Tbilisi State Medical University - USMD program - BAD

2. Patient case

3. “I was invisible…”
“My goal is to get into the
best university!”
“When I set my mind to do something, I do everything
in my power to achieve it!”

4. “I successfully entered the college of
my dream!”
 Extra layer of the eyes
 Raised bridge of the nose
 V-shaped face

5. Social convention: you have to
be skinny to be beautiful!
“I lost my self-confidence
and self-esteem…”
“so, I had to be skinny!”

6. “I kept myself inspired by
constantly looking at all
the beautiful and fit girls
on Instagram”

7. “it wasn’t
enough!”
“If I am not careful, I might go
back to being invisible”

8. Period stopped
Hair loss
Being cold
Skin peeling heavily
Struggle to concentrate

9. Refusal to maintain the
ideal body weight
(<85% of normal)
Extreme fear of gaining
weight
Distorted self-
perception
Loss of period

11. Severity
Evaluated by BMI

12. Fearful of weight
gain
• Restrictive behaviors
• Purging
• Exercises
• Weight check
Food rituals
• Cutting food into small
pieces
• Eating different food in
specific order Refuse to eat
in front of
people
• Cook for others
and don’t eat

13. Physical changes in
muscle
Skeletal muscle
loss
Cardiac muscle
loss
o Low creatinine
o Fatigue (weak
muscles)
o Weak diaphragm =
difficulty breathing
o Bradycardia (<60 bmp)
o Hypotension (<90/150)
o Orthostatic hypotension (dropping of
blood pressure upon standing)
o Congestive heart failure
o Swelling in the legs

14. Electrolyte
abnormalities
Vitamin
deficiencies
Amenorrhea
 Low potassium (k+)
 Low magnesium
(mg+2)
 Low phosphate
(po4 -3)
• Thiamine –
vitamin B1
• Normal menstruation
stops
• Doesn’t start until the
age of 15

15. Gastrointestinal tract
• Bloating
• Nausea
• constipation
Bone marrow
shutting down
• Less WBC – damped
immune response
• Less RBC – low
energy levels
• Less platelets – easy
bleeding
• Osteoporosis
• Dry skin and hair
• hair loss
Brain atrophy and
encephalopathy
• ataxia
• Confusion
• death

16.  Genetic Abnormalities in converting signals that convey hunger and fullness
 Hormones – serotonin and dopamine
 Social and environmental factors
Peer groups or popular culture
 Low self-esteem
 Loneliness
 Sensitivity to peer pressure
 Feeling of need of approval
 Overreaction to stressful situations
 Perfectionist character
• Mostly starts at teen age
• Higher risk in media
consumers
• Higher risk in females
• Statistics are rising for
men

17. Treatment
 Psychotherapy - This is a type of individual counseling that focuses on changing the
thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating
disorder.
 Medications - Certain antidepressant medications called selective serotonin reuptake.
 Nutrition counseling - This strategy is designed to teach a healthy approach to food and
weight.
 Group/family therapy - openly discuss their feelings and concerns with others who
share common experiences and problems.
 Hospitalization - Intravenous (in the vein) fluids, nasogastric tube feedings or total
parenteral nutrition (TPN) might be needed in cases of severe malnutrition.

18. Realize how little value of other peoples opinions have
Get love from your friend and family
Love yourself
I am me and I am beautiful in my own way