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eating disorder

Genetics: - implicated genes include: - NPY5R Clinical manifestations: - young females with eating disorders may present with gynecologic complaints [11] - irregular menses, amenorrhea, pelvic pain, atrophic vaginitis - red flags that call for hospitalization - dehydration, electrolyte disturbance, EKG abnormalities [11] Management: - conversations with teens that focus on healthful eating, without reference to weight issues reduce the risk of eating disorders [5] - from the American Academy of Pediatrics [10] - avoid dieting, skipping meals, diet pills, foucus on weight - healthy lifestyle, including healthy diet & exercise, positive body image, frequent family meals - inquire about abuse & bullying [10] - do not prescribe combination oral contraceptives to treat amenorrhea caused by eating disorders [11] - regaining of weight for low bone mineral density caused by eating disorders - USPSTF concludes that the current evidence is insufficient to assess the balance of benefits & harms of screening for eating disorders in adolescents & adults [12]

Related

anorexia hyperphagia hypophagia; loss of appetite obesity

Specific

anorexia nervosa binge eating disorder eating disorders in the elderly excess fluid intake excess salt intake excess sugar intake feeding disorder orthorexia nervosa overeating; gluttony; excessive calorie intake purging disorder rumination syndrome

General

chronic metabolic disease nutritional disorder (malnutrition)

References

  1. Prescriber's Letter 13(8): 2006 Drug Treatment for Eating Disorders Detail-Document#: 220811 (subscription needed) http://www.prescribersletter.com
  2. Medical Knowledge Self Assessment Program (MKSAP) 14, 16. American College of Physicians, Philadelphia 2006, 2012
  3. Yager J et al, PRACTICE GUIDELINE FOR THE Treatment of Patients With Eating Disorders, Third Edition http://www.psych.org/psych_pract/treatg/pg/EatingDisorders3ePG_04-28-06.pdf
  4. Sim LA, McAlpine DE, Grothe KB et al Identification and treatment of eating disorders in the primary care setting. Mayo Clin Proc. 2010 Aug;85(8):746-51 PMID: 20605951
  5. Berge JM et al Parent Conversations About Healthful Eating and Weight. Associations With Adolescent Disordered Eating Behaviors. JAMA Pediatr. 2013;():1-7. June 24, 2012 PMID: 23797808 http://archpedi.jamanetwork.com/article.aspx?articleid=1700514
  6. Anonymous Practice guideline for the treatment of patients with eating disorders (revision). American Psychiatric Association Work Group on Eating Disorders. Am J Psychiatry. 2000 Jan;157(1 Suppl):1-39. PMID: 10642782
  7. Eating Disorders: Facts About Eating Disorders and the Search for Solutions (NIMH) http://www.nimh.nih.gov/publicat/eatingdisorders.cfm
  8. Bulik CM et al, deprecated reference - National Guideline Clearinghouse Expert Commentary, Evidence Perspective Eating Disorders: Newer Practice Guidelines Reinforce Severity of Conditions But Still Reflect Deficits in Knowledge Base
  9. Attia E. In the clinic. Eating disorders. Ann Intern Med. 2012 Apr 3;156(7):ITC4-1 through 16 Review. PMID: 22473445
  10. Golden NH, Schneider M, Wood C et al Preventing Obesity and Eating Disorders in Adolescents. Pediatrics Aug 2016, e20161649. Aug 22, 2016 PMID: 27550979
  11. American College of Obstetricians and Gynecologists (ACOG) Gynecologic Care for Adolescents and Young Women With Eating Disorders. ACOG Committee Opinion. Number 740, June 2018 https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Gynecologic-Care-for-Adolescents-and-Young-Women-With-Eating-Disorders
  12. US Preventive Services Task Force Screening for Eating Disorders in Adolescents and Adults. US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(11):1061-1067 PMID: 35289876 https://jamanetwork.com/journals/jama/fullarticle/2789963 - Feltner C, Peat C, Reddy S et al Screening for Eating Disorders in Adolescents and Adults. Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2022;327(11):1068-1082 PMID: 35289875 https://jamanetwork.com/journals/jama/fullarticle/2789962 - Attia E, Guarda AS Prevention and Early Identification of Eating Disorders. JAMA. 2022;327(11):1029-1031. PMID: 35289893 https://jamanetwork.com/journals/jama/fullarticle/2789987 - Nagata JM, Golden NH New US Preventive Services Task Force Recommendations on Screening for Eating Disorders. JAMA Intern Med. Published online March 15, 2022 PMID: 35289838 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790195