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Eating Disorders PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Eating Disorders?”.

This medical PowerPoint presentation talks about eating disorders, serious mental health conditions characterized by abnormal and often harmful eating behaviors. There are several types of eating disorders, including anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorder (OSFED).

Anorexia nervosa is characterized by a fear of gaining weight, distorted body image, and a refusal to maintain a healthy weight. Individuals with anorexia may severely restrict their food intake, exercise excessively, and engage in other behaviors to lose weight.

Bulimia nervosa involves a cycle of binge-eating, followed by purging (vomiting, using laxatives, or other methods to eliminate food from the body). Individuals with bulimia may also engage in excessive exercise or fasting.

Binge-eating disorder is characterized by frequent episodes of eating large amounts of food, often to the point of discomfort or pain, without purging behaviors. Individuals with binge-eating disorder may feel a lack of control over their eating habits and may experience shame or guilt afterward.

OSFED is a diagnosis for individuals who display symptoms of an eating disorder but do not fit the criteria for one of the other disorders.

Eating disorders can have serious health consequences, including malnutrition, electrolyte imbalances, gastrointestinal problems, and heart problems. Treatment for eating disorders often involves a combination of therapy, medication, and medical monitoring to address both the physical and psychological aspects of the disorder.

Tags : Eating Disorders, harmful eating behaviors, anorexia nervosa, bulimia nervosa, binge-eating disorder, food and nutrition, nutrients, nutrition, nutrition PowerPoint presentation

