Eating Disorders
Presented by:
Nehazia shah
3rd year Medical Student (SHSU)
Psychiatry Rotation
Dr. D. Martinez
Topics Covered
1. Anorexia nervosa
2. Bulimia nervosa
Common psychiatric disorders affecting
eating habits of young adolescents world
Eating Disorders
Eating Disorders
What is anorexia nervosa?
Characterized by failure to maintain a normal or healthy weight.
These individuals have a very bad body image with extreme fear of
gaining weight.
They restrict their food intake by either dieting, starving
themselves or exercising heavily.[1]
“Two Subtypes of Anorexia”
a) Restricting Type
b) Binge Purging Type
Anorexics are very thin. Their body weight is <85% of that
expected [3] and they refuse to maintain normal body weight
Eating Disorders
What is Bulimia nervosa?
Characterized by eating a greater amount of food at once and then
getting rid of that food by self induced vomiting also known as “binging
and purging type” [2] And there are other individuals who will fast or
exercise heavily.
When bulimics binge they feel they have no control over their food
intake [4]
Persons with Bulimia are known to abuse laxative or diuretics
In bulimics their weight is within normal limits or are over weight.
It is common to see fear of weight gain in both anorexic and bulimic
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Bulimia Nervosa
Eating Disorders
Who are at risk?
Individuals at risk for eating disorders specifically anorexia are
females, those with low self esteem and those of high socioeconomic
Bulimia is common in females especially those with low self esteem, in
addition to that, mood disorders and Obsessive compulsive disorders
are usually present.[6]
Eating Disorders
Eating Disorders
Anorexia or bulimia may cause dehydration and other medical
complications like heart problems or kidney failure. In extreme
cases, eating disorders can lead to severe malnutrition and even
Anorexia nervosa can cause [2]
1) low blood pressure 2) amenorrhea, 3) thinning of bones,
4) kidney stones, 5) thyroid problems, 6) hair loss
7) fingernail breakage , 8) lightheadedness,
9) inability to concentrate, 10) dry and yellowish skin,
11) growth of fine hair over body, 12) feeling weak and
13) intolerable to cold.
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look at their selves in the mirror and see an
image distant from reality
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Complications of Bulimia
Constant vomiting and lack of nutrients can cause:[8]
Tooth decay (from exposure to stomach acids)
Enlarged parotid glands (swelling/redness of cheeks)
Scars of the dorsal hand surfaces (from inducing vomiting)
Amenorrhea (missing menses for about 3 cycles)
Fatigue (feeling lethargic and tired)
Electrolyte imbalance (Imbalance in sodium and potassium levels )
Heart problems such as Arrhythmias
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For Anorexics
- monitor caloric intake to restore nutritional status and to
establish weight
- then focus on gaining weight
- hospitalize if necessary to restore nutritional status [2]
- rehydrate and correct electrolyte imbalance
- Behavioral therapy should be initiated [2]
- Family Therapy is also helpful, “it is designed to reduce
conflicts about control by parents” [2]
- antidepressants may play a role, when depression is seen
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For both Bulimia and Anorexia
- Nutritional counseling is needed
Cognitive behavioral therapy (CBT) and Behavioral therapy
- (individual or group psychotherapy)
Antidepressants medications, especially SSRI [2] (Selective Serotonin
Reuptake Inhibitor ex: Celexa, Zoloft, Prozac)
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Eating Disorders
Parents can help prevent kids from developing an
eating disorder by
nurturing their self-esteem, and
encouraging healthy attitudes towards life,
peer pressure, nutrition and appearance
If parents develop their own healthy attitudes about
food and exercise they can set an excellent example
for their kids
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[2] USMLE Step 2 CK Kaplan lecture notes: psychiatry and epidemiology pg. 67-69
[8] Nelson Textbook Of Pediatrics - Eighteenth Edition by Robert M & Behrman,
Richard E & Jenson, Hal B & Stanton, Bonita F Kliegman (2008)
Eating Disorders