Session: 10 Eating disorders
Hypothalamus signals hunger and satiation
- Regulation of the person’s appetite
Anorexia nervosa – usually in females ages in 12-30 y.o. And the prevalence is about 1%
- Restrict eating
- Medical complications
- Cardiac arrhythmias, seizures, poor enamel, amenorrhea, constipation,
Bulimia nervosa – more chronic than anorexia. Prevalence ½% in males and three times that in females.
- Cannot control eating or how much you eat.
- Purging, laxatives, enemas, or diuretics
- Purging weekly for at least three months
- Generally normal weight to slightly over weight
- Medical complications: bradycardia, electrolyte imbalances, russell’s sign which is calloused knuckles on the hands, stomach pain, dehydration, and poor dentition.
Binge eating disorder – similar to bulimia but do not purge
- Extreme overeating from feelings of worthless self.
- Genetic component is not proven but is hypothesised
- Serotonin release occurs with eating almost any food. People with anorexia will feel anxious instead when feeling full.
- May start development at a very early age and delay the development of the ego.
- Cognitive-behavioral theory – learned behaviour based on the positive reinforcement for loss of weight.
Obesity – over 30 BMI
- Increases mortality
- Overweight americans are about 65% of the population
- Not classified as an eating disorder
- Contraindicated meds
- Bupropion (wellbutrin) – lowers seizure threshold which increases risk when the patient is already at a high risk.
- Caution psychostimulants
- Meds to use: there are no medications specific for an eating disorder
- Use medications that target anxiety and depression ie. SSRI’s,
- Medication for people with binge eating disorder: reduction of appetite
- Topiramate (topamax)
- Fluoxetine (Prozac)
- Phentermine or topiramate (Osymia) – may have paresthesias, tingling in the periphery.