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MNT 6000 - Eating Disorder Guest Lecture Exam
What percent of the US population will experience an eating disorder in their lifetime? 9% (28.8 million)
Less than __________ of people with eating disorders are medically diagnosed as "underweight." 6%
________ make up as many as 25% of people with eating disorders. Men
Individuals in ______________ bodies are at the highest risk of having developed an eating disorder in their lives, and among people in larger bodies, the higher the _______, the higher the risk. larger / BMI
What is anorexia nervosa? an intense fear of weight gain, refusal to maintain a healthy body weight, and distorted body image. (self starvation)
What are some common signs and symptoms of anorexia nervosa? -Calorie restriction
-Obsession with food, weight, calories, dieting, etc.¢Intense fear of weight gain or being fat
-Refusal or avoidance of certain foods or entire food groups¢Denial of hunger or wt loss
-Strange eating habits or food rituals
-Excessive or compulsive exercise ¢Withdrawal from family, friends, activities
-Fatigue, cold intolerance, dizziness, hair loss/thinning
What is Bulimia Nervosa? pattern of binging, sense of lack of control, and compensatory behavior to prevent weight change.
What are some common signs and symptoms of Bulimia Nervosa? -B/P more than once a week x 3 months (purging may be via SIV, laxatives, diet pill, diuretics, exercise, insulin misuse)
-Swelling of jaw or cheeks, discolored teeth, calluses or sores on knuckles (very uncommon)
Evidence of binges: food disappearance, wrappers in trash or hidden Feeling out of control or shame after eating ¢Fear of wt gain, self esteem tied to body image Chaotic relationship with food, presence of food rituals
Leading to malnutrition, weight loss, decline in psychosocial function
OSFED Other Specified Feeding or Eating Disorder
A feeding or eating disorder causing significant distress/impairment but does not meet criteria for another feeding or eating disorder.
What are some examples of Other Specified Feeding or Eating Disorders? -Atypical Anorexia Nervosa (normal wt)
-Bulimia Nervosa (less frequent behaviors or duration)
-Binge Eating Disorder (less frequent)
-Purging Disorder (without binge eating)
-Night Eating Syndrome (excessive nighttime food intake)
____________ is not an official DSM diagnosis. Orthorexia
What is orthorexia? unhealthy obsession with eating healthy
What are some signs and symptoms of orthorexia? -Compulsive checking of ingredient lists and nutritional labels
-Increased concern about the health of ingredients
Elimination of an increasing number of food groups, such as sugar, carbs, dairy, meat, animal products, etc. Inability to eat foods that aren't 'healthy' or 'pure' Exhibiting an excessive amount of stress/anxiety if the 'safe' or 'healthy' foods aren't available Behaviors of Obsessive health food/lifestyle bloggers follow through social media Body image concerns might or might not be present Part B Name at least 5 possible medical complications of eating disorders. Anemia Constipation Dehydration Electrolyte Imbalances Orthostatic hypotension Dizziness Fatigue Hair loss Decreased metabolic rate Lanugo hair Amenorrhea Testicular hormone deficiency (in males) Delayed gastric emptying
Brain chemicals
What are some of the psychological causes of an eating disorder? Low self-esteem, depression, anxiety, anger, loneliness,
Physical, Emotional, Sexual, or Spiritual abuse
Maturation fears (fear of growing up or separating from family)
Perfectionism or quest for perfection
Feelings of inadequacy or lack of control in life
Impulsivity
What are some of the social causes of an eating disorder? Cultural pressures of "thinness" and obtaining the "perfect body"
Narrow definitions of beauty that include only weight and shape
Teasing, body-based shaming, fat-shaming
- Disturbed personal and family relationships Difficulty in expressing feelings and emotions What below are not biological, social, and psychological causes of an eating disorder? —-Age
Emotional Disorders: (Self-esteem, anxiety depression, OCD) —-Dieting: (extreme) — Overweight body size: Overweight individuals show a wider use or abuse of laxatives, diet pills, diuretics, and vomiting. —-Sports and athleticism —Transitions: Sudden and stressful transitions
What is our role as an RD when treating a patient with an eating disorder? -Nutrition Therapist
-Nutrition Educator
-Role Model
-Clinician: Monitor wt patterns, calories, activity
-Establish meal plan or eating pattern
-Provide Accountability to client
-Collaborate with tx team - therapist(s), Doc, Psychiatrist, RN's. etc. In the role of a nutrition therapist, the RD should: -Motivational Interviewing
Chronically malnourished patients
Patients NPO for 3 days or more
When a patient is considered at risk for refeeding syndrome, it is important to collaborate closely with a physician and monitor ____________ daily. Electrolytes
Where would you start with your recommendation of calories for a patient at risk for refeeding syndrome in an inpatient setting? How would you advance calories over time? -1500 kcals/day inpatient
-Add 200-300 kcals every 2-3 days as tolerated.
***When in doubt, go slow
What do you monitor in patients at risk of refeeding syndrome? -tachycardia -BP -Edema
Best nutrition approaches for patients with ED? -All foods can fit -No "good" or "bad" foods -"normal" eating
no
In the no "good" or "bad" food approach, food ________ have moral value. does not
What is a loose definition for "normal" eating? Careful balance between eating for enjoyment and eating for nutritional value
How would you promote "normal" eating? -Healthy balance of carbs, fat, protein -No diet products -End goal of intuitive eating
What are some treatment goals for patients with ED? -Nourish the body w/ proper nutrition and cessation of disordered behaviors
Reach a healthy body weight or stabilization
Reduce fear and anxiety with food
Establish an appropriate exercise plan
Is it advisable to share the calculated calorie needs with your patient with an ED? No
