOREXIA NERVOSA
      CLINICAL FEATURES
    • B. THE BINGE EATING EPISODES ARE ASSOCIATED WITH 3 OR MORE OF THE FOLLOWING:
      1. EATING MUCH MORE RAPIDLY THAN NORMAL
      2. EATING UNTIL UNCOMFORTABLY FULL
      3. EATING LARGE AMOUNTS OF FOOD WHEN NOT PHYSICALLY HUNGRY
      4. EATING ALONE BECAUSE OF BEING EMBARRASSED BY HOW MUCH ONE IS EATING
      5. FEELING DISGUSTED WITH ONESELF, DEPRESSED, OR VERY GUILTY AFTER OVEREATING
      DSM CRITERIA FOR BINGE EATING DISORDER
    • C. MARKED DISTRESS REGARDING BINGE EATING IS PRESENT
      D. THE BINGE EATING OCCURS, ON AVERAGE, AT LEAST 2 DAYS A WEEK FOR 6 MONTHS
      E. THE BINGE EATING IS NOT ASSOCIATED WITH THE REGULAR USE OF INAPPROPRIATE COMPENSATORY BEHAVIORS, AND DOES NOT OCCUR EXCLUSIVELY DURING THE COURSE OF ANOREXIA NERVOSA OR BULIMIA NERVOSA
      CRITERIA FOR BINGE EATING DISORDER