Eating Disorders: Symptoms, Signs, Causes diagnosis complication and treatment ing disorders are actually serious and often fatal illnesses that cause severe disturbances to a person's eating behaviors. Obsessions with food, body weight, and shape may also signal an eating disorder

1. Eating disorder
Saleh almsened
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2. Definition
severity
Causes
Physical signs and effects of anorexia
nervosa

3. Definition
O Restriction of energy intake sufficient to cause
significantly low body weight
O • In the presence of :
• Intense fear of gaining weight or becoming fat
(or persistent behavior that interferes with weight
gain)
• Disturbance in the perception of his or her
body shape

4. O The discrepancy between weight
and perceived body image is key
to the diagnosis of anorexia
nervosa
• Body mass index BMI is a useful
measure
• BMI =18.5 not considered
significantly underweight.
• Mild: BMI ≥17 kg/m2
O Moderate: BMI 16–16.99 kg/m2
O Severe: BMI 15–15.99 kg/m2
O Extreme: BMI<15 kg/m2

5. Causes
1- Genetics and hormones might have an effect on
the
development of anorexia nervosa.
2- Environment Pressure from society to look thin
may
also contribute to the development of anorexia
nervosa.
3- Psychology Someone with obsessive-compulsive
disorder (OCD) might be more predisposed to
maintaining the strict diet and exercise regimen that
those with anorexia nervosa often maintain

6. Physical signs and effects of
anorexia nervosa

7. Diagnosis
Complications
Management

8. Diagnosis
Patient present body weight is < 85 of expected
with refusal to maintain normal body weight
Fear of weight gain
Body image perceive themselves as fat
BMI
CBC
Endocrine level
ECG
O Perform psychiatric evaluation
O DSM-5 Diagnostic criteria

9. O DSM-5 diagnostic criteria for anorexia
nervosa
A. Restriction of energy intake relative to
requirements, leading to a significantly low body
weight in the context of age, sex, developmental
trajectory, and physical health. Significantly low
weight is defined as a weight that is less than
minimally normal or, for children and adolescents,
less than that minimally expected.
.

10. DSM-5 diagnostic criteria
OB. Intense fear of gaining weight or
of becoming fat or persistent behavior
that interferes with weight gain, even
though at a significantly low weight

11. DSM-5 diagnostic criteria
OC. Disturbance in the way in which one's body weight
or shape is experienced, undue influence of body weight
or shape on self-evaluation, or persistent lack of
recognition of the seriousness of the current low body
weight.

12. DSM-5 diagnostic criteria
subtypes
O Restricting type:
O During last 3 months , weight
loss is accomplished primarily
through dieting, fasting,
and/or excessive exercise
O Purging type
During the last 3 months, the
individual has engaged in
recurrent episodes of binge
eating or purging behavior
(ie, self-induced vomiting or the
misuse of laxatives, diuretics).

13. DSM-5 diagnostic criteria
O In partial remission: After full criteria for anorexia
nervosa were previously met, criterion A (low body weight) has
not been met for a sustained period, but either criterion B
(intense fear of gaining weight or becoming fat or behavior that
interferes with weight gain) or criterion C (disturbances in self-
perception of weight and shape) is still met
O In full remission: After full criteria for anorexia
nervosa were previously met, none of the criteria have been
met for a sustained period of time

14. DDx:
O • Bulimia nervosa
O • Medical e.g : BRAIN TUMOR, GIT DISORDER,CANCER
O • Substance-use disorder
O • Depressive disorders
O • Schizophrenia (delusions about food is poisoned)
O • Somatization BODY DYSMORPHIC DISORDER???????????

15. COMPLICTION
MORTALITY FROM SUICIDE OR
MEDICAL MORE THAN 10%

16. Management
O Psychotherapy: individual, group, family
(Gold standard)
O Medications of little value, 2nd generation
antipsychotics (e.g., olanzapine)? if associated
psychological problem
O Monitor for complications
O Monitor for refeeding syndrome
O Potentially life-threatening metabolic response to refeeding in severely
malnourished patients resulting in severe shifts in fluid and
electrolyte levels - Complications include hypophosphatemia,
congestive heart failure, cardiac arrhythmias, delirium, and death
O Prevention: slow refeeding, gradual increase in nutrition,
supplemental phosphorus, and close monitoring of electrolytes and
cardiac status

18. O USMLE STEP 2 CK
O UpToDate
O Kati Morton YOUTUBE CHANEL