Disordered Eating (Exam 2; Dr. Yero)

Both Topiramate and Zonisamide promote weight loss in binge eating but, __(1)__ in particular helps patients with impulse control disorder while __(2)__ reduces binge eating frequency word bank: Zonisamide, Topiramate

1) Topiramate 2) Zonisamide

T/F: Although they both need to be used cautiously with cardiac abnormalities, Diethylpropion causes less insomnia than phentermine

True

T/F: Amphetamines are appetite suppressants but are no longer widely used due to their powerful stimulant effects, adverse effects, and addictive potential

True

T/F: Antidepressants are only appropriate for anorexia nervosa if depression, anxiety, and obsessions/compulsions symptoms remain after weight restoration

True

T/F: BMI is an acceptable measure of obesity and is the practical method of defining level and risk. BMI and waist circumference each can predict disease risk

True

T/F: Bulimia Nervosa (BN) is diagnosed when a patient has 1 binge per week for 3 months. Binge eating is an excessive intake of calories in a small amount of time and a sense of lack of control over eating

True

T/F: Drugs for weight loss work by increasing satiety

True

T/F: Ondansetron may be used and has shown promise in patients with bulimia nervosa but does not have enough data to support this claim. Antipsychotics and appetite suppressants have no role in bulimia nervosa

True

T/F: Oral refeeding is most common method for weight restoration in patients who are Anorexic. Severe cases we prefer nasogastric refeeding whereas Total parenteral nutrition (TPN) is reserved for severely malnourished patients

True

T/F: Prescription products are not appropriate if small amount of weight loss is needed and must be used along with dietary plan and increased physical activity. If the patient does not obtain at least 5% weight loss in 12 weeks, the drug should be discontinued

True

Drugs contraindicated only in patients with Anorexia:

-Amphetamine -Benzphetamine -Cisapride -Dextroamphetamine -Lisdexamfetamine -Phentermine

Medical complications that are common with Disordered Eating:

-Cardiac complications -Metabolic and electrolyte disturbances -Dehydration -Gastrointestinal, oropharyngeal, and dental -Hormonal changes (Female athlete triad or Suppressed estrogen) -Brain atrophy -Skeletal

What are the increase health risks in obese patients?

-Coronary heart disease -Hypertension -Stroke -Diabetes

Drugs contraindicated in both anorexia and bulimia patients:

-Ephedra, Ma Huang -Diethylpropion -Sibutramine -Bupropion -Phendimetrazine

Risk factors for eating disorders:

-Genetic predisposition -Family dynamics -Trauma and life stress (Abuse; Participation in athletics) -Societal pressure -Strong personality traits/disorders -High risk (Athletes and Victims of abuse)

Which of the following Eating Disorders occur mostly in females? (select all that apply) A) Anorexia Nervosa (AN) B) Bulimia Nervosa (BN) C) Binge Eating Disorder (BED)

A) Anorexia Nervosa (AN) B) Bulimia Nervosa (BN)

Which of the following are considered Eating Disorders? (select all that apply) A) Anorexia Nervosa (AN) B) Bulimia Nervosa (BN) C) Binge Eating Disorder (BED) D) Bipolar Disorder

A) Anorexia Nervosa (AN) B) Bulimia Nervosa (BN) C) Binge Eating Disorder (BED)

Which of the following OTC products are typically ineffective for long term weight less and can be harmful due to cardiac effects and should not be recommended? (select all that apply) A) Bitter orange B) Caffeine C) Hoodia D) Black Tea E) Green Tea F) Garcinia cambogia

A) Bitter orange B) Caffeine C) Hoodia E) Green Tea F) Garcinia cambogia

Which of the following are true about Binge eating disorder (BED)? (select all that apply) A) Features recurrent episodes of binge eating B) Distress regarding binge eating C) Lack compensatory behaviors D) Often overweight/obese E) Often underweight

A) Features recurrent episodes of binge eating B) Distress regarding binge eating C) Lack compensatory behaviors D) Often overweight/obese

Which of the following SSRI antidepressants has the most evidence of treatment in anorexia nervosa? A) Fluoxetine B) Citalopram C) Escitalopram D) Paroxetine

A) Fluoxetine

Which of the following mood characteristics matches a patient that is suffering from Bulimia Nervosa? A) Impulsive and moody B) High emotional stress C) Social withdrawal

A) Impulsive and moody

Which of the following are true about Lorcaserin? (select all that apply) A) Is a selective 5HT2C receptor agonist and a controlled substance B) Is a GLP-1 agonist and is a controlled substance C) Used for appetite suppression, and enhances satiety D) May cause headache, dizziness, constipation, fatigue, and dry mouth E) Patient should be monitored for cardiovascular outcomes and reported asap id dyspnea or edema occurs while using F) Patient must be on a support program while on this drug

