Bulimia |
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| 2007-12-24 | No history |  | Add My version | |
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| Mind map Bulimia (from MedMaps.co.uk) - the online mind map resource for medical students and doctors. Psychiatry. Medicine. | |
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Bulimia
Characteristics
Definition
Overvalued ideas
weight
shape
episodes of dietary restrain
excessive purging
vomiting
laxatives
episodes of bingeing
1000-2000 calories/episode
assoc. with guilt
failure to meet anorexia criteria
Causes
unclear
monozygotic = dizygotic concordance
~30%
Risks
Female
Western society
Caucasians
Alcohol abuse
NB: Equal distribution in social classes
Associations
Anxiety
Depression
Prevalence
1-2%
young women
Incidence
men
1/100,000/year
women
29/100,000/year
S&S
Purging consequences
Electrolyte imbalance
arrhythmias
muscular paralysis
tooth decay
erosion of dental enamel
stomach/oesophageal rupture
usually kept secret
delay in presentation
5yrs on average
no marked weight-loss
guilt
inability to control eating
callouses over knuckles
swollen salivary glands
Management
Investigations
electrolytes
Treatment
CBT
best treatment
remission in ~50%
20 sessions in 4-5 months
>50 randomised trials support it
Antidepressants
effects wane
combine with antipsychotics
Prognosis
worse prognosis
childhood obesity
low self-esteem
personality disorder
10 years
1/3-1/2 still have eating disorder
change of diagnosis
another eating disorder
easier to Rx than anorexia
Differential
Anorexia
Atypical eating disorder
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