Eating disorders assessment

K. P. (1998). The interview for the Diagnosis of Eating Disorders-IV Application to DSM-IV diagnostic criteria. Psychological Assessment, 10, 41-48. 

Although evaluation of obesity is important, the elucidation of patterns of eating behavior is the critical component in the assessment of eating-disordered obese patients. Unfortunately, it is just this aspect of the evaluation that is most often neglected in treatment programs that too narrowly focus on weight reduction. If a careful history is obtained, then BED is not difficult to diagnose. 

The newest appetite suppressant, sibutramine (Meridia), works by blocking the reuptake of both serotonin and norepinephrine. It does not stimulate nerve cells to release serotonin, as do fenfluramine and dexfenfluramine. Administered at 20 mg/ day, sibutramine effectively reduces weight in obese patients, but its use has not been assessed in eating disorder patients. The most common side effects of this medication are insomnia, dry mouth, and constipation. It has not been associated with the more serious heart and lung complications observed with fenfluramine and dexfenfluramine. Because sibutramine acts in part through modulation of norepinephrine, there is no rational basis for coadministering phentermine, which acts via this same mechanism. 

Three self-rating scales and two semistructured interview scales useful in the clinical assessment of eating disorders are summarized in Table 44.5 (Wilson and Smily, 1989). 

Fairburn, C.G. and Cooper, Z. (1993) The Eating Disorder Examination, 12th ed. In Fairburn, C.B. and Wilson, G.T., eds. Binge Eating Nature, Assessment, and Treatment. New York Guilford Press, pp. 317-360. 

Garner, D.M. (1991) Eating Disorder Inventory-2 Professional Manual. Obessa, FT Psychological Assessment Resources. 

Wilson, G.T. and Smith D. (1989) Assessment of bulimia nervosa an evaluation of the eating disorders examination. Int/ Eat Disord 8 173-179. 

TABLE 62—1. Physical and Laboratory Assessment of Eating Disorders... 

These data suggest that both NPY and PYY may be sensitive to factors regulating body weight in humans. The evidence provided by these studies, however, is not conclusive of the involvement of NPY or PYY in the pathology of such eating disorders, and is regarded by many as a simplistic view of what are highly complex diseases. Further research is needed to assess the role of these peptides in bulimia and anorexia nervosa. 

Chapter 79 Eating disorders Preparation Assessment Management What if... ... 

Table 79.1 Eating disorder medical risk assessment tadapted from Treasure 120091A Guide to the Medical Risk Assessment for Eating Disorders)...

Treasure, J. (2009) A Guide to The Medical Risk Assessment for Eating Disorders. Section of Eating Disorders, Institute of Psychiatry and Eating Disorders Unit, South London and Maudsley NHS Foundation Trust. 

Lorena is 32 and has schizoaffective disorder. Relatives found her immobile in bed last week, and she was admitted under Section 3. She didn t eat or drink over the weekend, and your consultant has asked you to assess Lorena and present a management plan. 

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