A) Is a selective 5HT2C receptor agonist and a controlled substance C) Used for appetite suppression, and enhances satiety D) May cause headache, dizziness, constipation, fatigue, and dry mouth E) Patient should be monitored for cardiovascular outcomes and reported asap id dyspnea or edema occurs while using F) Patient must be on a support program while on this drug

Which of the following is true about anorexia nervosa? (select all that apply) A) It can occur due to restriction of energy intake leading to a significantly low body weight B) It can occur due to intense fear about weight gain and being "fat" or persistent behavior that interferes with weight gain C) A patient can have a distorted body image D) Anorexia is a healthy condition to be in

A) It can occur due to restriction of energy intake leading to a significantly low body weight B) It can occur due to intense fear about weight gain and being "fat" or persistent behavior that interferes with weight gain C) A patient can have a distorted body image

Which of the following are true about Naltrexone/Bupropion? (select all that apply) A) It decreases food cravings and appetite B) It is an appetite suppression and enhances satiety C) Usually involves titration by increasing the dose weekly until meeting maintenance dose D) Side effects include nausea/vomiting, headache and increased HR & BP E) Must be used cautiously with opioid use and in seizure disorders F) Part of scale down program and is coupon incentive

A) It decreases food cravings and appetite C) Usually involves titration by increasing the dose weekly until meeting maintenance dose D) Side effects include nausea/vomiting, headache and increased HR & BP E) Must be used cautiously with opioid use and in seizure disorders F) Part of scale down program and is coupon incentive

Which of the following are true about Phentermine/Topiramate ER? (select all that apply) A) It is an appetite suppression of the stimulant plus weight loss from Topiramate B) It is a controlled substance C) It is not a controlled substance due to Topiramate being in the formulation D) This drug is part of REMS due to teratogenic effect, being an effective contraception, and it is only dispensed through special pharmacies

A) It is an appetite suppression of the stimulant plus weight loss from Topiramate B) It is a controlled substance D) This drug is part of REMS due to teratogenic effect, being an effective contraception, and it is only dispensed through special pharmacies

Which of the following are true about Orlistat? (select all that apply) A) Long-term lipase inhibitor that decreases absorption of dietary fats by 30% B) Must be taken 60 or 120 mg depending on formulation with each meal containing fat or up to 1 hour after meal C) Patient must be on a low fat diet (max 30%) while taking this drug D) Side effects include GI (Flatus with discharge), fecal urgency, fatty stools E) Must be separated from fat soluble vitamins and need to supplement with a multivitamin while on this drug to prevent deficiency

A) Long-term lipase inhibitor that decreases absorption of dietary fats by 30% B) Must be taken 60 or 120 mg depending on formulation with each meal containing fat or up to 1 hour after meal C) Patient must be on a low fat diet (max 30%) while taking this drug D) Side effects include GI (Flatus with discharge), fecal urgency, fatty stools E) Must be separated from fat soluble vitamins and need to supplement with a multivitamin while on this drug to prevent deficiency

Which of the following are considered as Long-term use drugs for weight loss? (select all that apply) A) Lorcaserin B) Phentermine/Topiramite ER C) Diethylpropion D) Naltrexone/Bupropion E) Orlistat F) Liraglutide

A) Lorcaserin B) Phentermine/Topiramite ER D) Naltrexone/Bupropion E) Orlistat F) Liraglutide

Which of the following drugs can be used for anorexia nervosa and helps with relief of bloating, early satiety, abdominal pain and has no effect on weight gain? A) Metoclopramide B) Benzodiazepines C) Estrogen replacement

A) Metoclopramide

Which of the following are true about the problems patient may experience after bariatric surgery? (select all that apply) A) Patient will have a deficiency in calcium (Micronutrients) and will need to be dependent on calcium citrate because it has non-acid-dependent absorption B) Patient may have anemia and will be deficient in Vitamin B12 and iron C) May require lifelong supplementation of fat soluble vitamins due to fat malabsorption D) Patient will be able to eat as they please after this surgery E) Medications may require dosage reductions and may need to be constantly crushed, put in liquid, or used as transdermal formulation F) GI irritants must be avoided in these patients making the use of NSAIDs and Bisphosphonates very limited

A) Patient will have a deficiency in calcium (Micronutrients) and will need to be dependent on calcium citrate because it has non-acid-dependent absorption B) Patient may have anemia and will be deficient in Vitamin B12 and iron C) May require lifelong supplementation of fat soluble vitamins due to fat malabsorption E) Medications may require dosage reductions and may need to be constantly crushed, put in liquid, or used as transdermal formulation F) GI irritants must be avoided in these patients making the use of NSAIDs and Bisphosphonates very limited

Which of the following short-term use drugs for weight loss is a controlled substance that comes in IR and SR formulations, should be written for smallest quantity possible, causes a tendency for patient to regain weight after stopping treatment, should be used cautiously with hypertension and cardiac abnormalities, and should not be dosed in the evening because it is a stimulant? A) Phentermine B) Diethylpropion

A) Phentermine

_____ is an effective appetite suppression for the day and is usually dosed at 30 mg Q AM A) Phentermine B) Diethylpropion

