Y khoa, dược - Spotlight on eating disorders

Spotlight on Eating DisordersEating DisordersEating disorders ≠ disordered eatingEating disorder: Serious illness affecting daily activitiesDisordered eating: Usually temporary or mild change in eating patternsThe Eating Disorders ContinuumDSM-5 assigns eating disorders to categories across a continuumSelf-starvation at one endBinge-eating disorder on the otherNo Simple CausesPredispositionSocial factorsExpectations for body size and shapePsychological factorsPeer relationshipsFamily expectationsEmotional traumaNo Simple CausesBiological factorsNeurotransmitter levelsGenetic factorsSynthesis and release of leptin and orexinAnorexia NervosaDiagnostic criteriaBody weight < 85% of expected (BMI ≥ 17.5 kg/m2)Intense fear of weight gainDistorted body imageAmenorrheaCausesWarning signsAnorexia NervosaTreatmentGoalsStabilize physical conditionConvert patient into participantRestore nutritional statusGradual weight gainPsychotherapyIndividualGroupFamilyBulimia NervosaDiagnostic criteriaRecurrent binge eatingRecurrent purging, excessive exercise, or fastingExcessive concern about weight and shapeAbsence of anorexia nervosaCausesBulimia NervosaBinge: large amount of food, short period of timeHigh-calorie, high-fat foodsPurgeAffects fluid and electrolyte balanceCan be life threateningBulimia NervosaTreatmentMedical Nutritional PsychotherapyAntidepressant medicationsBinge-Eating DisorderDiagnostic criteriaRecurrent binge eatingDistress over eating behaviorsNo recurrent purgingAbsence of anorexia nervosaTriggers of binge eatingStressConflictFrequent dietingBinge-Eating DisorderTreatmentPsychotherapyAntidepressant medicationsLong-term supportBody Dysmorphic DisorderPreoccupied with an imagined or slight defect in appearanceOften coexists with Obsessive-compulsive disorderMajor depressionDelusionsSocial phobiaNight-Eating SyndromeHabitual pattern of interrupting sleep to eatIndicationsEats more than half of daily calories during and after evening mealWakes up at least once a night to eatFeels tense or guilty while eatingPersists in behavior for 3+ monthsMales: An Overlooked PopulationFewer instances than femalesMost affected men are overweight, unlike womenMen involved in sports, modeling, entertainmentPressure for certain weight or shapeAnorexia AthleticaSports-related eating disordersBody size/shape important in competitionPressure from coachesThe Female Athlete TriadDisordered eatingAmenorrheaPremature OsteoporosisOther IssuesPregorexiaPregnant women who reduce calories and exercise in excessInfantile anorexiaSevere feeding difficulties beginning with introduction of solid foodsCombating Eating DisordersPromote self-esteemFocus on size acceptanceCelebrate the diversity in all sizes and shapesDiscourage meal skippingEncourage eating in response to hunger, not emotions