Materiały źródłowe

• #1 Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html

  Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). […] The DSM-5 diagnostic criteria for anorexia nervosa are similar to the previous DSM-IV criteria with respect to behavioral and psychological characteristics involving restriction of food intake resulting in low body weight, intense fear of gaining weight or becoming fat, and disturbance of body image. Notably, the DSM-5 criteria do not refer to a specific degree of weight loss required for the diagnosis, but instead provide guidelines for specifying the severity of weight loss. As in the DSM-IV, the new criteria specify two diagnostic types of anorexia nervosa (restricting type and binge eating/purging type). In a significant revision to previous criteria, diagnosis of anorexia nervosa no longer requires the presence of amenorrhea.

• #2 The Diagnosis and Treatment of Eating Disorders

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3221424/

  Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). […] The main symptom of anorexia nervosa (AN) is self-induced malnutrition with weight loss that may amount to cachexia. According to the diagnostic criteria, the body weight is so low that health impairment is to be feared. In adults, this danger is seen when the body mass index (BMI) drops below 17.5kg/m2; in children and adolescents, it corresponds to being below the 10th BMI-for-age percentile. […] Diagnosis of an eating disorder requiring treatment should be on the basis of positive screening according to the criteria of ICD-10 (2) or DSM-IV (4) (Box 2). […] The diagnosis binge eating disorder (BED) was incorporated by the American Psychiatric Association in the fourth revision of the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV) in 1994 (5); in the International Classification of Diseases (ICD-10) it can only be coded under the category eating disorder, unspecified (F50.9).

• #3 Anorexia Nervosa – National Eating Disorders Association

  https://www.nationaleatingdisorders.org/anorexia-nervosa/

  To be diagnosed with anorexia nervosa (AN) according to the DSM-5 TR, the following criteria must be met: […] Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. […] Intense fear of gaining weight or becoming fat, even though underweight. […] Disturbance in the way in which ones body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. […] Even if all the DSM-5 criteria for anorexia nervosa are not met, a serious eating disorder can still be present. […] Atypical anorexia includes those individuals who meet the criteria for anorexia but who are not underweight despite significant weight loss. […] Research studies have not found a difference in the medical and psychological impacts of anorexia nervosa and atypical anorexia nervosa.

• #4 McCallum Place | DSM 5 Diagnostic Criteria for Eating Disorders

  https://www.mccallumplace.com/admissions/dsm-5-diagnostic-criteria/

  Restriction of energy intake leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health […] Intense fear of gaining weight, even though underweight […] Body image disturbance, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight […] The only way to determine if you or a loved one has developed an eating disorder is to complete a thorough assessment with a qualified healthcare provider. […] At McCallum Place, we conduct thorough assessments for all clients to identify any co-occurring mental health, behavioral health, or psychiatric concerns. […] We treat individuals who have developed any eating disorder that is listed in the DSM-5, including: Anorexia nervosa. […] Significant improvement in eating disorder symptoms, reduced binge eating, purging, restriction, anxiety, depression, and improved mindset upon discharge. Average BMIs greater than 20 upon discharge for clients with Anorexia Nervosa.

• #5 Table 19, DSM-IV to DSM-5 Anorexia Nervosa Comparison – DSM-5 Changes – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/

  A. Refusal to maintain bodyweight at or above minimally normal weight for height/age (less than 85th percentile). […] A. Restriction of energy intake relative to requirements, leading to a significant low body weight in the context of the age, sex, developmental trajectory, and physical health (less than minimally normal/expected1). […] B. Intense fear of gaining weight or becoming obese, even though underweight. […] B. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain. […] C. Disturbed by ones body weight or shape, self-worth influenced by body weight or shape, or persistent lack of recognition of seriousness of low bodyweight. […] D. In menstruating females, absence of at least 3 consecutive non-synthetically induced menstrual cycles.

• #6 Anorexia nervosa – Wikipedia

  https://en.wikipedia.org/wiki/Anorexia_nervosa

  Anorexia nervosa is classified under the Feeding and Eating Disorders in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). There is no specific BMI cut-off that defines low weight required for the diagnosis of anorexia nervosa. […] The diagnostic criteria for anorexia nervosa (all of which needing to be met for diagnosis) are: Restriction of energy intake relative to requirements leading to a low body weight. (Criterion A) Intense fear of gaining weight or persistent behaviors that interfere with gaining weight. (Criterion B) Disturbance in the way a person’s weight or body shape is experienced or a lack of recognition about the risks of the low body weight. (Criterion C) […] Relative to the previous version of the DSM (DSM-IV-TR), the 2013 revision (DSM5) reflects changes in the criteria for anorexia nervosa. Most notably, the amenorrhea (absent period) criterion was removed.

• #7 Diagnosis and Assessment Issues in Eating Disorders

  https://www.psychiatrictimes.com/view/diagnosis-and-assessment-issues-eating-disorders

  Anorexia nervosa was first included in DSM-III and ICD-9. The key clinical criterion in anorexia nervosa is a significantly low body weight. However, the level at which body weight is considered significantly low has evolved. DSM-5 criteria for low weight consider what is normal for ones age, sex, physical health, and developmental trajectory. Severity level may be assigned based on specified BMI. Previously, the weight criteria were criticized for being arbitrary because the criterion of 15% below ideal body weight was not empirically derived. ICD-10 (F50.0) quantifies low weight as at least 15% below what is expected or a BMI of 17.5 or lower. […] Criteria from DSM-5 and ICD-10 recognize a fear of gaining weight and significant body image disturbance as essential features. One major change in DSM-5 is the removal of the amenorrhea criterion, which was criticized for not being applicable to males or prepubescent females. Moreover, the presence of amenorrhea does not differentiate severity of psychopathology. ICD-10, however, still acknowledges that amenorrhea may be present in females with anorexia nervosa. Anorexia nervosa is divided into 2 subtypes:

• #8 Diagnosis and Assessment Issues in Eating Disorders

  https://www.psychiatrictimes.com/view/diagnosis-and-assessment-issues-eating-disorders

  Restricting type (F50.01): the patient has refrained from binge eating and/or purging in the past 3 months […] Binge-eating/purging type (F50.02): characterized by recurrent episodes of bingeing and/or purging over the past 3 months. […] Some additional guidance for determining low weight has been added to the criteria for anorexia nervosa in DSM-5. However, it still may be somewhat subjective and may be difficult to assess without obtaining a patients growth charts. […] When diagnosing an eating disorder, it is important to ensure that symptoms such as low weight or vomiting are not due to a medical condition (eg, gastrointestinal condition, hyperthyroidism). Typically, patients with medical conditions responsible for low weight and/or vomiting do not present with significant concern for shape and weight.

