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University of Manitoba
Biochem. and Medical Genetics
BGEN 3020
Jason Leboe- Mcgowan

Lecture 13 Eating disorders – includes obesity, anorexia, bulimia Difference between anorexia and bulimia? Anorexia Distorted body image; women with anorexia can have distorted image; control issue; they have lost control of everything in their life, and the only thing that they can control over is what they put in their mouth. With a decrease of body fat and wt, GnRH decreases, therefore FSH and LH also decrease, leading to low estrogen; as a result, amenorrhea occurs, AND predisposes to osteoporosis, as if pt is postmenopausal. Anorexic people will eventually develop osteoporosis. Rx – convince person to gain enough wt to bring period back; not birth control. (ie first step in management of HP/diabetes = wt loss; as you lose adipose, you upregulate insulin resistance). In anorexia, usually die to cardiac dz (heart failure: heart just stops). Bulimia Nervosa 1. Metabolic Alkalosis: It’s not a body image problem – they can be obese, normal or thin (no weight issue); however, they binge (eat a lot), then force themselves to vomit. Pic on boards: from vomiting, wear down enamel on teeth; so, brownish stuff seen on teeth is just dentine (erosions seen on teeth). Metabolic alkalosis from forced vomiting will be seen. Metabolic alkalois is bad b.c there is a left shift curve, and the compensation is resp acidosis, which drops pO 2 therefore will get hypoxia with metabolic alkalosis, and the heart do not like that. The heart already with low O w2ll get PVC’s (pre-mature ventricular contractions), RRT phenom, then V-fib, then death. Therefore, met alkalosis is very dangerous in inducing cardiac arrythmias, and this commonly occurs in bulimics due to forced vomiting. Pt can also vomit out blood – Mallory Weiss Syndrome – tear in distal esophagus or proximal stomach. 2. Borhav
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