Other Eating Disorders

Snapshot

• A young woman who is 4 months pregnant comes into her primary care physician to discuss an unusual craving. She reluctantly admits that, for the past five weeks, she has been consuming large amounts of ice. She will often prefer to eat ice instead of food. She has never experienced this craving before, and eating ice is not a part of any of her social customs. She and her husband are both concerned about this behavior. (Pica)

Binge Eating Disorder

• Definition  
  • recurrent episodes of binge eating
    • eating a large amount of food in a discrete period of time
    • a feeling of loss of control during episode
  • no compensatory behaviors
  • episodes occur at least once a week for 3 months
• Epidemiology
  • F > M
• associated with other psychopathologies

Pica

• Definition
  • repeatedly craving and eating non-food products, such as chalk, dirt, hair
    • intense craving and consumption of ice (pagophagia) is associated with iron deficiency 
  • inappropriate to developmental level or culture
  • occurs for at least 1 month
  • may be associated with other conditions, such as autism
• Complications
  • anemia
  • malnutrition
  • electrolyte abnormalities
  • constipation
  • exposure to toxins
  • infections
• Epidemiology
• most common in pregnant women and school-age children

Rumination

• Definition
  • repeated regurgitation of food that is not due to a gastrointestinal issue or an underlying eating disorder
• occurs for at least 1 month

Avoidant/Restrictive Food Intake Disorder

• Definition
  • avoiding or restricting food intake for a variety of reasons
    • disinterest in food
    • negative experience with eating
    • not caused by fear of weight gain, body dysmorphia, the unavailability of food, or social custom
  • associated with negative consequences
    • significant weight loss in adults or poor weight gain in children
    • malnutrition
    • supplemental feeding requirement to maintain health
    • psychosocial dysfunction
• Epidemiology
  • among adolescents with eating disorders, patients with avoidant/restrictive food intake disorder are more likely to be male than patients with anorexia nervosa
• onset usually occurs in infancy or early childhood

Other Specified Feeding or Eating Disorder

• Definition
  • symptoms or behavior surrounding foods that cause significant distress but do not meet full criteria for another eating disorder
  • can present with refeeding syndrome when patients are rapidly refed 
    • seen as hypokalemia and hypocalcemia due to rapid intracellular shift with insulin activity