Eating disorders

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Eating Disorders

  1. . Binge Eating Disorder
1.Recurrent and persistent episodes of binge eating
2.Binge eating episodes are associated with three (or more) of the following:
Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of being embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or very guilty after overeating
3. Marked distress regarding binge eating
4. Absence of regular compensatory behaviors (such as purging).
Lisdexamphetamine / Vyvanse approved for Rx of Binge Eating DisorderDont use with MAOI, Caution with HTN.

2. Night Eating Syndrome

>25% of calories consumed after the evening meal.
Recurrent Awakenings that require food seeking to fall asleep
Little interest in AM food
Behavioral therapy

3. Bulimia Nervosa

1. Recurrent episodes of binge eating
Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
A sense of lack of control over eating during the episode.
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
At least once a week for 3 months.
Self-evaluation is unduly influenced by body shape and weight.
Fluoxetine is FDA approved, Topiramate & Naltrexone may also work.

4. Anorexia Nervosa

1. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
2. Intense fear of gaining weight or of becoming fat or persistent behavior that interferes with weight gain, even though at a significantly low weight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
CBT, medications are an adjunct.
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