Hi, this is Tom, and in this episode I'm going to be going through eating disorders.

And you can find notes at 0.0.5.com and in the 0 to Finals Pediatrics book. And you can find

flashcards and questions at members.0.0.0.com. So let's jump straight in.

Eating disorders are psychiatric conditions involving an unhealthy and distorted obsession with

body image and food. The three main types are anorexia nervosa, bulimia nervosa,

and binge eating disorder.

Eating disorders are more common in adolescent females, but they can occur at any age and in

males.

Let's start with anorexia nervosa.

With anorexia nervosa, the person feels that they're overweight despite evidence of

normal or low body weight. It involves obsessively restricting calorie intake to lose weight.

Often the person exercises excessively and may use diet pills or laxatives to limit the absorption of food. Features of anorexia

nervosa include excessive weight loss, for example being 15% below their expected weight, or a BMI

of less than 17.5, a menorrhea, which is absent periods, and we'll talk in more detail about that shortly,

lenugo hair, which is fine, soft hair across most of the body, hypotension, being low blood pressure,

hypothermia, which is a low body temperature, and mood changes including anxiety and depression.

Amenerea, or the absence of periods in females, occurs due to disruption of the hypothylamic

pituitary genadal axis. There is a lack of gonadotropins, LH and FSA, from the pituitary gland,

leading to reduced activity of the ovaries, which is called hypogonadism.

Cardiac complications of anorexia nervosa include arrhythmias, cardiac atrophy, or shrinking and weakening of the heart,

and sudden cardiac death. Low bone mineral density is another complication, and this can lead to

abnormal fractures. Anorexia nervosa has the highest mortality of any psychiatric condition.

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