Eating Disorders

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Introduction

Anorexia nervosa (AN) affects 1% of adolescent and young adult females, with an onset of 13-20 years old. Bulemia nervosa (BN) has a incidence of 2-4% in adolescent and young adult females, with an onset of 16-18.

Females are more affected than males (10:1).

Mortality is 5-10%!!!

The Case of...

a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.

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Causes and Risk Factors

Eating disorders are multifactorial, with psychological, sociological, and biological underpinnings.

Individual: perfectionism, lack of control in some life areas, history of sexual abuse

personality: obsessive-compulsive, histrionic, borderline

familial: maitenance of equilibrium in a dysfunctional family

cultural: prevalent in industrialized societies, where thinness is idolized in the media

genetic

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Pathophysiology

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Signs and Symptoms

history
physical exam

History

Bulemia Nervosa

Recurrent episodes of binge eating:

eating an amount of food definitely larger than most people would eat in a similar amount of time and in similar circumstances
a sense of lack of control over eating during the episode

Recurrent, inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting, laxatives, diuretics, enemas, or other mediciations, fasting, or excessive exercise.

Binge eating and compensation both occur, on average, at least twice a week for 3 months

self-evaluation is unduly influenced by body shape and weight