A) Phentermine

Which of the following are true about the recommendations of weight loss? (select all that apply) A) Reduced caloric intake is necessary with women (1200-1500 kcal/day) and men (1500-1800 kcal/day) B) Increased physical activity is necessary C) Behavioral and lifestyle modifications D) The patient will require effort as well as counseling and education

A) Reduced caloric intake is necessary with women (1200-1500 kcal/day) and men (1500-1800 kcal/day) B) Increased physical activity is necessary C) Behavioral and lifestyle modifications D) The patient will require effort as well as counseling and education

Which of the following are true about using mood stabilizers for patients with bulimia nervosa? (select all that apply) A) Reserved for patients with bipolar disorder B) Must be used cautiously with lithium due to higher risk of toxicity C) Weight gain is a side effect that patients may not accept D) They will cause the patient to eat less

A) Reserved for patients with bipolar disorder B) Must be used cautiously with lithium due to higher risk of toxicity C) Weight gain is a side effect that patients may not accept

Which of the following are true about using antipsychotics for anorexia nervosa? (select all that apply) A) They help to reduce obsessive and paranoid thoughts B) They help cure anorexia C) They cause a weight increase D) They help with reduction of comorbid anxiety and depressive symptoms

A) They help to reduce obsessive and paranoid thoughts C) They cause a weight increase D) They help with reduction of comorbid anxiety and depressive symptoms

Which of the following are physical signs of Anorexia Nervosa? (select all that apply) A) Underweight B) Russell's sign (calluses on the knuckles) C) Lanugo D) Dental erosion E) Overweight

A) Underweight B) Russell's sign (calluses on the knuckles) C) Lanugo D) Dental erosion

Due to Bariatric surgery, a patient may have increased risk of gallstones due to rapid weight loss. If this occurs they may use ____ to help in this situation unless the gallbladder is removed then there is no issue. A) Ursodiol B) Sucralfate C) Creon D) Pepcid

A) Ursodiol

Which of the following drugs may be given as a low-dose and short acting formulation for an anorexic patient to be given before meals to help with anxiety that limits eating? A) Metoclopramide B) Benzodiazepines C) Estrogen replacement

B) Benzodiazepines

Which of the following short-term use drugs for weight loss stimulates NE release, decreases appetite and food intake and is considered a controlled substance? A) Phentermine B) Diethylpropion

B) Diethylpropion

Which of the following mood characteristics matches a patient that is suffering from Binge eating disorder? A) Impulsive and moody B) High emotional stress C) Social withdrawal

B) High emotional stress

Which part of the brain is referred to as the "hunger" center? A) Pituitary Gland B) Hypothalamus C) Parietal Lobe D) Frontal Lobe

B) Hypothalamus

Which of the following are true about Liraglutide? (select all that apply) A) Is a selective 5HT2C receptor agonist B) Is a GLP-1 receptor agonist C) Used to increase satiety which leads to weight loss D) Must be injected in the abdomen, thigh, or upper arm and can be administered at any time of day without regard to meals E) Side effects include Nausea (even at lower doses), tachycardia, hypoglycemia

B) Is a GLP-1 receptor agonist C) Used to increase satiety which leads to weight loss D) Must be injected in the abdomen, thigh, or upper arm and can be administered at any time of day without regard to meals E) Side effects include Nausea (even at lower doses), tachycardia, hypoglycemia

Which of the following is FDA approved for binge eating disorder (BED)? A) Fluoxetine 60 mg/day B) Lisdexamfetamine 50-70 mg daily C) Amphetamine 10 mg/day D) Escitalopram 20 mg daily

B) Lisdexamfetamine 50-70 mg daily

Which of the following drugs are considered to be short-term use for weight loss? (select all that apply) A) Lorcaserin B) Phentermine C) Diethylpropion D) Phentermine/Topiramate E) Amphetamines

B) Phentermine C) Diethylpropion E) Amphetamines

Which of the following drugs are used for an anorexic patient but is not recommended? A) Metoclopramide B) Benzodiazepines C) Estrogen replacement

C) Estrogen replacement

Which of the following SSRIs is the only FDA approved medication to be used for bulimia nervosa? A) Citalopram 20 mg/day B) Sertraline 100 mg/day C) Fluoxetine 60 mg/day D) Escitalopram 10 mg/day

C) Fluoxetine 60 mg/day

What is the most common form of purging? A) Frequent urination B) Frequent diarrhea C) Self-induced vomiting

C) Self-induced vomiting

Which of the following mood characteristics matches a patient that is suffering from Anorexia Nervosa? A) Impulsive and moody B) High emotional stress C) Social withdrawal

C) Social withdrawal

What increases food intake stimuli in the hypothalamus region of the brain? A) Serotonin B) Dopamine C) Norepinephrine D) Orexin

D) Orexin

T/F: Patients with wasted heart muscle and bradycardia that are suffering from an eating disorder should not avoid exercise and caffeine

False