Enhance your skills to identify and manage eating disorders with wise counsel from Dr. Rosalind Kaplan, Associate Professor of Clinical Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women’s Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified.
Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak.
Goal: Listeners will recognize common eating disorders, the basics of management, and how to recognize who needs hospital admission.
After listening to this episode listeners will…
Disclosures: Dr. Kaplan reports no relevant financial disclosures
01:19 Listener feedback
02:43 Picks of the week
06:50 Topic intro and guest bio
09:10 Getting to know our guest
15:18 Clinical case
20:15 Broad overview of eating disorders
26:40 Eating disorder not otherwise specified
29:19 Underreporting and under diagnosis in men
30:25 Who to screen and how to do it
34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory
38:42 Initial lab workup for eating disorders
42:38 Bone density screening, treatment
45:41 Back to the case: Initial patient counseling
49:22 Medical therapy
52:20 Can we use bupropion?
54:02 What’s the role for primary care?
58:14 Hyponatremia in eating disorders
60:34 Complications of purging
66:25 How to be an ally for your patient
69:12 Treatment for binge eating
72:51 Take home points
Links from the show:
Mystery Team (film) 2008 on Amazon
Rain Main (film) 1988 on Amazon
How We Learn (book) by Benedict Carey
Scoff questionnaire: https://doi.org/10.1136/bmj.319.7223.1467
ESP questionnaire: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1494802/
Eating Disorders in the Primary Care Setting: https://www.ncbi.nlm.nih.gov/pubmed/27262009
The Patient in the White Coat: My Odyssey from Health to Illness and Back by Rosalind Kaplan: https://www.amazon.com/Patient-White-Coat-Odyssey-Illness/dp/1607146940/ref=sr_1_1?ie=UTF8&qid=1504449109&sr=8-1&keywords=the+patient+in+the+white+coat+kaplan
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