Eating Disorders GP Training (MS Powerpoint)

How to recognise an eating
Eating Disorders
“Eating disorders are complex illnesses,
rooted in psychological and emotional
distress, where people use food and
eating as a means of coping with
seemingly insurmountable problems. They
offer a mechanism for control in a life that
seems out of control.”
Eating Disorders Association (now b-eat)
17.5 - 20
15 – 17.5
13.5 - 15
12 – 13.5
< 12
Irregular or absent ovulation
Osteoporosis risk increased
Anorexia nervosa. Amenorrhoea, loss
of substance of all organs and
Osteoporosis high risk
Severe Anorexia nervosa.
Compromised bone, heart and brain.
Metabolism reduced 50%
Organs begin failing muscle, heart,
bone marrow. Life threatening
Sudden Death
Effects of excessive weight loss or
food restriction
• Decreased heart rate
• Digestive system slows down – gastro intestinal
Decreased tolerance for cold temperature –
extremities become purple/blue
To conserve heat, fine hair may grow on the
Decrease in body tempera
Decrease in metabolic rate
Reduced strength
Dizziness, headaches
Decreased need for sleep
Skin and hair become dry/hair falls out
Females may notice that periods become irregular
Hormone imbalance and poor diet can lead to
Hurts to sit down
Long-term muscle loss can damage the heart, kidney
and other organs
Collapse and even death
Psychological effects
• Food becomes the principle topic of conversation
• Pre occupation with reading cook books and
collecting recipes
There may be signs of hoarding
Much of day spent planning allotted food
Unusual concoctions
Increased use of salt and spices
Often increased consumption of tea and coffee
• Emotionally there may be periods of depression and low
Anxiety high with outbursts of anger and irritability
Socially withdrawn
Loss of sexual interest
Feeling of social inadequacy
Humour seems to disappear
Concentration becomes increasingly difficult
Decision making almost impossible
Forgetfulness common
SCOFF questionnaire
Do you ever make yourself sick
because you feel uncomfortably full?
Do you worry you have lost control
over how much you eat?
Have you recently lost more than one
stone in a three month period?
Do you believe yourself to be fat
when others say you are too thin?
Would you say that food dominates
your life?
What to do?
• Complete referral to CMHT
• If monitoring risk, use King’s College
Case study 1
Patient presents feeling cold all the time,
lack of motivation, tired, eating very
little, feeling sick
Recent weight - 41kg
Height – 1.54m
What next?
Case Study 2
Patient presented with restricted food
intake, vomiting, regular alcohol intake
and exercising every day but looks normal
What next?
Case Study 3
Patient presents with weight loss, anxiety,
insomnia, increased alcohol intake,
exercising every day, chest pains –
recently moved to the area after brief
recent admission to psychiatric unit for
suicidal ideation.
Weight 43kg, Height - 1.75m, BMI 14
What next?