Eating Disorders

Eating Disorders Topics Covered • Anorexia nervosa • Bulimia nervosa Common psychiatric disorders affecting eating habits of young adolescents world wide Presented by: Nehazia shah 3rd year Medical Student (SHSU) Psychiatry Rotation Dr. D. Martinez Eating Disorders Eating Disorders 1

http://www.smh.com.au/national/fathers-anger-at-anorexia-death-20090214-87n7.htmlhttp://www.smh.com.au/national/fathers-anger-at-anorexia-death-20090214-87n7.html http://treatingeatingdisorders.info/ http://drlindamintle.com/wp-content/uploads/2010/06/size0Model_228x360.jpg http://briancuban.com/wp-content/uploads/2008/05/eatingdisorders.jpg Eating Disorders http://www.health-res.com/EX/08-04-20/1823049.c17b9a51.560.jpg http://www.selfhelptopics.net/bulimia-eating-disorder-2/

What is anorexia nervosa? • These individuals have a very bad body image with extreme fear of gaining weight. • They restrict their food intake by either dieting, starving themselves or exercising heavily.[1] “Two Subtypes of Anorexia” [2] • Restricting Type • Binge Purging Type • Anorexics are very thin. Their body weight is <85% of that expected [3] and they refuse to maintain normal body weight Characterized by failure to maintain a normal or healthy weight. Eating Disorders

What is Bulimia nervosa? • Characterized by eating a greater amount of food at once and then getting rid of that food by self induced vomiting also known as “binging and purging type” [2] And there are other individuals who will fast or exercise heavily. • When bulimics binge they feel they have no control over their food intake [4] • Persons with Bulimia are known to abuse laxative or diuretics • In bulimics their weight is within normal limits or are over weight. • It is common to see fear of weight gain in both anorexic and bulimic patients.[4] Eating Disorders

Bulimia Nervosa (Examples) http://www.targetwoman.com/articles/binge-eating-disorder.html http://eatingdisorder-clinics.yolasite.com/ Eating Disorders

Who are at risk? Individuals at risk for eating disorders specifically anorexia are females, those with low self esteem and those of high socioeconomic status.[5] Bulimia is common in females especially those with low self esteem, in addition to that, mood disorders and Obsessive compulsive disorders are usually present.[6] Eating Disorders

Anorexia (Examples) http://3.bp.blogspot.com/_RaOrchOImw8/TTpCgqjj1MI/AAAAAAAAp-s/-TLQPuegnlc/s1600/anorexia+nervosa2.jpg http://1.bp.blogspot.com/_RaOrchOImw8/TTpAwh-bJzI/AAAAAAAAp-k/FSrG2JqT6s4/s1600/Anorexia+nervosa.jpg Eating Disorders

Effects/complications Anorexia or bulimia may cause dehydration and other medical complications like heart problems or kidney failure. In extreme cases, eating disorders can lead to severe malnutrition and even death.[7] Anorexia nervosa can cause [2] 1) low blood pressure 2) amenorrhea, 3) thinning of bones, 4) kidney stones, 5) thyroid problems, 6) hair loss 7) fingernail breakage , 8) lightheadedness, 9) inability to concentrate, 10) dry and yellowish skin, 11) growth of fine hair over body, 12) feeling weak and 13) intolerable to cold. Eating Disorders

Anorexics look at their selves in the mirror and see an image distant from reality http://www.weightlossexercisediet.com/images/eating-disorders.jpg http://eatingdisorder-clinics.yolasite.com/ Eating Disorders

Complications of Bulimia Constant vomiting and lack of nutrients can cause:[8] • Tooth decay (from exposure to stomach acids) • Enlarged parotid glands (swelling/redness of cheeks) • Scars of the dorsal hand surfaces (from inducing vomiting) • Amenorrhea (missing menses for about 3 cycles) • Fatigue (feeling lethargic and tired) • Electrolyte imbalance (Imbalance in sodium and potassium levels ) • Heart problems such as Arrhythmias Eating Disorders

Treatment For Anorexics - monitor caloric intake to restore nutritional status and to establish weight - then focus on gaining weight - hospitalize if necessary to restore nutritional status [2] - rehydrate and correct electrolyte imbalance - Behavioral therapy should be initiated [2] - Family Therapy is also helpful, “it is designed to reduce conflicts about control by parents” [2] - antidepressants may play a role, when depression is seen Eating Disorders Eating Disorders 11

For both Bulimia and Anorexia - Nutritional counseling is needed Cognitive behavioral therapy (CBT) and Behavioral therapy - (individual or group psychotherapy) Antidepressants medications, especially SSRI [2](Selective Serotonin Reuptake Inhibitor ex: Celexa, Zoloft, Prozac) Eating Disorders Eating Disorders 12

Anorexia http://betyudidntknow.blogspot.com/2011/01/did-you-know-what-anorexia-nervosa.html http://blog.timesunion.com/highschool/files/2010/03/eating-disorder1.jpg Eating Disorders

Prevention Parents can help prevent kids from developing an eating disorder by nurturing their self-esteem, and encouraging healthy attitudes towards life, peer pressure, nutrition and appearance [9] If parents develop their own healthy attitudes about food and exercise they can set an excellent example for their kids [7] Eating Disorders

References: [1] http://www.womenshealthcaretopics.com/TeenEatingDisorders.html [2] USMLE Step 2 CK Kaplan lecture notes: psychiatry and epidemiology pg. 67-69 [3] http://en.wikipedia.org/wiki/Eating_disorder [4] http://kidshealth.org/teen/food_fitness/problems/eat_disorder.html [5] http://www.eatingdisorders.org.au/media/key-statistics.html [6] http://www.aafp.org/afp/2003/0115/p297.html [7] http://kidshealth.org/parent/emotions/feelings/eating_disorders.html [8] Nelson Textbook Of Pediatrics - Eighteenth Edition by Robert M & Behrman, Richard E & Jenson, Hal B & Stanton, Bonita F Kliegman (2008) [9] http://www.apa.org/pubs/info/brochures/girls.aspx Eating Disorders

Eating Disorders