• #9 Table 19, DSM-IV to DSM-5 Anorexia Nervosa Comparison – DSM-5 Changes – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/

  Severity is based on body mass index (BMI) derived from World Health Organization categories for thinness in adults; corresponding percentiles should be used for children and adolescents: Mild: BMI greater than or equal to 17 kg/m2, Moderate: BMI 1616.99 kg/m2, Severe: BMI 1515.99 kg/m2, Extreme: BMI less than 15 kg/m2. […] Purging is self-induced vomiting or misuse of laxatives, diuretics, or enemas.

• #10 DSM-5-TR Guided Film Preview Anorexia Nervosa – Symptom Media

  https://symptommedia.com/dsm-5-guided-anorexia-nervosa-binge-eating-purging-film-preview/

  The DSM-5-TR defines both subtypes of anorexia nervosa with three major criteria: Restriction: A person with anorexia nervosa will significantly restrict their calorie intake, which leads them to develop a low body weight relative to their size, gender, and age. Fear: Those with anorexia fear gaining weight. They will engage in behaviors to avoid gaining weight, even though these fears are unfounded. Lack of recognition: Many people who suffer with anorexia nervosa cannot recognize or acknowledge that they are underweight or have a medical problem. Even when they are severely underweight, they will not recognize the severity of their condition. […] The DSM-5-TR further defines anorexia nervosa by severity — a person with a body mass index (BMI) of less than 15 is classified as having an “extreme” disorder.

• #11 Anorexia Nervosa – National Eating Disorders Association

  https://www.nationaleatingdisorders.org/anorexia-nervosa/

  To be diagnosed with anorexia nervosa (AN) according to the DSM-5 TR, the following criteria must be met: […] Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. […] Intense fear of gaining weight or becoming fat, even though underweight. […] Disturbance in the way in which ones body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. […] Even if all the DSM-5 criteria for anorexia nervosa are not met, a serious eating disorder can still be present. […] Atypical anorexia includes those individuals who meet the criteria for anorexia but who are not underweight despite significant weight loss. […] Research studies have not found a difference in the medical and psychological impacts of anorexia nervosa and atypical anorexia nervosa.

• #12 What Is Atypical Anorexia Nervosa? | Definition & Criteria

  https://withinhealth.com/learn/articles/atypical-anorexia-nervosa

  Atypical anorexia nervosa is categorized in the DSM-5 as an Other Specified Feeding or Eating Disorder (OSED). […] Atypical anorexia nervosa is a newer diagnostic category for eating disorders in the DSM-5, so careful diagnosis is a critical part of proper healing. […] To correctly diagnose atypical anorexia nervosa, there are a few things that the clinician needs to take into account. […] In diagnosing atypical anorexia nervosa, an individual’s weight may be considered part of the evaluation process. […] However, if an individual meets any of the below-mentioned criteria, though are not considered underweight, they are more likely to receive a diagnosis of atypical anorexia nervosa. […] The American Psychiatric Association has defined the following signs and symptoms for the disorder.

• #13 Medical complications and management of atypical anorexia nervosa | Journal of Eating Disorders | Full Text

  https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00720-9

  Atypical anorexia nervosa (AAN) is a new diagnosis in the 5th edition of the Diagnostic and Statistical Manual. […] Because current weight is in the normal range, the diagnosis of an eating disorder is often missed under the false assumption that people of normal weight cannot have an eating disorder. […] However, the medical complications in patients with AAN can be just as severe as those with classic AN and the degree of eating disorder psychopathology can be even more severe. […] To date, studies of the medical complications of eating disorders have largely focused on AN, here we review the literature regarding medical complications of AAN. […] It is worth noting that the medical complications associated with AAN are similar, if not, in some cases, more severe than those associated with typical AN.

• #14 What Is Atypical Anorexia Nervosa? – Child Mind Institute

  https://childmind.org/article/what-is-atypical-anorexia-nervosa/

  The patient has a pattern of obsessive, dangerous weight loss but is not underweight […] Atypical anorexia nervosa is a type of anorexia nervosa that’s often not noticed because the person doesn’t look very thin. They have all the symptoms of anorexia — obsessed with extreme dieting and exercise to the point of putting severe stress on their body — except that since they were overweight when they started, they’re not underweight. […] Atypical anorexia is dangerous because it’s often not recognized — families and even doctors might be praising a young woman for impressive weight loss when she is actually critically unwell. […] The atypical anorexia nervosa diagnosis is fairly new, but cases have been seen for decades. […] Atypical anorexia nervosa is a relatively new diagnosis. It was officially codified as a type of anorexia in DSM-5, which was published in 2013.

• #15 How To Be Diagnosed With Anorexia Nervosa | Nourish

  https://www.usenourish.com/anorexia/anorexia-diagnosis

  Atypical anorexia is a newer diagnosis, previously known as subthreshold anorexia. […] It occurs when a person meets all of the DSM-5 criteria for anorexia, except they are not significantly underweight. […] Atypical anorexia is an important diagnosis option because it helps more people with anorexia to be appropriately diagnosed and treated. […] Research shows it has similar health implications as traditional anorexia nervosa. […] This means they might be living with anorexia for much longer and experience severe medical issues as a result. […] The addition of the atypical anorexia diagnosis also helps to fight against the stereotype that all people with anorexia are emaciated and severely underweight.

• #16 Anorexia nervosa – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/diagnosis-treatment/drc-20353597

  If your healthcare professional thinks that you have anorexia nervosa, you may have several tests and exams to pinpoint a diagnosis, rule out medical causes for the weight loss and check for any related complications. […] These exams and tests generally include: […] Physical exam. This exam includes measuring your height and weight and checking your vital signs. Vital signs include heart rate, blood pressure and temperature. Usually, the exam also includes checking skin and nails for problems, listening to the heart and lungs, and looking at the stomach area. […] Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein, as well as the function of your liver, kidney and thyroid. A urine test also may be done. […] Mental health evaluation. Your healthcare professional likely will ask about your thoughts, feelings and eating habits. Your healthcare professional also may ask you to answer a series of questions about your health. […] Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. An electrocardiogram may be done to look for heart issues.

