1. Community Medicine Lec - 10 -
بسم الله الرحمن الرحيم
Community Medicine
Lec

2. Learning objectives
At the end of this lecture student would be able to :
1-Identify anorexia nervosa & bulimia as the most common eating disorders .
2-Describe population at risk for such disorders .
3-Identify the prevalence of such disorders among different population groups .
4-Mention the main diagnostic criteria of such disorders .
5-Outline the main differences between both disorders .
6-Enumerate common causes & classes of malnutrition health problems .
To a level accepted to the accreditation standard of the College .

3. Anorexia Nervosa and Bulimia
۞Anorexia nervosa and bulimia are eating disorders in young , previously healthy , women who develop a paralyzing fear of becoming fat.
۞Population at risk consist largely of white women from middle-class backgrounds . Rarely occurs in black or oriental poor women or in men.
۞The driving force is the pursuit of thinness , all other aspects of life being secondary.
۞In anorexia nervosa ,there is a radical restriction of caloric intake ,the end result will be emaciation.
۞In bulimia ,massive being eaten followed by vomiting and excessive use of laxatives .
Weight loss , however is not great despite the obsession with food.

4. ۞Prevalence of anorexia nervosa is
۞Some authors consider anorexia nervosa and bulimia to be distinct illnesses , while others classify bulimia as variant of anorexia nervosa . However , both disorders are different expressions of a psychological obsession with body weight .
۞Prevalence of anorexia nervosa is
/100,000 population
1% among adolescent white risky women.
5% sub-clinical among highest risk group

5. ۞Vomiting after eating may occur in 18% of college female students.
Self induced vomiting is 1-2%
Full-blown bulimia is less frequent.
۞Diagnosis is made on clinical grounds . No specific diagnostic tests exist.

6. Diagnostic criteria :-
1.Weight loss by 15-25% of expected ideal weight .
2.Intense fear of gaining weight or becoming fat even when under-weight.
3.Disturbance in the way , body weight ,size or shape is experienced by the individual “feels fat”.
4.Primary or secondary amenorrhea for at least three consecutive periods.
5.Absence of organic or psychiatric illness that might account for failure to eat.
6.Denial of hunger , fatigue or emaciation.

8. Malnutrition Diseases
Food security is the main world health problem in most of developing countries.
About 450 million people are suffering from sever malnutrition all over the world.
15-20 million individuals are dying yearly from hunger related problems.
Causes of malnutrition health problems are:-
1.Poverty. 2.Population growth. 3.Soil deterioration and bad farming. 4.Political problems. 5.Mal-distribution of food supply.

9. classification Groups of malnutrition diseases
1.Protein -energy malnutrition .
2.Nutritional anemia .
3.Vitamin A deficiency among children.
4.Endemic deficiencies such as goiter , rickets , ……etc.