Published on : Apr 26, 2023 | Views : 2123 | Downloads : 1

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Slide 1-

TS OTHER DISORDERS EATINGDISORDERS Adapted by Julie Chilton Chapter H1 Companion PowerPoint Presentation Phillipa Hay & Jane Morris
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The “IACAPAP Textbook of Child and Adolescent Mental Health” is available at the IACAPAP website http://iacapap.org/iacapap-textbook-of-child-and-adolescent-mental-healthPlease note that this book and its companion PowerPoint are:· Free and no registration is required to read or download it· This is an open-access publication under the Creative Commons Attribution Non- commercial License. According to this, use, distribution and reproduction in any medium are allowed without prior permission provided the original work is properly cited and the use is non-commercial.
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Eating DisordersOutline Historical Background Definitions Epidemiology Gender Culture Aetiology & Risk Factors Clinical Features & Diagnosis Physical Conditions & Psychological Symptoms Comorbidity Course & Burden Management Service Delivery Course & Prognosis Prevention Barriers of Care
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Eating DisordersIntroduction
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Eating DisordersHistorical Background
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Eating DisordersRed Flags for Eating Disorders Menstrual irregularities Fertility problems Unexplained seizures “Funny turns” Chronic fatigue Callouses on hands Loss of dental enamel
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Eating DisordersDefinitions
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Eating DisordersBody Mass Index (BMI) Commonly used index of adiposity Controls for effects of height when assessing weight BMI= weight in kg divided by height (in meters) squared Used in actuarial tables BMI 20-25 associated with lower morbidity and mortality May be blind to fall-off in expected height or weight
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Eating DisordersComparative symptoms
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Eating DisordersEpidemiology, Gender & Culture: Anorexia Average age of onset= 15-19 Most common cause of: Weight loss in teen girls Inpatient admission Life history--1% in 20 yr old women Increased risk of comorbidities 90% female prevalence Rationale varies across cultures Somatic Ascetic Media-endorsed thinness
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Eating DisordersEpidemiology, Gender & Culture: Bulimia & Binge Eating DIsorder Emergence corresponds with: Media glorification of thinness High calorie snack food Loss of mealtimes Peak age of onset=15-20 yrs Average clinical presentation after 10 yrs 12% adolescent girls have some form Gay boys may be more vulnerable Increasing prevalence in men>15 yrs
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Eating DisordersAetiology & Risk Factors Complex genetic factors Concordance: mono> dizygotic twins Possible increase of anorexia in autism Anorexia: family with high perfectionistic and obsessive traits Bulimia or bingeing: family with obesity, depression, substance misuse Eating disorders comorbid with borderline personality disorder Environmental risk possible in families
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Eating DisordersAetiology & Risk Factors: Triggers
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Eating DisordersClinical Features and Diagnosis: Anorexia Restricted eating leading to deliberate weight loss or failure to grow and increase in weight and height as expected according to age and gender with: Fear of weight gain and/or persistent failure to maintain a normal weight for age and height, and: Disturbance of body image, which translates any distress into a perception that their body is too fat
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Eating DisordersClinical Features and Diagnosis: Anorexia Loss of 15% of minimal normal weight BMI <17.5 in adults Exceptions Other specified feeding or eating disorder: atypical anorexia Children and adolescents—watch fall-offs from trends in growth charts Menstruation typically absent in females Low testosterone leading to atrophied genitalia and absence of morning erections in males
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Eating DisordersImportant Information: Anorexia Weight loss timeline Collateral information about consequences Highest, lowest, and preferred weight Menstruation Current daily food and liquid intake Alcohol, drugs, medications Vomiting, compulsive exercise, laxatives, diet pills Herbal medicines, exposure to cold Body-checking , avoidance Social withdrawal or conflict Physical diseases: diabetes, thyrotoxicosis, cystic fibrosis, bowel disease, malignancies
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Eating DisordersSCOFF Questionnaire: Anorexia Do you 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 (6kg) in weight over a 3 month period? Do you believe yourself to be Fat when others say you are thin? Would you say that Food dominates your life?
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Eating DisordersExample of Weight Graph: Anorexia
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Eating DisordersBinge Eating Disorder Recurrent regular binge eating (weekly x 3 months) Larger amount of food than most people would eat in 2 hour period Sense of lack of control No purging, vomiting, fasting or compulsive exercise Body image concern not a requirement Marked distress At least 3 other symptoms Eating more rapidly than normal Eating until uncomfortably full Large amounts of food when not hungry Eating alone due to embarrassment Feeling disgusted, depressed, or guilty afterward
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Eating DisordersBulimia Nervosa Binge symptoms Purge symptoms Self-induced vomiting Misuse of laxatives, diuretics, other medications Fasting Excessive exercise Both symptoms occur weekly x 3 months Self-evaluation unduly influenced by body shape and weight Usually normal weight Bulimic Inventory Test (BITE): http://www.davidfaeh.ch/fileadmin/media/pdf_norm/bite.pdf
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Eating DisordersOther Disorders DSM-5: Other Specified Feeding or Eating Disorders (OSFED) Atypical Anorexia Nervosa Subthreshold bulimia nervosa Binge-eating disorder (of low frequency or limited duration) Purging disorder Night eating syndrome Avoidant Restrictive Food Intake Disorder (ARFID) Unspecified Feeding or Eating Disorder (UFED)
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Eating DisordersRating Scales The Eating Disorders Examination (EDE-Q) Eating Disorders Inventory-3 The Children’s Eating Attitudes Test Morgan-Russell Average Outcome Scale (MRAOS) Bulimic Investigatory Test (BITE)
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Eating DisordersInvestigation of Physical Conditions and Psychological Symptoms Physical investigations Food diaries Growth charts Psychiatric assessment Family history and involvement Observation of family meal Height and weight Routine blood tests: glucose, thyroid, electrolytes, liver function tests, pregnancy, complete blood count Electrocardiogram Bone density