• #17 Diagnosis of Eating Disorders in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html

  Because family physicians serve as primary care providers for a large percentage of adolescents, they have an important role in diagnosing these disorders. […] It is also important to aggressively treat patients who have traits of eating disorders but who do not meet the full criteria for anorexia or bulimia. […] A wide variety of medical problems can masquerade as eating disorders. […] The medical history is the most powerful tool for diagnosing eating disorders. […] All patients in high-risk categories for eating disorders should be screened during routine office visits. […] Accurate weight measurements are important in diagnosing an eating disorder. […] Laboratory findings might be completely normal, but targeted laboratory testing can be helpful to rule out medical illness.

• #18 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  A healthcare provider can diagnose anorexia nervosa based on the criteria for it listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The three criteria include: […] The DSM-5 criteria classify the severity of anorexia according to body mass index (BMI). People who meet the criteria for anorexia but don’t have underweight despite significant weight loss have atypical anorexia. […] If you have signs and symptoms of anorexia, a provider will do a complete medical history and physical exam. The provider will likely ask questions about your: […] A person with anorexia or any eating disorder will have the best recovery outcome if they receive an early diagnosis. If you or someone you know is experiencing signs and symptoms of anorexia, be sure to talk to a provider as soon as possible.

• #19 Anorexia Treatment in New Jersey

  https://www.rwjbh.org/treatment-care/mental-health-and-behavioral-health/conditions/eating-disorders/anorexia-nervosa/

  Although there are no specific tests to diagnose anorexia, a comprehensive evaluation, including medical history, physical exam, various diagnostic tests and a mental health assessment can help pinpoint a diagnosis. […] Health care providers will explore a diagnosis of anorexia from many angles including: dietary history, exercise history, psychological history, body image, bingeing and purging frequency and elimination habits (use of diet pills, laxatives and supplements), family history of eating disorders, menstrual status (if your periods are regular or irregular), medication history. […] Early diagnosis is important to achieve the best recovery outcome. If you or someone you know is experiencing signs and symptoms of anorexia, be sure to talk to a health care provider as soon as possible. RWJBarnabas Health is here to help.

• #20 Anorexia Nervosa | Types, Symptoms, Causes, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/a/anorexia-nervosa

  Anorexia cant be diagnosed by any test or lab result. The doctor will do a physical exam and rule out other causes of weight loss. There will also be an in-depth psychological assessment. […] Your child may see any of these care team members: Medical doctors who are experts in the care of teens, Mental health experts such as: Child psychiatrists, Child psychologists, Mental health therapists, Registered dietitians who are experts in nutrition.

• #21 Diagnosing Eating Disorders in Children & Adolescents | NYU Langone Health

  https://nyulangone.org/conditions/eating-disorders-in-children-adolescents/diagnosis

  Most children and teens who have an eating disorder, especially anorexia, resist being diagnosed and may withhold or provide misleading information. Our specialists work as a team with family members and other people close to the child to assess his or her condition and arrive at an accurate diagnosis. […] For a diagnosis of anorexia nervosa, for instance, a person’s body weight must consistently be significantly below what is healthy, either through weight loss or a failure to gain weight. […] A doctor determines during the evaluation if a person is troubled by weight gain or the prospect of being fat, even though he or she is thin. The expert also looks for evidence of an unrealistic body image or denial of the severity of the condition. […] Many children and teens have some or most of the above symptoms without meeting the full criteria for one of these disorders. For example, a teen may show all symptoms of anorexia nervosa at a normal weight if he or she was previously overweight or obese. People with some, but not all, of the symptoms associated with an eating disorder may still be at risk of medical or psychological problems, and may require evaluation and treatment.

• #22 Anorexia nervosa – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/diagnosis-treatment/drc-20353597

  If your healthcare professional thinks that you have anorexia nervosa, you may have several tests and exams to pinpoint a diagnosis, rule out medical causes for the weight loss and check for any related complications. […] These exams and tests generally include: […] Physical exam. This exam includes measuring your height and weight and checking your vital signs. Vital signs include heart rate, blood pressure and temperature. Usually, the exam also includes checking skin and nails for problems, listening to the heart and lungs, and looking at the stomach area. […] Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein, as well as the function of your liver, kidney and thyroid. A urine test also may be done. […] Mental health evaluation. Your healthcare professional likely will ask about your thoughts, feelings and eating habits. Your healthcare professional also may ask you to answer a series of questions about your health. […] Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. An electrocardiogram may be done to look for heart issues.

• #23 Anorexia | Diagnosis, DSM-5 Criteria, Exams, Tests

  https://www.waldeneatingdisorders.com/what-we-treat/anorexia/anorexia-diagnosis/

  According to the DSM-5, diagnostic criteria for anorexia includes: […] If your doctor suspects that you have anorexia, they will typically run several exams and tests to help narrow down a diagnosis, eliminate other medical causes for weight loss or other symptoms, and check for any related complications. […] Physical Exam. This may include measuring your height and weight, checking your vital signs, such as heart rate, blood pressure and temperature, checking your skin and nails, listening to your heart and lungs, and examining your abdomen. […] Lab Tests. These may include a complete blood count and more specialized tests to check electrolytes and protein, as well as liver, kidney and thyroid functions. A urinalysis may also be performed. […] Psychological Evaluation. A therapist or mental health provider will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete a psychological self-assessment questionnaire.

• #24 Red flags and diagnostic criteria for eating disorders – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/eating-disorder-diagnostic-criteria/

  One of the main OSFED classifications is atypical anorexia, which has the same self-esteem and body image features of classic anorexia and the same restricted intake, but weight is normal. […] Clues of anorexia during a physical exam include flattened affect or a depressed state, pale skin, dry skin, cachexia and facial wasting, decreased muscle mass, thinning hair, and lanugo at the nape of the neck or the backs of the arms. […] Hospitalization is warranted if the heart rate is 40 or below, total blood pressure of 80/50 or less, and orthostatic changes in pulse higher than 20 beats per minute or orthostatic change in blood pressure greater than 10 mmHg. […] Eating disorders are the second deadliest DSM diagnosis, with about half the deaths coming from suicide. The mortality for anorexia is 5% to 6%. Early identification of an eating disorder is associated with better outcomes, making early diagnosis critical. […] “It can be very hard to overcome if the patient gets stuck in that state of starvation for years on end,” Dr. Krause said. “Early intervention is key.”

