Anorexia Nervosa-
-Anorexia nervosa is a disorder that the patient has an abnormally low body weight, intense fear of gaining weight, and distorted perception of body weight and shape.
-The term anorexia is not correct because the patient maintains their appetite
-Associated features of anorexia nervosa include: relentless pursuit of thinness, fear of certain foods, obsessional preoccupation with food, preference for low calorie foods, overuse of condiments, concerns about eating in public, social withdrawal, exercise related rituals, restlessness or hyperactivity, resistance to treatment and weight gain, feeling of ineffectiveness, poor sleep, dysphoria, low libido, inflexible thinking, need to control their environment, and perfectionism
-Anorexia occurs more in females than males
-Medical complications of anorexia include: emaciation, hypothermia, bradycardia, hypotension, hypoactive bowel sounds, amenorrhea, xerosis, brittle hair, and hair loss
-Common laboratory findings with anorexia include: leukopenia, elevated BUN, hypercholesterolemia, low estrogen levels, low T3, and low testosterone in males, and low bone mineral density
-Common comorbid conditions include with anorexia nervosa include: anxiety disorders, obsessive compulsive disorders, body dysmorphic disorders, post traumatic stress disorder, mood disorders, substance abuse disorders, disruptive impulse control and conduct disorders
-According to the DSM 5 Anorexia Nervosa must have all of the following:
1. Restriction of energy intake that leads to low body weight, given the patients age, sex, developmental trajectory, and physical health
2. Intense fear of gaining weight or becoming fat, or persistent behavior that prevents weight gain, despite being underweight
3. Distorted perception of body weight and shape, undue influence, of weight and shape on self worth or denial of medical seriousness of one's low body weight.
-The treatment of anorexia nervosa involves nutritional rehabilitation and psychotherapy.
-Patients should also be monitor for complications of their anorexia nervosa
-Types of psychotherapy involved include: cognitive behavior therapy, specialist supportive clinical management, motivational interviewing, and family therapy
-Medications are not the indicated for the initial treatment of anorexia. Adjunctive medical therapy is indicated for the acutely ill patients who do not respond to initial treatment with nutritional rehabilitation and psychotherapy
-Bulimia Nervosa-
-Bulimia nervosa is episodes of binge eating which patients use inappropriate compensatory methods to prevent weight gain, including self induced vomiting, misuse of laxatives, diuretics, and enemas. Can also use excessive exercise, fasting and strict diets
-Common physical signs of bulimia nervosa include: tachycardia, hypotension, xerosis, parotid gland swelling, and erosion of dental enamel
-Many medical complication of bulimia nervosa and affects many systems: gastrointestinal, cardiac, endocrine, dental, skin, and renal and electrolytes
-Core features of bulimia nervosa include: binge eating, inappropriate compensatory behavior, excessive concern about body weight and shape
-Patients with bulimia nervosa can have comorbid disorders: anxiety disorders, depression disorders, post traumatic stress disorder, and substance use disorders
-Common personality disorders associated with Bulimia Nervosa include: borderline, avoidant, dependent, paranoid, histrionic, and obsessive compulsive disorder
-DSM 5 Criteria for Bulimia Nervosa includes the each of the following:
1. Episodes of binge eating
2. Inappropriate compensatory behavior to prevent weight gain
3. The patients self evaluation is unduly influenced by the body shape and weight
4. The disturbance does not occur exclusively during episodes of anorexia nervosa
-The treatment of Bulimia Nervosa includes nutritional rehabilitation, psychotherapy, and pharmacology.