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Psychological Depression Anxiety and obsessionality Autism spectrum disorders Emerging borderline personality disorder Substance abuse Chronic fatigue syndrome Physical Diabetes Cystic fibrosis Gastrointestinal conditions Obesity Eating DisordersComorbidity
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Anorexia One of the most lethal psychiatric conditions ~40% achieve full recovery Small percentage severe and enduring course Ave time to recovery= 6-7 years Bulimia May remit spontaneously in young >50% achieve remission at 5 yrs Untreated symptoms likely to persist with significant impact Eating DisordersCourse and Burden
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Eating DisordersManagement of Anorexia: Issues to Consider Challenging management of acute physical risk Precipitous weight loss >1kg/week Purging Substance use Weakness in emaciated patients Behavioral risk Urgency to refeeding underweight children Consequences of starvation on developing brain and cognition Importance of family/caregiver education Specialist dietetic input Family-based therapy most effective Individual therapy for depression before re-nutrition likely ineffective
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Eating DisordersManagement of Anorexia: Principles of Maudsley Model of Family Therapy Family encouraged to take illness very seriously Anorexia externalized ~life-threatening illness Therapy NOT focused on causes/avoids blaming family Responsibility for recovery IS placed with family and professionals Family assumed to know best how to feed child Adults re-take control to child can feed self Appropriate autonomy encouraged ONLY when adequately nourished
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Eating DisordersManagement of Anorexia: Motivational Approach Help children see links between anorexia and symptoms they dislike: Weariness Agitation Obsessionality Preoccupation with food and its avoidance Sleep problems Feeling cold Lost friendships Inability to join in socially Falling sport/academic performance “Fussing” by parents
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Eating DisordersManagement of Anorexia: Motivational Approach Help children see benefits of weight gain: More energy Clear headedness Resistance to cold Growing in height Capacity for fun with friends Being well enough to join in games
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Eating DisordersManagement of Anorexia: Acknowledgement of benefits of eating disorder Power to oblige people to care and placate Relief from social and sexual demands Sense that body is controlled vs terrifyingly unpredictable ***Young patients need new techniques for coping with these aspects of life rather than starving themselves***
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Eating DisordersManagement of Anorexia: Medication Food is medicine Food must be taken in amounts prescribed and at the times specified Choice for the child is how they take the medicine Orally as food Orally as supplement drink Naso-gastric tube Little evidence for psychoactive medication Important to avoid medication with QTc prolongation Some evidence for olanzapine or other antipsychotic to help with rumination and aid weight gain in anorexia
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Eating DisordersManagement of Anorexia: Home vs Inpatient Outcome better in outpatient clinics with eating disorder specialists Even general outpatient child and adolescent psychiatrists brought about better outcomes than inpatient Guidelines now recommend outpatient care if patients with anorexia are medically stable Where no outpatient clinic available, consider outreach medicine and telemedicine for home-based care (Gowers et al 2007)
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Eating DisordersAnorexia Treatment: Refeeding Syndrome Potentially fatal shift in electrolytes and fluids Too fast, imperfectly balanced, artificial or oral feeding Hypophosphatemia, hypomagnesemia, hypokalemia, gastric dilation, congestive cardiac failure, severe edema, confusion, coma, death Criticism: current guidelines are over cautious Should not occur with adequate monitoring, especially phosphate
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Eating DisordersManagement of Bulimia Nervosa and Binge-Eating Disorder Antidepressants—fluoxetine 60 mg Cognitive Behavioral Therapy targeting bulimic symptoms = gold standard Self-help books, CDs, web-based programs when no trained therapist available Interpersonal Therapy model for bulimia Fairburn’s CBT-E for patients 15 and older and with BMI=15
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Eating DisordersModels of Service Delivery for Eating Disorders Coordinated systemic response is key Return to school Less supervision Competitive academic environment as trigger Group therapy Potential for competition in anorexia Successful for bulimia and binge eating disorder Growing evidence for multi-family groups Adjunctive web-based and CD-ROM manualized treatment Getting Better Bit(e) by Bit(e) (Schmidt & Treasure, 1993)
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Eating DisordersCourse and Prognosis: Anorexia Older studies: ~20% mortality rate Now: 10 x that in general population Average time to recovery 6-7 years Younger, more intensively treated show more rapid improvement Tolerant, respectful relationship vs rewarding/punishing based on weight Effects on fertility High death rates Ambivalent overdoses Substance abuse at low weight Perforations from vomiting Cold climates: exercise, hypothermia, and infections Hot climates: dehydration and enteric infections
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Eating DisordersPrevention Usually in groups at schools, clinics or athletic clubs Results mixed Targeted programs more effective Minimum BMI for dancers and models Anti-obesity campaigns emphasis on healthy nutrition and exercise rather than weight reduction important
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Eating DisordersBarriers to the Implementation of Care in Developing Countries Until recently, culture in developing countries protective vs eating disorders Structured regular eating patterns Eat what is put in front of you Eat alongside others Thin body image ideal not endorsed Disordered and obsessive body image values transmitted by TV, internet, other media Anorexia treatment, especially, related to level of experience of clinician Families are most likely source of recovery
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Eating DisordersWebsites The Centre for Eating and Dieting Disorders (Australia)http://cedd.org.au/?id=1 Academy of Eating Disorders http://www.aedweb.org Royal College of Paediatrics and Child Health http://www.rcpch.ac.uk Royal College of Psychiatrists http://www.rcpsych.ac.uk/workinpsychiatry/faculties/eatingdisorders/resourcesforprofessionals.aspx BEAT (formerly UK Eating Disorders Association)https://www.b-eat.co.uk Diabetics with Eating Disorders (DWED) http://dwed.org.uk Men get eating disorders too http://mengeteatingdisorderstoo.tumblr.com Something Fishy http://www.something-fishy.org The Butterfly Foundation (Australia) https://thebutterflyfoundation.org.au
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Anxiety Disorders in Children and Adolescents Thank You!