• #25 Anorexia nervosa – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/diagnosis-treatment/drc-20353597

  If your healthcare professional thinks that you have anorexia nervosa, you may have several tests and exams to pinpoint a diagnosis, rule out medical causes for the weight loss and check for any related complications. […] These exams and tests generally include: […] Physical exam. This exam includes measuring your height and weight and checking your vital signs. Vital signs include heart rate, blood pressure and temperature. Usually, the exam also includes checking skin and nails for problems, listening to the heart and lungs, and looking at the stomach area. […] Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein, as well as the function of your liver, kidney and thyroid. A urine test also may be done. […] Mental health evaluation. Your healthcare professional likely will ask about your thoughts, feelings and eating habits. Your healthcare professional also may ask you to answer a series of questions about your health. […] Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. An electrocardiogram may be done to look for heart issues.

• #26 Anorexia | Diagnosis, DSM-5 Criteria, Exams, Tests

  https://www.waldeneatingdisorders.com/what-we-treat/anorexia/anorexia-diagnosis/

  According to the DSM-5, diagnostic criteria for anorexia includes: […] If your doctor suspects that you have anorexia, they will typically run several exams and tests to help narrow down a diagnosis, eliminate other medical causes for weight loss or other symptoms, and check for any related complications. […] Physical Exam. This may include measuring your height and weight, checking your vital signs, such as heart rate, blood pressure and temperature, checking your skin and nails, listening to your heart and lungs, and examining your abdomen. […] Lab Tests. These may include a complete blood count and more specialized tests to check electrolytes and protein, as well as liver, kidney and thyroid functions. A urinalysis may also be performed. […] Psychological Evaluation. A therapist or mental health provider will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete a psychological self-assessment questionnaire.

• #27 Eating Disorders

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/

  The essential features of anorexia nervosa are refusal to maintain a minimally normal body weight, intense fear of gaining weight, and significant disturbance in the perception of the shape or size of one’s body. […] In addition to the clinical interview, the Eating Attitudes Test, Eating Disorders Inventory, Body Shape Questionnaire, and others can be used to assess eating disorders. […] Common comorbid conditions include major depressive disorder or dysthymia (50% to 75%), sexual abuse (20% to 50%), obsessive-compulsive disorder (25% with anorexia nervosa), substance abuse (12% to 18% with anorexia nervosa, especially the binge-purge subtype, and 30% to 37% with bulimia nervosa), and bipolar disorder (4% to 13%). […] Medical illnesses include brain tumors, including craniopharyngioma, and other malignancies, gastrointestinal disease, and acquired immunodeficiency syndrome.

• #28 Testing & Assessments for Eating Disorders

  https://www.eatingdisorderhope.com/information/eating-disorder/testing-assessments

  Eating disorders are more commonly discussed in our culture, however, much of what people believe they understand about eating disorders is false. Identifying, diagnosing, and treating these disorders is much more complicated than many assume. […] To diagnose eating disorders, doctors, therapists, and psychiatrists must consider specific criteria that are identified and can be measured using psychological assessments as well as physical examinations. […] Doctors can utilize physical examinations to determine the presence of eating disorder behaviors as well as their severity. An individual’s labs and vital signs can indicate that an individual is malnourished or engaging in binge/purge behaviors. […] Psychological evaluations can go beyond diagnostic criteria to learn more about the specific beliefs regarding food, body, weight, and self-worth and how these relate to eating disorder behaviors.

• #29 Anorexia Diagnosis: Tests, Screening, and Criteria

  https://www.verywellhealth.com/anorexia-diagnosis-5181747

  Tests may be performed to rule out other health conditions that could be causing weight loss and other symptoms, or to check for problems that may have arisen as a result of anorexia. […] One point is given for every yes answer. A score of two or higher indicates a likelihood of anorexia nervosa or bulimia nervosa and that the person should see a healthcare provider for further steps. […] Diagnostic tools such as screening tests, physical and psychological examinations, and other health procedures can help determine if you or someone you love is experiencing disordered eating such as anorexia.

• #30 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  Laboratory tests alone can’t diagnose anorexia. But your healthcare provider may use various tests to rule out any medical conditions that could cause weight loss. Tests can also evaluate the physical effects of anorexia. […] These tests may include: […] Hospitalization might be necessary to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications. […] The most serious complication of treating anorexia is a condition called refeeding syndrome. It can happen when a seriously malnourished person begins to receive nutrition again. […] Since refeeding syndrome can have serious and life-threatening side effects, people with anorexia need to receive medical treatment and/or guidance.

• #31 Anorexia nervosa – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/diagnosis-treatment/drc-20353597

  If your healthcare professional thinks that you have anorexia nervosa, you may have several tests and exams to pinpoint a diagnosis, rule out medical causes for the weight loss and check for any related complications. […] These exams and tests generally include: […] Physical exam. This exam includes measuring your height and weight and checking your vital signs. Vital signs include heart rate, blood pressure and temperature. Usually, the exam also includes checking skin and nails for problems, listening to the heart and lungs, and looking at the stomach area. […] Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein, as well as the function of your liver, kidney and thyroid. A urine test also may be done. […] Mental health evaluation. Your healthcare professional likely will ask about your thoughts, feelings and eating habits. Your healthcare professional also may ask you to answer a series of questions about your health. […] Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. An electrocardiogram may be done to look for heart issues.

• #32 Anorexia nervosa – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/440

  Other diagnostic factors include general fatigue, weakness, and poor concentration, significant preoccupation with thoughts of food, orthostatic hypotension, nonspecific gastrointestinal symptoms, cardiac symptoms and signs, changes to hair, skin, and nails, dependent edema, and osteopenia or osteoporosis. […] 1st tests to order include clinical diagnosis, CBC, serum chemistry, thyroid function tests, liver function tests, blood glucose, and urinalysis. […] Tests to consider include Sick, Control, One, Fat, and Food (SCOFF) questionnaire, ECG, bone densitometry (dual-energy x-ray absorptiometry), estradiol in females, testosterone in males, and urine or serum pregnancy test.

