Question

Anna, age 19 years, fainted at the gym, where she worked out for a minimum of 2 hours every day. When paramedics arrived, they found her dehydrated, but conscious. Further physical examination revealed erosion of some of her tooth enamel, open lesions in her oral mucosa, and a slightly irregular heartbeat, and she reported abdominal cramping. When questioned about medications, she told them she had taken some laxatives that day but otherwise she had been feeling fine.

1. Relate the signs and symptoms and behaviors to eating disorders. (See Bulimia Nervosa.)

2. Discuss what other signs and symptoms or behaviors might also indicate this condition, and what factors might predispose toward this disorder. (See Bulimia Nervosa.)

Answer 1

1. Relate the signs and symptoms and behaviors to eating disorders.

Eating disorders are illnesses characterized by abnormal eating habits in concern to weight ,body shape.It includes more food intake or inadequate food intake which is very harmful to the health of an individual.The eating disorders are

• Anorexia nervosa
• Bulimia Nervosa
• Binge Eating Disorder
• Otherwise specified feeding or eating disorder (OSFED)
• Avoidant restrictive food intake disorder(ARFID)
• PICA
• Rumination disorder

Other behaviour and food concerns

• Orthorexia
• Compulsive exercise
• Diabulimia

(www.nationaleatingdisorders.org/warning-signs-and-symptoms)

BULIMIA NERVOSA:

According to the DSM-5, the official diagnostic criteria for bulimia nervosa are:

• Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • Eating, in a discrete period of time (e.g. within any 2-hour period), 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 (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
• 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.
• The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
• Self-evaluation is unduly influenced by body shape and weight.
• The disturbance does not occur exclusively during episodes of anorexia nervosa.

When comparing with Anna's behaviour and symptoms she may have BULIMIA NERVOSA.

• Maintains excessive, rigid exercise regimen despite weather, fatigue, illness, or injury due to the need to “burn off ” calories - Anna works out minimum of 2 hours every day
• Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.) - Anna complaints of abdominal cramping
• Fainting/syncope - Anna fainted at the gym and has irregular heartbeat
• Dental problems, such as enamel erosion, cavities, and tooth sensitivity- Anna revealed erosion of some of her tooth enamel
• Swelling around area of salivary glands - Open lesions are found in Anna's mouth( oral mucosa)
• Purges after a binge (e.g. self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, fasting) - Anna has taken laxatives

2. Discuss what other signs and symptoms or behaviors might also indicate this condition, and what factors might predispose toward this disorder. (See Bulimia Nervosa.)

• Dental erosion (erosive tooth wear) is the situation of a chronic loss of dental hard tissue that is chemically etched away from the tooth surface by acid and/or chelation without bacterial involvement.
• Crohn's disease
• Ulcerative colitis
• Addison's disease
• Anorexia nervosa

These are some of the diseases with some of the signs and symptoms as bulimia nervosa

The predisposing causes for Bulimia nervosa are

• Close relative with an eating disorder
• Social isolation
• History of dieting or following any weight contolling methods
• Body image dissatisfaction.
• Anxiety disorder
• Behavioral inflexibility
• Weight stigma
• Teasing
• Historical trauma

The harmful effects of bullying have received increased attention in recent years, starting an important national conversation. Bullying can lead to low self-esteem, social isolation, poor body image, and has also been shown to directly contribute to the development of eating disorders. It is found about 65% of people with eating disorders say bullying contributed to their condition.