Eating

Disorders
By group A1: Marwa Alsaleh, Zahra Almousa,
Maha Alshrywi, Israa Alagnam
Outlines:
1- introduction
2- basic traits of anorexia nervosa, bulimia nervosa, binge eating
disorder.
3- warning signs, observations, and medical findings for eating
disorders.
4- brain’s mechanism that lead to overeating, and either bulimia
nervosa or binge eating disorder.
5- laboratory values important for evaluation of a patient with an
eating disorder.
6- summary
7- take home message
8- reference
 Introduction
Eating disorders are a range of psychological conditions that cause
unhealthy eating habits to develop. They might start with an
obsession with food, body weight, or body shape. Although eating
disorders can affect people of any gender at any life stage, they’re
most often reported in adolescents and are most prevalent among
young women especially. In fact, up to 13% of youth may
experience at least one eating disorder by the age of 20.
 Basic traits of anorexia
nervosa, bulimia nervosa,
binge eating disorder.
 Anorexia nervosa
 Restricted energy intake relative to requirements
leading to a markedly low body weight.

 Intense fear of gaining weight or becoming fat or

persistent behaviour to avoid weight gain, even
though at a markedly low weight.

 Disturbance in the way in which one’s body

weight or shape is experienced.
 Bulimia nervosa

 Recurrent episodes of binge eating with a sense

of a lack of control with inappropriate
compensatory behaviour.

 Self-evaluation is unduly influenced by body

shape and weight.
 Binge eating

 Repeated episodes of overconsumption of food

with a sense of a lack of control with a list of
possible descriptors such as how much is eaten
and distress about the episode.

 Frequency described as at least once a week for

3 months.
 Q
Which of the following disorder characterised
by restricted energy intake relative to
requirements?

1- anorexia nervosa
2- bulimia nervosa
3- Binge eating disorder
Warning signs, observations, and
medical findings for eating
disorders.
 Warning signs, observations, and medical
findings for eating disorders.

Emotional and behavioural

• Preoccupation with weight, food, calories, carbohydrates, fat grams,
and dieting
• Refusal to eat certain foods
• Appears uncomfortable eating around others
• Food rituals
• Skipping meals
 Warning signs, observations, and medical
findings for eating disorders.

Emotional and behavioural

• Any new practices with food or fad diets, including cutting out entire
food groups
• Withdrawal from usual friends and activities  
• Frequent dieting    
• Extreme concern with body size and shape   
• Frequent checking in the mirror
• Extreme mood swings
 Warning signs, observations, and medical
findings for eating disorders.
Physical
• Stomach cramps, other non-specific gastrointestinal complaints
• Dry skin and hair, and brittle nails
• Noticeable fluctuations in weight
• Abnormal laboratory findings
• Dizziness  
• Fainting/syncope
• Difficulties concentrating    
 Warning signs, observations, and medical
findings for eating disorders.
Physical
• Feeling cold all the time
• Sleep problems    
• Dental problems
• Dry skin and hair, and brittle nails
• Fine hair on body
• Yellow skin
• Poor wound healing
• Impaired immune functioning medical findings for eating
disorders
 Warning signs, observations, and medical
findings for eating disorders.

Anorexia Nervosa:
osteopenia, primary amenorrhea, osteoporosis, Hypothermia, low white
and red blood cell, electrolyte abnormalities, Low body weight,
dehydration, and muscle wasting.
Bulimia Nervosa:
Arrhythmia, depressed, irritable mood, Muscle weakness, amenorrhea,
gastritis, esophagitis, peripheral myopathy, Dental caries.
 Q

Give one example of physical warning signs for

eating disorder:

Difficulties concentration, Dry skin and hair

 brain’s mechanism that lead to
overeating, and either bulimia
nervosa or binge eating disorder.
 Brain’s mechanism

●Neurological mechanism for overeating

is like substance abuse
●Imbalance in the reward and inhibitory
control system
●2 major neurotransmitter that affect the
eating disorder: Serotonin and dopamine
 Brain’s mechanism
Serotonin
Bulimia nervosa
• B u liinmiserotonin
Binge eating disorder
•Dysfunction a n e rv o sa
circuitry. •Serotonin alterations fairly similar to
•When not eating for a long period of bulimia.
time such, people with bulimia have •BED suffer from chronically ↓
severe ↓ serotonin which → binge eating serotonin levels which → binge eating to
and irritability. relieve depressed mood.
•women with bulimia have variant of a •There is an association between
serotonin receptor are more impulsive. impulsivity and strict dieting with
serotonin receptor genes and binge
eating in young women.
 Brain’s mechanism
Dopamine
Bulimia
• B u li mi a nnervosa
e rv o sa Binge eating disorder
•↓ both dopamine and its receptors
•BED has ↑ hyper-responsiveness to
•Binge eating ↑ dopamine release in rewards such as food, which makes
certain parts of the brain. eating more rewarding and pleasurable
•Compensatory behaviours such as •leads to a continuation of compulsive
purging is rewarding overeating with no compensatory
•Purging ↓ of acetylcholine → makes food behaviour.
more pleasant and delay satiety.
 Q

Name the 2 major neurotransmitter that

affect eating disorder:

Serotonin & dopamine

laboratory values important for
evaluation of a patient with an
eating disorder.
 Laboratory values

 The need for laboratory analyses should be

determined on an individual basis depending
on the patient’s condition or when necessary
for making treatment decisions.
 Laboratory values
 Laboratory values test ( Basic analyses – All patients with
eating disorders):

 Serum electrolytes.
 Blood urea nitrogen.
 Serum creatinine (interpretations must incorporate
assessments of weight).
 Thyroid-stimulating hormone test (T3, T4).
 Complete Blood Count (CBC).
 Liver enzymes ( AST , ALP , ALT) 
 Urinalysis
 Q
The need for laboratory analyses should be
determined on an individual basis depending on the
patient’s condition or when necessary for making
treatment decisions:

True or false
 Summary

People that have an eating disorder may eat too much food,
too little food, or become preoccupied with their body shape
or weight. Without treatment, an eating disorder may become
serious and potentially life-threatening. However, recovery
from an eating disorder is possible with treatment. This often
involves a team of health professionals that work together to
help you on your way to recovery.
 Take home message
Registered dietitian and other professionals involved in your treatment can
help you better understand your eating disorder and help you develop a plan
to achieve and maintain healthy eating habits. Goals of nutrition education
may be to:

* Work toward a healthy weight

* Understand how nutrition affects your body, including recognising how your eating
disorder causes nutrition issues and physical problems
* Practice meal planning
* Establish regular eating patterns — generally, three meals a day with regular snacks
* Take steps to avoid dieting or bingeing
* Correct health problems that are a result of malnutrition or obesity
 REFERENCES
• the ADA Practice Paper “Nutrition Intervention in the Treatment of Eating Disorders”
available for members at http://www.eatright.org/practice

• Miller, K. K., Grinspoon, S. K., Ciampa, J., Hier, J., Herzog, D., & Klibanski, A. (2005).
Medical findings in outpatients with anorexia nervosa. Archives of internal
medicine, 165(5), 561-566.

•  https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/neurotransmitters

Yager, J., Andersen, A., Devlin, M., Egger, H., Herzog, D., Mitchell, J., ... & Zerbe, K. (2002).
Practice guideline for the treatment of patients with eating disorders.
American Psychiatric Association.
Thank you