-First line medication for Bulimia is the SSRI, Prozac
-Second line medication consider celexa, luvox, or zoloft
-Obesity-
-Obesity is defined by a BMI over 30 kg/m2
-Severe obesity is considered a BMI over 40 kg/m2
-The initial management of individuals who would benefit from weight loss is lifestyle intervention, a combination of diet, exercise, and behavior modification
-Some patients may require pharmacologic therapy or bariatric surgery
-Pharmacologic therapy can include: orilstat, locaserin, combination phentermine or topamax
-For patients with a BMI greater than 30 kg/m2 or a BMI 27-29.9 kg/m2 with comorbidities who have failed to achieve weight loss goals though diet and exercise alone, pharmacologic therapy should be added to lifestyle intervention
-For patients with a BMI greater than 40 kg/m2 who have failed diet and exercise, bariatric surgery is recommended
-The term anorexia is not correct because the patient maintains their appetite
-Associated features of anorexia nervosa include: relentless pursuit of thinness, fear of certain foods, obsessional preoccupation with food, preference for low calorie foods, overuse of condiments, concerns about eating in public, social withdrawal, exercise related rituals, restlessness or hyperactivity, resistance to treatment and weight gain, feeling of ineffectiveness, poor sleep, dysphoria, low libido, inflexible thinking, need to control their environment, and perfectionism
-Anorexia occurs more in females than males
-Medical complications of anorexia include: emaciation, hypothermia, bradycardia, hypotension, hypoactive bowel sounds, amenorrhea, xerosis, brittle hair, and hair loss
-Common laboratory findings with anorexia include: leukopenia, elevated BUN, hypercholesterolemia, low estrogen levels, low T3, and low testosterone in males, and low bone mineral density
-Common comorbid conditions include with anorexia nervosa include: anxiety disorders, obsessive compulsive disorders, body dysmorphic disorders, post traumatic stress disorder, mood disorders, substance abuse disorders, disruptive impulse control and conduct disorders
-According to the DSM 5 Anorexia Nervosa must have all of the following:
1. Restriction of energy intake that leads to low body weight, given the patients age, sex, developmental trajectory, and physical health
2. Intense fear of gaining weight or becoming fat, or persistent behavior that prevents weight gain, despite being underweight
3. Distorted perception of body weight and shape, undue influence, of weight and shape on self worth or denial of medical seriousness of one's low body weight.
-The treatment of anorexia nervosa involves nutritional rehabilitation and psychotherapy.
-Patients should also be monitor for complications of their anorexia nervosa
-Types of psychotherapy involved include: cognitive behavior therapy, specialist supportive clinical management, motivational interviewing, and family therapy
-Medications are not the indicated for the initial treatment of anorexia. Adjunctive medical therapy is indicated for the acutely ill patients who do not respond to initial treatment with nutritional rehabilitation and psychotherapy
-Bulimia Nervosa-
-Bulimia nervosa is episodes of binge eating which patients use inappropriate compensatory methods to prevent weight gain, including self induced vomiting, misuse of laxatives, diuretics, and enemas. Can also use excessive exercise, fasting and strict diets
-Common physical signs of bulimia nervosa include: tachycardia, hypotension, xerosis, parotid gland swelling, and erosion of dental enamel
-Many medical complication of bulimia nervosa and affects many systems: gastrointestinal, cardiac, endocrine, dental, skin, and renal and electrolytes
-Core features of bulimia nervosa include: binge eating, inappropriate compensatory behavior, excessive concern about body weight and shape
-Patients with bulimia nervosa can have comorbid disorders: anxiety disorders, depression disorders, post traumatic stress disorder, and substance use disorders
-Common personality disorders associated with Bulimia Nervosa include: borderline, avoidant, dependent, paranoid, histrionic, and obsessive compulsive disorder
-DSM 5 Criteria for Bulimia Nervosa includes the each of the following:
1. Episodes of binge eating
2. Inappropriate compensatory behavior to prevent weight gain
3. The patients self evaluation is unduly influenced by the body shape and weight
4. The disturbance does not occur exclusively during episodes of anorexia nervosa
-The treatment of Bulimia Nervosa includes nutritional rehabilitation, psychotherapy, and pharmacology.
-First line medication for Bulimia is the SSRI, Prozac
-Second line medication consider celexa, luvox, or zoloft
-Obesity-
-Obesity is defined by a BMI over 30 kg/m2
-Severe obesity is considered a BMI over 40 kg/m2
-The initial management of individuals who would benefit from weight loss is lifestyle intervention, a combination of diet, exercise, and behavior modification
-Some patients may require pharmacologic therapy or bariatric surgery
-Pharmacologic therapy can include: orilstat, locaserin, combination phentermine or topamax
-For patients with a BMI greater than 30 kg/m2 or a BMI 27-29.9 kg/m2 with comorbidities who have failed to achieve weight loss goals though diet and exercise alone, pharmacologic therapy should be added to lifestyle intervention
-For patients with a BMI greater than 40 kg/m2 who have failed diet and exercise, bariatric surgery is recommended
No comments:
Post a Comment