All right, as a quick recap. Anorexia is characterized by significant food restrictions that happen at least once a week for 3 months and by a fear of gaining weight while having a BMI below 18.5. Bulimia is when somebody goes through cycles of binging and purging at least once a week for 3 months but are typically still normal weight or overweight with a BMI above 18.5. In binge-eating disorder, individuals frequently lose control over their eating and experience at least one binge eating episode a week, for three months which are not followed by purging or fasting. Rumination disorder is when individuals regurgitate food for at least one month, but without wanting to lose weight. Avoidant or restrictive food intake disorder is where people don’t seem interested in food, or they avoid it because they think it smells or tastes bad or are concerned about the consequences of eating it. In pica, individuals crave and eat strange substances like dirt or clay for at least a month. Finally, individuals who don’t fully meet the criteria can be diagnosed with “other specified eating disorder” or “unspecified eating disorder”. Standard treatment options for eating disorders include nutritional rehabilitation and psychotherapy, which involve restoring a normal weight and eating patterns, as well as changing their thoughts and beliefs about body weight and shape. Clinicians need to pay attention to the refeeding syndrome, which is when large amounts of food cause lots of insulin to be released, which promotes cellular intake of electrolytes - depleting them from the serum, which leads to severe issues such as arrhythmias. In anorexia, the target is a 2 to 3 pounds per week for hospitalized patients and 0.5 to 1 pounds per week for individuals in outpatient programs. Oral nutrition is preferred - 30 to 40 kilocalories per kilogram per day, and should include all major food groups. Other treatment options include pharmacotherapy with medications such as antidepressants to treat comorbid psychiatric disorders.
