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46 Cards in this Set
- Front
- Back
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Eating disorders |
persistent disturbance of eating or eating-related behavior that results in significantly impaired physical health and psychosocial functioning. |
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EDNOS |
eating disorder not otherwise specified |
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BED |
binge-eating disorder |
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AN |
Anorexia Nervosa |
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Characteristics of AN |
-refusal to maintain a minimally normal bdwt -bd image distortion -amenorrhea in postmenarchal females. |
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two subtypes of AN |
-restristing -binge eating and purging |
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Prevalence of AN |
-lifetime prevalence 1% of W, 0.5% in M -Initial presentation is usually during adolescence or young adulthood -Temperament, environmental, genetic, and psychosocial factors -Crude mortality rate is approximately 5% per decade. |
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Psychological features of AN |
-perfectionism and compulsivity -feelings of ineffectiveness -inflexible thinking -overly restrained emotional expression -limited social spontaneity -coexists with major depression, dysthymia, anxiety disorders, OCD, personality disorders, and substance abuse. |
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BN |
Bulimia Nervosa |
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BN characteristic |
repeated episodes of binge eating followed by inappropriate compensatory behaviors to prevent wt gain -self induced vomiting, laxatives misuse, diuretic misuse, compulsive exercise or fasting -binge |
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BN Prevalence |
-Lifetime prevalence 2% in W and 0.5% M -initial presentation is usually during adolescence or young adulthood -diagnostic crossover from BN to AN occurs in 10-15% of cases -Temperament, environmental, genetic and psychosocial factors -crude mortality rate is approx. 2%/decade |
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BED characteristics |
-binge-eating episodes at least 2 x week for 6 m. -no inappropriate compensatory behaviors after a binge -occurs in late adolescence -emotional distress and feeling powerless |
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Prevalence of BED |
-3.5% W 2% M -more prevalent among individuals seeking wt loss treatment than in the general pop -crossover from BED to other eating disorder is uncommon -appears to run in families |
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EDNOS Characteristics |
-a diagnostic category for eating disorders that meet most but not all criteria for either AN or BN |
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EDNOS Atypical BN and BED |
episodes are less frequent or of limited duration |
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EDNOS Atypical AN |
restrictive eating in the presence of normal wt |
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Purging disorder |
recurrent purging in the absence of binge eating |
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EDNOS: Night_______ |
eating syndrome |
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Orthorexia |
-Fixation of food to be perfect and clean -Disrupts everyday life, social life, and creates disordered behaviors -No clinical diagnosis |
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Other eating disorders |
Anorexia athletica Muscle Dysmorphia |
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AN Medical comp |
-cachectic and prepubescent body habits -Lanugo: dry, brittle hair -hypercarotenemia -cold intolerance -PEM and cardiovascular comp -GI complications -Osteopenia -effects on growth and development |
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BN medical comp |
-usually normal et and secretive behavior -signs of self-induced vomiting: Russells sign -results in chronic vomiting can include esophagus and stomach damage -effects of laxative and diuretic abuse include electrolyte imbalance and cardiac arrhythmia |
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BED medical comp |
-excessive eating -functional impairment -decreased quality of life -upper and lower GI distress -MetS |
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Treatment approach |
multidisciplinary: psychiatric or psychological, medical nutritional |
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Treatment includes |
inpatient hosp., residential treatment, day hosp., intensive outpatient treatment and outpatient treatment. |
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Goals of psychologic mang. |
-help patients understand and cooperate with nutritional and physical rehab. -help patients understand and change behaviors and dysfunctional attitudes -improve interpersonal and social functioning -address psychopathology and psychological conflicts |
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Psychologic Mang. |
Goals Behavioral reinforcers Psychotherapy, cognitive behavior therapy, family/maternal therapy |
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Psy. mang. treatment usually ______________ |
1 yr or more |
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_______,__________, and ________ must also be treated along with the ED |
depression, separation anxiety, and generalized anxiety |
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Compared to AN, BN patients are: |
generally more open to intervention |
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Nutritional Assessment |
Diet History Eating behavior |
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Diet History with ED |
-over and under reporting -calories retained form binges -specific dietary practices and chaotic eating -nutritional adequacy |
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Eating behavior with ED |
-food aversions -unusual or ritualistic behaviors -trigger foods |
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Biochemical assessment |
-vitamin and mineral deficiencies -fluid and electrolyte balance -energy expenditure -anthropometric assessment |
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MNT counseling goals for AN |
-correct biological and psychological signs of malnutrition -restpre bdwt -normalize eating patterns -normalize hunger and satiety cues |
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MNT counseling strategies for AN |
-Hospitalizewhen patient is medically unstable, severely malnourished, or growth retarded -RD’soutpatient counseling skills are important -Mostpatients are pre contemplative - Reasonable weight gain goals:2 to 3 lbs/week for inpatient; 0.5 to 1 lb/wk outpatient |
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initial caloric prescription for AN |
30-40 kcal/kg/day |
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Progressive increase in caloric prescription |
+100-200 kcal every 2-3 days |
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care to avoid ________ |
refeeding syndrome |
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May need ____ to _____ kcal/day to achieve goal wt |
3000-4000 |
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in wt maintenance phase: |
40-60 kcal/kg/day |
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intake of ________ and ________ Use of ________ and__________ ________ variety |
macro and micro
snacks and supps diet |
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MNT goals of BED |
-self acceptance -improved bd image -increased PA -better overall nutrition |
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MNT Counseling BN strategies |
-reasonable plan of control eating -outpatient counseling -interrupt bing-and-purge cycle, restore normal eating behavior, and stabilize bd wt. -restoration of hunger and satiety cues -cognitive-behavior therapy -individual and group psychotherapy -medication |
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Patient Monitoring |
-bd wt -ht -BMI -out patient diet monitoring |
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approx ____ of BN achieve remission |
70% |
