Mental Health Exam 3
Unit
Chapter 18: Eating Disorders? – someone with Anorexia can become Bulimic (common)
• Anorexia Nervosa (very difficult to treat, EGOSYNTONIC)
o Epidemiology: predominantly in girls/women ages 12-30
o Comorbidity:
§ Hypercarotenemia, electrolyte imbalance
o Risk Factors: genetics (learned behavior), neurotransmitter: Serotonin missing
(needs tryptophan to be created- through food)
o Assessment: eating habits, assess for suicide, perception of the problem,
overexercise
§ Fear of gaining weight
§ Starvation- no periods (amenorrhea), hypothermia, bradycardia,
hypotension, edema, lanugo, anxiety, depression
o Restricting Type
§ No binge eating or purging (last 3 months)
o Binge Eating/Purging Type
§ Binge eating and purging (last 3 months)
o Treatment: pharmacotherapy, yoga, etc., insight-oriented, AFT, CBT, FBT
• Bulimia Nervosa (Pg. 335) – more prevalent than anorexia- 4 percent of young women
o Symptoms: Compulsive eating, self-induced vomiting (purging within an hour)
§ Rapid ingestion of large quantities of food, vomiting, laxative overuse,
diuretics, enemas, fasting, and excessive exercise
§ Normal weight range, slightly underweight, slightly overweight
• (not obvious external signs)
• Esophageal rupture, dental caries, MI (massive) at young age
(electrolyte depletion)
o Comorbidities: Depression, anxiety, substance abuse
§ Dehydration and electrolyte imbalances
o Rustles Sign: excoriation of knuckles- due to fingers in the throat- scratching from
teeth
o Outcomes: low electrolytes (sodium, magnesium)
o Assess: (pg 341) teeth- molars, throat (esophageal ruptures)
o Treatment
§ Prozac, other antidepressants
• CANNOT BE GIVEN BUPROPION (WELLBUTRIN pg 342)-
increased risk of developing seizures
, § CBT, DBT, IPT, ACT
• Binge Eating (BED) D/O (Box 18.1) – My 600 Pound Life
o No exercise, just eat a lot
o BMI 30 or greater
§ 68.5 % of adult Americans are overweight, 35 % obese
o Distress over binge eating 1x/week for 3 months
o Comorbidity:
§ specific phobia, social phobia, PTSD, alcohol abuse/dependence
o Risk factors:
§ genetics, neurobiological, cognitive factors, and environmental factors
o Assessment
§ Perception, weight cycling, skin integrity, edema, nutritional pattern,
psychosocial history, vital signs, hygiene, respiratory issues
§ Outcomes and Diagnosis, planning, and implementation
o AVOID judgmental language- binge eating is not about food, but about coping
with emotion
o Incremental approach
o Treatment:
§ SSRIs, SNRIs, Lisdexamfetamine (Vyvanse) (lowered relapse risk)
§ Bariatric surgery
§ CBT, DBT, IPT
o Hypoalbuminemia produces peripheral edema
• Pica: Eating nonfood items past toddlerhood no part of another illness
• Rumination: regurgitation with rechewing, re-swallowing, or spitting, no medical or
mental reason
• Avoidant/ restrictive food intake: picky eater
• Tryptophan: an essential amino acid for serotonin synthesis
• Refeeding Syndrome
o a potentially fatal condition caused by rapid, metabolic, and electrolyte shifts
(mainly hypophosphatemia) when introducing nutrition too quickly to a severely
malnourished person
• Prozac
• Bupropion (contraindicated- bulimia)
• Bariatric Surgery
• Definitions
o Ego-syntonic: refers to behaviors, thoughts, and impulses that align with an
individual’s self-image, values, and goals.
ADDITIONAL NOTES:
The hypothalamus controls appetite regulation
Unit
Chapter 18: Eating Disorders? – someone with Anorexia can become Bulimic (common)
• Anorexia Nervosa (very difficult to treat, EGOSYNTONIC)
o Epidemiology: predominantly in girls/women ages 12-30
o Comorbidity:
§ Hypercarotenemia, electrolyte imbalance
o Risk Factors: genetics (learned behavior), neurotransmitter: Serotonin missing
(needs tryptophan to be created- through food)
o Assessment: eating habits, assess for suicide, perception of the problem,
overexercise
§ Fear of gaining weight
§ Starvation- no periods (amenorrhea), hypothermia, bradycardia,
hypotension, edema, lanugo, anxiety, depression
o Restricting Type
§ No binge eating or purging (last 3 months)
o Binge Eating/Purging Type
§ Binge eating and purging (last 3 months)
o Treatment: pharmacotherapy, yoga, etc., insight-oriented, AFT, CBT, FBT
• Bulimia Nervosa (Pg. 335) – more prevalent than anorexia- 4 percent of young women
o Symptoms: Compulsive eating, self-induced vomiting (purging within an hour)
§ Rapid ingestion of large quantities of food, vomiting, laxative overuse,
diuretics, enemas, fasting, and excessive exercise
§ Normal weight range, slightly underweight, slightly overweight
• (not obvious external signs)
• Esophageal rupture, dental caries, MI (massive) at young age
(electrolyte depletion)
o Comorbidities: Depression, anxiety, substance abuse
§ Dehydration and electrolyte imbalances
o Rustles Sign: excoriation of knuckles- due to fingers in the throat- scratching from
teeth
o Outcomes: low electrolytes (sodium, magnesium)
o Assess: (pg 341) teeth- molars, throat (esophageal ruptures)
o Treatment
§ Prozac, other antidepressants
• CANNOT BE GIVEN BUPROPION (WELLBUTRIN pg 342)-
increased risk of developing seizures
, § CBT, DBT, IPT, ACT
• Binge Eating (BED) D/O (Box 18.1) – My 600 Pound Life
o No exercise, just eat a lot
o BMI 30 or greater
§ 68.5 % of adult Americans are overweight, 35 % obese
o Distress over binge eating 1x/week for 3 months
o Comorbidity:
§ specific phobia, social phobia, PTSD, alcohol abuse/dependence
o Risk factors:
§ genetics, neurobiological, cognitive factors, and environmental factors
o Assessment
§ Perception, weight cycling, skin integrity, edema, nutritional pattern,
psychosocial history, vital signs, hygiene, respiratory issues
§ Outcomes and Diagnosis, planning, and implementation
o AVOID judgmental language- binge eating is not about food, but about coping
with emotion
o Incremental approach
o Treatment:
§ SSRIs, SNRIs, Lisdexamfetamine (Vyvanse) (lowered relapse risk)
§ Bariatric surgery
§ CBT, DBT, IPT
o Hypoalbuminemia produces peripheral edema
• Pica: Eating nonfood items past toddlerhood no part of another illness
• Rumination: regurgitation with rechewing, re-swallowing, or spitting, no medical or
mental reason
• Avoidant/ restrictive food intake: picky eater
• Tryptophan: an essential amino acid for serotonin synthesis
• Refeeding Syndrome
o a potentially fatal condition caused by rapid, metabolic, and electrolyte shifts
(mainly hypophosphatemia) when introducing nutrition too quickly to a severely
malnourished person
• Prozac
• Bupropion (contraindicated- bulimia)
• Bariatric Surgery
• Definitions
o Ego-syntonic: refers to behaviors, thoughts, and impulses that align with an
individual’s self-image, values, and goals.
ADDITIONAL NOTES:
The hypothalamus controls appetite regulation
