Psychological medicine

Eating Disorders

History Questions

  • Do you worry about how much you weigh?
  • What do you think of your body/weight?
  • Do you diet?
  • Do you ever make yourself sick after a meal?

Anorexia Nervosa

  • Low weight not due to other illness 
  • Persistent refusal to maintain weight (cf depression – don‟t want to eat). Obsession with food, weight and thinness
  • 90% female, usual onset from 11 – 19 years
  • Aetiology:
    • Media message: thin = beautiful
    • Already painfully aware of body image due to changes in puberty
    • Stressful life situations
    • Genetics
    • Family dynamics
    • Something they can have control over when they don‟t have control in other areas of their lives
    • Failure to achieve weight control ® ¯sense of failure ® try harder
  • Signs:
    • Deliberate self-starvation
    • Fear of gaining weight
    • Denial of hunger
    • Constant exercising
    • Self perception of being fat
    • Absent or irregular periods
    • May purge (vomiting, laxatives) 
  • Complications: starvation, heart, osteomalacia, ¯fertility

Bulimia

  • Purging a more dominant feature
  • Don‟t usually loose so much weight