Medical history (history of illness) represents an important component in the diagnosis of bulimia nervosa (binge eating disorder). Family history Is there a history of mental illness in your family that is common? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? How can … Binge Eating Disorder (Bulimia Nervosa): Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus Infectious and parasitic diseases (A00-B99). Hepatitis (inflammation of the liver) Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87). Hepatitis Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93). Chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease. Functional gastrointestinal disorders Gastritis (inflammation of the gastric … Binge Eating Disorder (Bulimia Nervosa): Or something else? Differential Diagnosis
The following are the major diseases or complications that may be contributed to by bulimia nervosa (binge eating disorder): Respiratory system (J00-J99) Laryngitis (reflux laryngitis; inflammation of the larynx due to vomiting of acidic stomach contents). Endocrine, nutritional, and metabolic diseases (E00-E90). Electrolyte disorders (derailment of blood salts). Hypochloremia (chlorine deficiency) Hypokalemia (potassium deficiency) Hyponatremia … Binge Eating Disorder (Bulimia Nervosa): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, oral cavity, and sclera (white part of the eye) [accompanying symptoms: sialadenosis (salivary gland enlargement); scars on the back of the hand from repeated bite wounds; … Binge Eating Disorder (Bulimia Nervosa): Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count Electrolytes – sodium, potassium, calcium Pancreatic parameters – amylase, elastase (in serum and stool), lipase. Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin. Renal parameters – urea, creatinine, cystatin C or creatinine clearance, … Binge Eating Disorder (Bulimia Nervosa): Test and Diagnosis
Therapy goals Improvement of the symptomatology Avoid complications or secondary diseases Therapy recommendations Patients with bulimia nervosa (BN) should always be treated as outpatients whenever possible. Improvement of symptoms by drug therapy is possible. In principle, BN can not be treated with medication alone. Psychotherapy and nutritional therapy must always be carried out simultaneously. Note: … Binge Eating Disorder (Bulimia Nervosa): Drug Therapy
Obligatory medical device diagnostics. Electrical impedance analysis (measurement of body compartments/body composition) – to determine body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass), and total body water including body mass index (BMI, body mass index) and waist-to-hip ratio (THV). Electrocardiogram (ECG; recording of the electrical activity of … Binge Eating Disorder (Bulimia Nervosa): Diagnostic Tests
A risk group indicates the possibility that the disease may be associated with the risk of micronutrient deficiency (vital substances). The complaint bulimia nervosa indicates a micronutrient deficiency (vital substances) for Vitamin K Selenium Zinc
To prevent bulimia nervosa (binge eating disorder), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Recurrent dieting behavior Psycho-social situation Childhood obesity (adiposity). Relationship problems Emotional neglect Food as a substitute satisfaction Low self-esteem Cultural factors Maltreatment (physical and/or sexual experience of violence). Psychiatric illness of family members Sexual abuse … Binge Eating Disorder (Bulimia Nervosa): Prevention
The following symptoms and complaints may indicate bulimia nervosa (binge eating disorder): Leading symptoms Cravings/eating binges occurring several times a week (usually secretly!) consisting of high-calorie meals followed by vomiting or the use of laxatives (laxatives), diuretics (dehydrating agents), appetite suppressants, or excessive exercise for weight loss The binge eating produces a great sense of … Binge Eating Disorder (Bulimia Nervosa): Symptoms, Complaints, Signs
Pathogenesis (development of the disease) The pathogenesis of bulimia nervosa is not yet well understood. It is thought to be a combination of genetic, sociocultural, and psychological factors. In addition, personality traits such as perfectionism and introversion are present. Furthermore, additional disturbances occur in the central nervous system that disrupt satiety regulation, further driving the … Binge Eating Disorder (Bulimia Nervosa): Causes
General measures Psychosocial integration: this mainly includes (re)integration into school. In addition, the integration in groups of peers counts to it, in order to lift the social isolation. Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in … Binge Eating Disorder (Bulimia Nervosa): Therapy
