The weekend is over and I have to say that it was a good one. I didn’t go too crazy. No hangover, no headache, no overeating. My weekends usually end with at least one of these signs of a great time!

I’ve been meaning to write a blog about eating disorders because I feel that it is more common than people think. While we have to control our nutrition, there is a fine line between being healthy and developing an eating disorder. Coincidentally, my brother Chudi, called me because he wanted to rehearse his presentation for one of his classes for medical school. The topic of his presentation was on eating disorders. His presentation was perfect, so I decided to share it. This blog will help you find out if you or someone you know has an eating disorder. I made the extremely medical terms easier to understand.

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Eating disorder characterized by refusal to maintain normal body weight. The patient usually loses more than 15-20% of ideal body weight. Usually by excessive exercise, fasting or purging.

TYPES OF EATING DISORDERS

• Anorexia
• Bulimia
• Compulsive overeating
• Rumination

DEFINITION AND SIGNS OF ANOREXIA:

• Distorted body image.
• Patients have a distorted body image and believe that they are overweight.
•  There is a fear and preoccupation with gaining weight.
• The absence of a menstrual period in a woman of reproductive age for 3 cycles or more

TYPES OF ANOREXIA

• Restricting with no binge-eating or purging
• Binge with eating /purging regularly

STUDY OF THE DISTRIBUTION AND DETERMINANTS OF HEALTH-RELATED STATES OR EVENTS

• The lifetime prevalence of anorexia nervosa in women is estimated to be 0.3 to 1 percent . Rates for men  are significantly lower.
• Data from the National Comorbidity Replication survey indicate a lifetime prevalence of 0.9 and 0.3 percent for  women and men respectively .
• Data from a Finnish birth cohort study suggest a higher lifetime prevalence (2.2 percent), with inclusion of  untreated cases identified by screening.
• Onset is about the age of 17.
• Late onset has worse prognosis.
• Onset is usually associated with emotional stressors particularly conflicts with parents about independence and  sexuality.

RISK FACTORS

• Biological factors are suggested by higher concordance in monozygous twins
• Adolesence age
• High socioeconomic status
• Cultural risk factors may emphasize thinness as beauty.

ANOREXIC EATING FACTORS

• Patients restrict food intake and maintain very low calorie intake.
• Patients prefer to eat alone.
• Collect food recipes and spend a lot of time preparing food but don’t eat it.
• Post pictures of food on “facebook” to prove that they are eating normally.

PRESENTING SYMPTOMS

• Body weight of less than 85% of ideal body weight.
• Amenorrhea, absence of at least 3 consecutive menstrual cycles.
• Signs of Malnutrition.
• Signs of purging.
• Cold intolerance.

EVIDENCE OF PURGING

• Eroded dental enamel.
• Scarred or scratched hands from self gagging.
• Mallory weis tears
• Metabolic Alkalosis (Alkalosis is a condition in which the body fluids have excess base … (a base) levels make the body too alkaline)
• Hypochloremia (an electrolyte disturbance whereby there is an abnormally depleted level of the chloride ion in the blood)
• Metabolic acidosis (Laxative use)

EVIDENCE OF MALNUTRITION

• Eroded dental enamel.
• Scarred or scratched hands from self gagging.
• Mallory weis tears
• Metabolic Alkalosis
• Hypochloremia
• Metabolic acidosis (Laxative use)
• Emaciation
• Increased Liver Enzymes
• Abnormal electrolytes
• Abnormal EEG (EEG is used to help diagnose seizures and their type)
• Decreased estrogen or testosterone
• Lanugo (Lanugo is the fine white hair that grows on anorexics when they have no body fat left to keep themselves warm)

DIAGNOSTIC CRITERIA

DSM-IV-TR diagnostic criteria for anorexia nervosa

• Refusal to maintain body weight at or above a minimally normal weight for age and height (eg, weight loss or failure to gain weight that leads to a body weight less than 85 percent of that expected for age and height).
• Intense fear of gaining weight or becoming fat, even though underweight.
• Disturbed perception of one’s body weight or shape, undue influence of weight or shape on self-evaluation, or denial  of the seriousness of the current low body weight.
• In postmenarcheal females, amenorrhea, ie, absence of at least three consecutive menstrual cycles. Menstruation that occurs only after hormonal treatment, eg, estrogen, is considered amenorrhea.

Adapted from: American
Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders,
4th Ed, Text Revision, Washington, DC 2000. p.589.

USE THESE QUESTIONS TO SCREEN FOR EATING DISORDERS

• 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 (14 pounds or 6.35 kg) 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?
• Are you satisfied with your eating patterns? (No is abnormal)
• Do you ever eat in secret? (Yes is abnormal)
• Does your weight affect the way you feel about yourself? (Yes is abnormal)
• Have any members of your family suffered with an eating disorder? (Yes is abnormal)
• Do you currently suffer with or have you ever suffered in the past with an eating disorder? (Yes is abnormal)
• Two abnormal responses to the above is diagnostic to the eating disorder.

REFERENCE

www.uptodate.com

Kaplan medical.

BY

NGO OKAFOR

BLACK MALE MODEL AND ACTOR

AFRICAN AMERICAN BLACK MALE MODEL AND ACTOR

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