Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
EATING DISORDERS<br />BULIMIA<br />ANOREXIA NERVOSA<br />
EPIDEMIOLOGY<br />Up to 4% of adolescent & young adults<br />Most common age of onset bet. 14 & 18 yrs<br />0.5% to 1 %  o...
BIOLOGICAL<br />opiods- deny hunger<br />hypercortisolemia<br />Non suppression on DST<br />Thyroid fxn-supressed<br />Ame...
A. REFUSAL TO MAINTAIN BODY WEIGHT AT OR ABOVE A MINIMALLY NORMAL WEIGHT FOR AGE & HEIGHT(e.g. weight loss leading to main...
B. INTENSE FEAR OF GAINING WEIGHT OR BECOMING FAT EVEN THOUGH UNDERWEIGHT<br />C. DISTURBANCE IN THE WAY WHICH ONE’S BODY ...
D. IN POSTMENARCHEAL FEMALES, AMENORRHEA,(ABSENCE OF AT LEAST 3 CONSECUTIVE MENSTRUAL CYCLES)<br />TYPES<br />1. RESTRICTI...
Onset between 10 and 30 years<br />Behavior and psychopathology present for at least 3 months; HALF WILL HAVE BULIMIA WITH...
CLINICAL FEATURESMORTALITY 5 TO 18%<br />RESTRICTING TYPE<br />BINGE EATING/PURGING TYPE<br />OBSESSIVE COMPULSIVE TRAITS<...
VERSUS DEPRESSION<br />NORMAL APPETITE<br />HYPERACTIVITY PLANNED & RITUALISTIC<br />FEAR OF OBESITY<br />VERSUS SCHIZOPHR...
MORE PREVALENT<br />LATER ONSET<br />MAINTAIN NORMAL WEIGHT<br />FEMALES>MALES  10:1  <br />BULIMIA NERVOSA<br />
BIOLOGICAL FACTORS<br />NE & SEROTONIN<br />RAISED ENDORPHINS<br />SOCIAL FACTORS<br />DEPRESSED AND MORE CONFLICTUAL FAMI...
A. RECURRENT EPISODES OF BINGE EATING. AN EPISODE OF BINGE EATING IS CHARACTERIZED BY both of the following:<br />(1) EATI...
B. RECURRENT INAPPROPRIATE COMPENSATORY BEHAVIOR IN ORDER TO PREVENT WEIGHT GAIN<br />C. THE BINGE EATING AND INAPPROPRIAT...
E. THE DISTURBANCE DOES NOT OCCUR EXCLUSIVELY DURING EPISODES OF ANOREXIA NERVOSA<br />TYPE:<br />1. PURGING TYPE: ENGAGED...
MOST HAVE NORMAL WEIGHT<br />SEXUALLY  ACTIVE<br />HIGH RATES OF MOOD AND IMPULSE CONTROL DISORDER  (15%)<br />HIGHER RECO...
B. THE BINGE EATING EPISODES ARE ASSOCIATED WITH 3 OR MORE OF THE FOLLOWING:<br />1. EATING MUCH MORE RAPIDLY THAN NORMAL<...
C. MARKED DISTRESS REGARDING BINGE EATING  IS PRESENT<br />D. THE BINGE EATING OCCURS, ON AVERAGE, AT LEAST 2  DAYS A WEEK...
Upcoming SlideShare
Loading in …5
×

Eating disorders

2,257 views

Published on

  • Be the first to comment

  • Be the first to like this

Eating disorders

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

×