• #33 Anorexia Nervosa Workup: Approach Considerations, CBC and ESR, Blood Chemistries

  https://emedicine.medscape.com/article/912187-workup

  Because an eating disorder is a clinical diagnosis, no definitive diagnostic tests are available for anorexia nervosa. However, given the multi-organ system effects of starvation, a thorough medical evaluation is warranted. Basic tests include the following: […] Thyroid function tests, prolactin, and serum follicle-stimulating hormone (FSH) levels can differentiate anorexia nervosa from alternative causes of primary amenorrhea. […] The ESR is normal in anorexia nervosa. Therefore, elevations should prompt a search for an organic etiology, such as neuropsychiatric involvement including affective disorders, psychosis, cognitive dysfunction, and steroid-induced anorexia nervosa in adolescents with systemic lupus erythematosus (SLE), which may be triggered by steroid-induced changes in weight and body shape.

• #34 Anorexia Nervosa Workup: Approach Considerations, CBC and ESR, Blood Chemistries

  https://emedicine.medscape.com/article/912187-workup

  Serum vitamin D and calcium levels may be helpful, especially if osteoporosis is suspected, and should always be obtained if a trial of bisphosphonates is attempted for confirmation of osteoporosis. […] Liver function test results are minimally elevated, but levels encountered in patients with active hepatitis are not observed. […] A chest radiograph may reveal rib fractures or pneumomediastinum in the presence of other examination and laboratory findings to suggest repetitive vomiting. […] Electrocardiography (ECG) can reveal evidence of sinus bradycardia, ST-segment elevation, T-wave flattening, low voltage, and rightward QRS axis, although these changes are clinically insignificant. A finding of QT-interval prolongation, however, may indicate that the patient is at risk for cardiac arrhythmias and sudden death. […] The use of scales such as the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) can be helpful in the assessment of mental capacity to refuse treatment.

• #35 Anorexia nervosa – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/diagnosis-treatment/drc-20353597

  If your healthcare professional thinks that you have anorexia nervosa, you may have several tests and exams to pinpoint a diagnosis, rule out medical causes for the weight loss and check for any related complications. […] These exams and tests generally include: […] Physical exam. This exam includes measuring your height and weight and checking your vital signs. Vital signs include heart rate, blood pressure and temperature. Usually, the exam also includes checking skin and nails for problems, listening to the heart and lungs, and looking at the stomach area. […] Lab tests. These may include a complete blood count (CBC) and more-specialized blood tests to check electrolytes and protein, as well as the function of your liver, kidney and thyroid. A urine test also may be done. […] Mental health evaluation. Your healthcare professional likely will ask about your thoughts, feelings and eating habits. Your healthcare professional also may ask you to answer a series of questions about your health. […] Other studies. X-rays may be taken to check your bone density, check for stress fractures or broken bones, or check for pneumonia or heart problems. An electrocardiogram may be done to look for heart issues.

• #36 Anorexia | Diagnosis, DSM-5 Criteria, Exams, Tests

  https://www.waldeneatingdisorders.com/what-we-treat/anorexia/anorexia-diagnosis/

  Other Studies. X-rays may be taken to measure your bone density, check for stress fractures or broken bones, or evaluate you for pneumonia or heart problems. Electrocardiograms may be used to identify heart irregularities. Tests may also be used to determine how much energy your body uses, which can help in planning nutritional requirements. Based on the results of the exams and tests, an appropriate treatment program will be recommended.

• #37 Anorexia Nervosa | Peter O’Donnell Jr. Brain Institute | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/anorexia-nervosa/

  Depending on each patients symptoms and overall health, the individual might also see a physician for: A physical exam, Lab tests to measure levels of blood electrolytes and assess liver, kidney, and thyroid function, An electrocardiogram (EKG/ECG) to check for heart symptoms, X-rays to evaluate bone density and check for pneumonia or other health issues.

• #38 Anorexia Nervosa Differential Diagnoses

  https://emedicine.medscape.com/article/912187-differential

  Patients may or may not carry a diagnosis of anorexia nervosa when presenting to an emergency department for acute care, and other physiologic causes of malnutrition, weight loss, and amenorrhea, including the following, must be ruled out before making the diagnosis: […] Cancer […] Cardiac valvular disease […] Cataracts […] Chronic, undiagnosed organic disease (infectious, congenital, or metabolic) […] Clostridium difficile colitis, clostridial cholecystitis […] Cystic fibrosis (if the patient has pulmonary and/or pancreatic symptoms) […] Cytomegalovirus esophagitis, cytomegalovirus colitis […] Esophageal motility disorders, esophageal spasm, esophageal stricture […] Inflammatory bowel disease, including Crohn disease and ulcerative colitis […] Low vitamin D and calcium levels (hypocalcinosis)

• #39 Differential diagnoses of anorexia nervosa – Wikipedia

  https://en.wikipedia.org/wiki/Differential_diagnoses_of_anorexia_nervosa

  The differential diagnoses of anorexia nervosa (AN) includes various types of medical and psychological conditions, which may be misdiagnosed as AN. […] Anorexia Nervosa is a psychological disorder characterized by extremely reduced intake of food. […] Some of the differential or comorbid medical diagnoses may include: achalasia, acute pandysautonomia, lupus, Lyme disease, mitochondrial neurogastrointestinal encephalomyopathy (MNGIE), superior mesenteric artery syndrome (SMA syndrome), Addison’s disease, brain tumors, colonic tuberculosis, Crohn’s disease, hypothyroidism, hyperthyroidism, hypoparathyroidism, hyperparathyroidism, insulinomas, and multiple sclerosis. […] The distinction between the diagnoses of anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified (EDNOS) is often difficult to make as there is considerable overlap between patients diagnosed with these conditions.

