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Eating Disorders

Anorexia Nervosa
: More common in females

Clinical features:
  1. ​Failure to maintain a normal body weight; weight less than 85% of expected weight (Body mass index < 17.5)
  2. Fear and preoccupation with gaining weight,
  3. Unrealistic self evaluation as overweight (body image distortion)
  4. Amenorrhea for 3 cycles.
Diagnostic Features of Anorexia Nervosa
  1. Refusal to maintain body weight at or above a minimally normal weight for age and height.  (This includes a failure to achieve weight gain expected during a period of growth leading to an abnormally low body weight)
    1. Weight loss of at least 15% of original body weight (or weight <15% below norm for age and height)
    2. Avoidance of high calorie foods
  2. Intense fear of weight gain or becoming fat.
  3. Distortion of body image (e.g., feeling fat despite an objectively low weight orminimizling the seriousness of low weight).
  4. Amenorrhea for at least 3 Months. (This criterion is met if menstrual period occur only following hormone- e.g., estrogen-administration.)
Complications: hypokalemia, osteoporosis, CHF

Type: It is of two types
  1. Restricting typedoes not regularly engage oneself in binge eating or purging behavior.
  2. Binge eating / purging type​
    1. Associated with poor prognosis
    2. Associated with Kleptomania

Death may be due to Hypokalemia, dehydration, CCF (Anemia)

Good prognosis
  1. Low no. of hospitalization
  2. Younger age                    
  3. No bulimic episodes       
 Treatment - Cognitive Behavioral therapy , Family therapy*
* Drug of choice is SSRI

Cyproheptadine - 12 – 32 mg/day with improvement in wt and elevation of mood.
Antidepressant (Fluoxetine, Tricyclic antidepressants have been extensively used but with little benefit.)

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