Updated: 9/10/2020

Other Eating Disorders

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Questions
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Evidence
5 5
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Snapshot
  • A young woman who is 4 months pregnant comes into her primary care physician to discuss an unusual craving. She reluctantly admits that, for the past five weeks, she has been consuming large amounts of ice. She will often prefer to eat ice instead of food. She has never experienced this craving before, and eating ice is not a part of any of her social customs. She and her husband are both concerned about this behavior. (Pica)
Binge Eating Disorder
  • Definition
    • recurrent episodes of binge eating
      • eating a large amount of food in a discrete period of time
      • a feeling of loss of control during episode
    • no compensatory behaviors
    • episodes occur at least once a week for 3 months
  • Epidemiology
    • F > M
    • associated with other psychopathologies
Pica
  • Definition
    • repeatedly craving and eating non-food products, such as chalk, dirt, hair
      • intense craving and consumption of ice (pagophagia) is associated with iron deficiency 
    • inappropriate to developmental level or culture
    • occurs for at least 1 month
    • may be associated with other conditions, such as autism
  • Complications
    • anemia
    • malnutrition
    • electrolyte abnormalities
    • constipation
    • exposure to toxins
    • infections
  • Epidemiology
    • most common in pregnant women and school-age children
Rumination
  • Definition
    • repeated regurgitation of food that is not due to a gastrointestinal issue or an underlying eating disorder
    • occurs for at least 1 month
Avoidant/Restrictive Food Intake Disorder
  • Definition
    • avoiding or restricting food intake for a variety of reasons
      • disinterest in food
      • negative experience with eating
      • not caused by fear of weight gain, body dysmorphia, the unavailability of food, or social custom
    • associated with negative consequences
      • significant weight loss in adults or poor weight gain in children
      • malnutrition
      • supplemental feeding requirement to maintain health
      • psychosocial dysfunction
  • Epidemiology
    • among adolescents with eating disorders, patients with avoidant/restrictive food intake disorder are more likely to be male than patients with anorexia nervosa
    • onset usually occurs in infancy or early childhood
Other Specified Feeding or Eating Disorder
  • Definition
    • symptoms or behavior surrounding foods that cause significant distress but do not meet full criteria for another eating disorder
 

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(M1.PY.15.73) A 16-year-old female presents to your clinic concerned that she has not had her menstrual cycle in 5 months. She has not been sexually active and her urine pregnancy test is negative. She states that she has been extremely stressed as she is in the middle of her gymnastics season and trying to get recruited for a college scholarship. Physical exam is remarkable for a BMI of 16, dorsal hand calluses, and fine hair over her cheeks. What other finding is likely in this patient? Tested Concept

QID: 106568
1

Polycythemia

4%

(2/47)

2

Elevated TSH

6%

(3/47)

3

Normal menstrual cycles

2%

(1/47)

4

Elevated estrogen levels

0%

(0/47)

5

Low bone density

81%

(38/47)

M 2 D

Select Answer to see Preferred Response

(M1.PY.13.36) In your outpatient clinic you are seeing a 22-year-old female for her annual check-up. She has a past medical history significant for sexual abuse in her teens. Currently she has no complaints. She reports that her last menstrual period was 1 week ago. Her temperature is 98.5 deg F (36.9 deg C), pulse is 65/min, blood pressure is 110/75 mmHg, respirations are 11/min. Physical exam is notable only for dry mucous membranes with multiple dental carries and calluses on the dorsum of her right hand. Her BMI is 17. What is the most likely diagnosis? Tested Concept

QID: 100036
1

Anorexia nervosa - restrictive type

8%

(2/26)

2

Anorexia nervosa - purging type

73%

(19/26)

3

Bulimia nervosa

4%

(1/26)

4

Obsessive compulsive disorder

8%

(2/26)

5

Eating disorder not otherwise specified

0%

(0/26)

M 2 D

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Evidence (5)
Topic COMMENTS (4)
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