• #40 Anorexia Nervosa Differential Diagnoses

  https://emedicine.medscape.com/article/912187-differential

  Patients may or may not carry a diagnosis of anorexia nervosa when presenting to an emergency department for acute care, and other physiologic causes of malnutrition, weight loss, and amenorrhea, including the following, must be ruled out before making the diagnosis: […] Cancer […] Cardiac valvular disease […] Cataracts […] Chronic, undiagnosed organic disease (infectious, congenital, or metabolic) […] Clostridium difficile colitis, clostridial cholecystitis […] Cystic fibrosis (if the patient has pulmonary and/or pancreatic symptoms) […] Cytomegalovirus esophagitis, cytomegalovirus colitis […] Esophageal motility disorders, esophageal spasm, esophageal stricture […] Inflammatory bowel disease, including Crohn disease and ulcerative colitis […] Low vitamin D and calcium levels (hypocalcinosis)

• #41 Anorexia Nervosa Differential Diagnoses

  https://emedicine.medscape.com/article/912187-differential

  Myeloma […] Occult infection (if heart rate is normal or elevated) […] Osteopenia […] Osteoporosis […] Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) (rare) […] Pellagra […] Rash (due to low zinc) […] Sheehan syndrome […] Systemic lupus erythematosus (SLE)

• #42 Eating Disorders

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/

  Other psychiatric disorders with disturbed appetite or food intake include depression, somatization disorder, and schizophrenia. […] Patients with bulimia nervosa do not have an abnormally low body weight. […] Patients who meet some but not all of the diagnostic criteria for anorexia nervosa set out by the DSM5 may be given a diagnosis of other specified feeding or eating disorder. […] The evidence for significant efficacy of psychotropic medication is lacking, with very few methodologically sound studies. […] Although medication is less successful in anorexia nervosa than in bulimia nervosa, it is most often used in anorexia nervosa after weight has been restored but may begin earlier when indicated for associated psychiatric symptoms.

• #43 Anorexia Nervosa: Diagnostic Criteria, Symptoms, Causes

  https://www.verywellmind.com/diagnostic-criteria-for-anorexia-nervosa-1138312

  There are two subtypes of anorexia: the restricting type and the binge-eating/purging type. […] Before diagnosing anorexia, a healthcare provider must also rule out the following conditions: Avoidant/restrictive food intake disorder, Bulimia nervosa, Major depressive disorder, Schizophrenia, Social anxiety disorder or social phobia, Substance use disorder. […] A healthcare provider will do a thorough review of both physical and mental health symptoms before making a diagnosis.

• #44 Eating Disorders

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/

  The essential features of anorexia nervosa are refusal to maintain a minimally normal body weight, intense fear of gaining weight, and significant disturbance in the perception of the shape or size of one’s body. […] In addition to the clinical interview, the Eating Attitudes Test, Eating Disorders Inventory, Body Shape Questionnaire, and others can be used to assess eating disorders. […] Common comorbid conditions include major depressive disorder or dysthymia (50% to 75%), sexual abuse (20% to 50%), obsessive-compulsive disorder (25% with anorexia nervosa), substance abuse (12% to 18% with anorexia nervosa, especially the binge-purge subtype, and 30% to 37% with bulimia nervosa), and bipolar disorder (4% to 13%). […] Medical illnesses include brain tumors, including craniopharyngioma, and other malignancies, gastrointestinal disease, and acquired immunodeficiency syndrome.

• #45 Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html

  The first priority in the evaluation of patients with eating disorders is to identify emergency medical conditions that require hospitalization and stabilization. […] Indications for hospitalization include significant electrolyte abnormalities, arrhythmias or severe bradycardia, rapid persistent weight loss in spite of outpatient therapy, and serious comorbid medical or psychiatric conditions, including suicidal ideation. […] Treatment success may be dependent on developing a therapeutic alliance with the patient, involvement of the patient’s family, and close collaboration within the treatment team.

• #46 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  Laboratory tests alone can’t diagnose anorexia. But your healthcare provider may use various tests to rule out any medical conditions that could cause weight loss. Tests can also evaluate the physical effects of anorexia. […] These tests may include: […] Hospitalization might be necessary to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications. […] The most serious complication of treating anorexia is a condition called refeeding syndrome. It can happen when a seriously malnourished person begins to receive nutrition again. […] Since refeeding syndrome can have serious and life-threatening side effects, people with anorexia need to receive medical treatment and/or guidance.

• #47 Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html

  The first priority in the evaluation of patients with eating disorders is to identify emergency medical conditions that require hospitalization and stabilization. […] Indications for hospitalization include significant electrolyte abnormalities, arrhythmias or severe bradycardia, rapid persistent weight loss in spite of outpatient therapy, and serious comorbid medical or psychiatric conditions, including suicidal ideation. […] Treatment success may be dependent on developing a therapeutic alliance with the patient, involvement of the patient’s family, and close collaboration within the treatment team.

• #48 Early detection of eating disorders in general practice

  https://www.racgp.org.au/afp/2017/november/early-detection-of-eating-disorders

  GPs failure to identify that certain symptoms and signs may represent an eating disorder may preclude early detection. […] NICE guidelines note that diagnosis is often delayed when doctors inadvertently collude by over-investigating and referring to other specialties rather than confronting the possibility of an eating disorder. […] The first priority in the management of a patient with an eating disorder is securing medical and psychiatric safety. […] The criteria for admission to hospital are listed in Table 4. […] For most patients who will not need immediate hospitalisation, treatment should be individualised and take place initially in an outpatient community setting, if possible. […] The role of the GP includes assessment and initial diagnosis (including urgent referral to the emergency department, if indicated).

• #49 Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html

  The first priority in the evaluation of patients with eating disorders is to identify emergency medical conditions that require hospitalization and stabilization. […] Indications for hospitalization include significant electrolyte abnormalities, arrhythmias or severe bradycardia, rapid persistent weight loss in spite of outpatient therapy, and serious comorbid medical or psychiatric conditions, including suicidal ideation. […] Treatment success may be dependent on developing a therapeutic alliance with the patient, involvement of the patient’s family, and close collaboration within the treatment team.

• #50 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  Laboratory tests alone can’t diagnose anorexia. But your healthcare provider may use various tests to rule out any medical conditions that could cause weight loss. Tests can also evaluate the physical effects of anorexia. […] These tests may include: […] Hospitalization might be necessary to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications. […] The most serious complication of treating anorexia is a condition called refeeding syndrome. It can happen when a seriously malnourished person begins to receive nutrition again. […] Since refeeding syndrome can have serious and life-threatening side effects, people with anorexia need to receive medical treatment and/or guidance.

