eating disorders are a collection of psychiatricconditions that involve abnormal eating habits associated with physical and/or psychologicalproblems. there are many causes of abnormal eating habits,but if the situation is better explained by another medical problem it is not classifiedas an eating disorder. for example, a depressed patient who losestheir appetite has an abnormal level of food
different types of medical diets, intake, but does not have an eating disorder.our discussion will focus on anorexia nervosa and bulimia nervosa which have many similarities.in both cases patients are preoccupied with food, their physical appearance and how muchthey weigh. they may have low self-esteem due to theirdistorted self image.
these disorders are significantly more commonin young females. the treatment for both disorders primarilyfocuses on ssri antidepressants and various types of therapy.there is a significant amount of overlap between the presentation of bulimia and anorexia nervosa.they key distinguishing factor is the patient’s body mass index (bmi), which is very low inanorexia nervosa and normal to mildly elevated in bulimia nervosa.despite popular belief, you cannot use the presence of purging activities alone to distinguishthe 2 disorders. patients with an can use things like laxativesand intentional vomiting just like bulimia. bulimia nervosa periods of overeating (akabinging) followed by compensatory activities
(aka purging)patients feel as if they lose control during periods of binge eating.bmi is within normal ranges or slightly high (>20).although this warning is debated by some, current guidelines suggest not using bupropion(antidepressant) in bulimic patients as they may have an increased risk for seizures asa side effect. binge eating disorder was recently added thedsm so it is unlikely to show up on step 1. it has similar binging behavior to bulimia,but there is no purging and the patients don’t necessarily have body image issues.those that vomit may have alkalosis (due to loss of stomach acid), enlarged parotid glands,losses of enamel on teeth, or esophageal pathology.
those that use laxatives frequently may haveacidosis due to the loss of bicarb. these activities can be present in anorexianervosa too anorexia nervosa = eating very little and/orexcessive exercise as a result of a distorted body image.these patients may feel like they are overweight even if they are very thin.they have low bmis (<17) and significant weight loss.severe cases require hospitalization to correct starvation and the metabolic consequences.when a female’s body fat percentage gets very low the pulsatile release of gnrh fromthe hypothalamus stops and causes amenorrhea which of course is the absence of a menstrualperiod.
it’s like the endocrine system is saying“i can’t have a baby right now. i’m not even getting enough food for just me rightnow.†chronic anorexia nervosa can lead to osteoporosisdue to the low levels of estrogen. can look similar to hypothyroidism with fatigueand changes to skin/hair, but the key difference is hypothyroidism has weight gain.the term anorexia is used often in step 1 to describe weight loss and a lack of appetite,but that is different than anorexia nervosa which is sometimes abbreviated as anorexia.anorexia can be used to explain a symptom of any disease/illness or a side effect ofa treatment. it is not psychological in origin.in fact patients with anorexia nervosa do
not have anorexia, because they usually stillhave an appetite and feel hungry. the presence of an appetite can be used todifferentiate anorexia nervosa from things like depression.
0 komentar