• #51 Anorexia nervosa in adults and adolescents: Medical complications and their management – UpToDate

  https://www.uptodate.com/contents/anorexia-nervosa-in-adults-and-adolescents-medical-complications-and-their-management

  Anorexia nervosa is associated with numerous general medical complications that are directly attributable to weight loss and malnutrition. The complications involve most major organ systems and often include physiologic disturbances such as hypotension, bradycardia, hypothermia, and amenorrhea. Medical complications account for approximately half of all deaths in anorexia nervosa, which has one of the highest mortality rates of any psychiatric disorder. […] The medical complications of low weight in anorexia nervosa and the management of these complications are reviewed here. The evaluation for medical complications and criteria for hospitalizing patients with anorexia nervosa; epidemiology and pathogenesis; clinical features, assessment, and diagnosis; treatment of anorexia nervosa; and the refeeding syndrome are discussed separately.

• #52 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  Laboratory tests alone can’t diagnose anorexia. But your healthcare provider may use various tests to rule out any medical conditions that could cause weight loss. Tests can also evaluate the physical effects of anorexia. […] These tests may include: […] Hospitalization might be necessary to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications. […] The most serious complication of treating anorexia is a condition called refeeding syndrome. It can happen when a seriously malnourished person begins to receive nutrition again. […] Since refeeding syndrome can have serious and life-threatening side effects, people with anorexia need to receive medical treatment and/or guidance.

• #53 Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa

  A healthcare provider can diagnose anorexia nervosa based on the criteria for it listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The three criteria include: […] The DSM-5 criteria classify the severity of anorexia according to body mass index (BMI). People who meet the criteria for anorexia but don’t have underweight despite significant weight loss have atypical anorexia. […] If you have signs and symptoms of anorexia, a provider will do a complete medical history and physical exam. The provider will likely ask questions about your: […] A person with anorexia or any eating disorder will have the best recovery outcome if they receive an early diagnosis. If you or someone you know is experiencing signs and symptoms of anorexia, be sure to talk to a provider as soon as possible.

• #54 Anorexia nervosa – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/440

  People with anorexia nervosa (AN) typically have low body weight, intense fear of gaining weight, and a body image disturbance. […] While more often detected in women, AN in young men may be under-diagnosed. […] People with AN are often identified through family referral, pediatric monitoring of weight during routine physical exam, and their physical complaints. […] Early intervention is key in order to prevent long-term psychiatric and physical complications of AN. […] AN is an eating disorder characterized by restriction of caloric intake relative to requirements leading to low body weight, an intense fear of gaining weight, and a body image disturbance. […] Key diagnostic factors include significantly low body weight, fear of gaining weight or becoming fat, or behaviors that interfere with weight gain despite evidence of significantly low body weight, disturbed body image, calorie restriction, binge-eating and/or purging, misuse of laxatives, diuretics, or diet pills, amenorrhea, and decreased subcutaneous fat.

• #55 Diagnosis of Eating Disorders in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html

  The prognosis of patients who have eating disorders is variable. The general consensus is that 50 percent of patients with anorexia have good outcomes, 30 percent have intermediate outcomes, and 20 percent have poor outcomes. […] Because of the severity of these illnesses and the improvement in outcomes when diagnosis occurs earlier, the family physician can play a crucial role in helping patients recover from eating disorders by detecting them at an early stage.

• #56 Red flags and diagnostic criteria for eating disorders – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/eating-disorder-diagnostic-criteria/

  One of the main OSFED classifications is atypical anorexia, which has the same self-esteem and body image features of classic anorexia and the same restricted intake, but weight is normal. […] Clues of anorexia during a physical exam include flattened affect or a depressed state, pale skin, dry skin, cachexia and facial wasting, decreased muscle mass, thinning hair, and lanugo at the nape of the neck or the backs of the arms. […] Hospitalization is warranted if the heart rate is 40 or below, total blood pressure of 80/50 or less, and orthostatic changes in pulse higher than 20 beats per minute or orthostatic change in blood pressure greater than 10 mmHg. […] Eating disorders are the second deadliest DSM diagnosis, with about half the deaths coming from suicide. The mortality for anorexia is 5% to 6%. Early identification of an eating disorder is associated with better outcomes, making early diagnosis critical. […] “It can be very hard to overcome if the patient gets stuck in that state of starvation for years on end,” Dr. Krause said. “Early intervention is key.”

• #57 Anorexia Nervosa: Symptoms, Causes, Diagnosis and Treatment

  https://www.medicalnewstoday.com/articles/267432

  Anorexia nervosa is the name of a mental health condition. It is a serious disease, but, with the right treatment, recovery is possible. […] A psychological evaluation is also necessary to determine if a person meets the diagnostic criteria for anorexia nervosa. […] According to the National Eating Disorders Association, the criteria below can help doctors make a diagnosis. However, they note that not everyone with a serious eating disorder will meet all these criteria. […] Early diagnosis and prompt treatment increase the chance of a good outcome. […] The doctor may ask the person questions to get an idea of their eating habits, weight, and overall mental and physical health. […] They may order tests to rule out other underlying medical conditions with similar signs and symptoms, such as malabsorption, cancer, and hormonal problems.

• #58 Azthena logo with the word Azthena

  https://www.news-medical.net/health/How-is-Anorexia-Nervosa-Diagnosed.aspx

  The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association provides the following diagnostic criteria for anorexia: […] The primary presenting symptoms associated with anorexia nervosa are severe and excessive weight loss. Therefore, measuring the height and weight of the individual is one of the first components of the physical exam. […] Urine and blood tests can be useful to identify other underlying causes of severe weight loss or significant complications of anorexia. […] Anorexia nervosa is closely associated with psychological issues and disorders. Therefore, a patient presenting with symptoms of the condition warrants a psychological evaluation to ensure they are able to receive the best medical care. […] Other tests that may be used to confirm the diagnosis of anorexia nervosa and investigate possible complications may include: […] Many patients with anorexia nervosa initially deny symptoms of the condition and may try to hide the signs from concerned family or friends by wearing loose-fitting clothes and lying about their diet.

• #59 Red flags and diagnostic criteria for eating disorders – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/eating-disorder-diagnostic-criteria/

  One of the main OSFED classifications is atypical anorexia, which has the same self-esteem and body image features of classic anorexia and the same restricted intake, but weight is normal. […] Clues of anorexia during a physical exam include flattened affect or a depressed state, pale skin, dry skin, cachexia and facial wasting, decreased muscle mass, thinning hair, and lanugo at the nape of the neck or the backs of the arms. […] Hospitalization is warranted if the heart rate is 40 or below, total blood pressure of 80/50 or less, and orthostatic changes in pulse higher than 20 beats per minute or orthostatic change in blood pressure greater than 10 mmHg. […] Eating disorders are the second deadliest DSM diagnosis, with about half the deaths coming from suicide. The mortality for anorexia is 5% to 6%. Early identification of an eating disorder is associated with better outcomes, making early diagnosis critical. […] “It can be very hard to overcome if the patient gets stuck in that state of starvation for years on end,” Dr. Krause said. “Early intervention is key.”

• #60 Diagnosis of Eating Disorders in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html

  Because family physicians serve as primary care providers for a large percentage of adolescents, they have an important role in diagnosing these disorders. […] It is also important to aggressively treat patients who have traits of eating disorders but who do not meet the full criteria for anorexia or bulimia. […] A wide variety of medical problems can masquerade as eating disorders. […] The medical history is the most powerful tool for diagnosing eating disorders. […] All patients in high-risk categories for eating disorders should be screened during routine office visits. […] Accurate weight measurements are important in diagnosing an eating disorder. […] Laboratory findings might be completely normal, but targeted laboratory testing can be helpful to rule out medical illness.

• #61 Early detection of eating disorders in general practice

  https://www.racgp.org.au/afp/2017/november/early-detection-of-eating-disorders

  The aim of this article was to heighten awareness of the role of early identification and diagnosis of eating disorders, especially anorexia nervosa and bulimia nervosa, in the primary care setting. […] Eating disorders are formally classified on the basis of the Diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) criteria. […] The diagnostic criteria for anorexia nervosa and bulimia nervosa were updated in the DSM-5. […] Some of the significant revisions are the removal of amenorrhoea as a diagnostic criterion for anorexia nervosa in female patients, and reduction of binge frequency to an average of once per week for bulimia nervosa. […] In theory, these modifications broaden the criteria for specific eating disorders such as anorexia nervosa and bulimia nervosa, but also more precisely categorise the previous diagnostic category of EDNOS.

• #62 Overview – Anorexia nervosa – NHS

  https://www.nhs.uk/mental-health/conditions/anorexia/overview/

  If you think you may have anorexia, even if you’re not sure, see a GP as soon as you can. […] They will ask you questions about your eating habits and how you’re feeling. They will probably weigh you, and check your heart rate, blood pressure and temperature. […] They may also want to do some blood tests and to check your overall physical health. […] If they think you may have anorexia, or another eating disorder, they should refer you to an eating disorder specialist or team of specialists.

• #63 Anorexia nervosa. Symptoms, diagnosis and treatment. Clínica Universidad de Navarra

  https://www.cun.es/en/diseases-treatments/diseases/anorexia-nervosa

  These are patients who, as a rule, do not initially ask for help voluntarily, but rather arrive at the professional’s office through parents or teachers, when the process has already been established. […] For the establishment of the diagnosis, it is done: Diagnostic interview. Discard of organic disease by means of magnetic resonance, general and specific analyses and evaluation by other specialists (endocrinologists). Psycho diagnostic tests.

• #64 Anorexia | Anorexia signs, symptoms, diagnosis, and treatment | UKAT

  https://www.ukat.co.uk/eating-disorders/anorexia/

  Properly diagnosing anorexia nervosa is a complex process that requires a comprehensive and sensitive approach. A multidisciplinary team usually performs the assessment, encompassing physical, psychological and behavioural evaluations. This may include your GP, psychiatrists, psychologists, dietitians and nutritionists. […] One of the first anorexia diagnosis tools available is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This provides specific criteria for diagnosing anorexia, which include: Restriction of energy intake, which leads to significantly low body weight. Intense fear of gaining weight or persistent behaviour that interferes with weight gain. Distorted body image and the inability to recognise the severity of the low body weight. […] Anorexia diagnosis will also involve evaluating your overall physical health, including weight, vital signs and the presence of any symptoms related to malnutrition or excessive weight loss. A mental health professional may assess your attitudes towards food, body image, eating habits and any underlying psychological issues such as anxiety, depression or trauma. Blood tests, bone density scans and other laboratory tests help rule out other medical conditions and assess the physical impacts of anorexia, such as malnutrition and electrolyte imbalances.

• #65 Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0101/p46.html

  The first priority in the evaluation of patients with eating disorders is to identify emergency medical conditions that require hospitalization and stabilization. […] Indications for hospitalization include significant electrolyte abnormalities, arrhythmias or severe bradycardia, rapid persistent weight loss in spite of outpatient therapy, and serious comorbid medical or psychiatric conditions, including suicidal ideation. […] Treatment success may be dependent on developing a therapeutic alliance with the patient, involvement of the patient’s family, and close collaboration within the treatment team.

• #66 Eating Disorders | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/eating-disorders

  Anorexia nervosa is a complicated eating disorder with medical, behavioral, and psychological components. […] Early diagnosis and treatment are therefore extremely important. […] To diagnose an eating disorder, your child’s doctor will assess changes in your child’s weight. […] Your child’s doctor will likely also conduct the following studies: A social history, a review of risk factors at home, school, and outside activities; A family history to assess conditions such as eating disorders, obesity, alcoholism, depression, or other mental illness in the family; A physical exam, including pulse, temperature, weight and height, skin and hair changes, heart function, and abdomen. […] Complete recovery from an eating disorder is possible. The goal of eating disorder treatment is to treat any immediate medical concerns, work on eliminating disordered behaviors, and treat co-occurring issues like depression and anxiety. […] Eating disorders are usually treated with a combination of therapies: Individual therapy (usually including both cognitive and behavioral techniques), Family therapy, Medical care and monitoring, Nutritional counseling, Behavior modification, Medications.

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