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Understanding eating disorders in adolescence

Criteria and diagnosis

Patients can be medically stable and have normal lab tests, but they may still have a serious eating disorder. Taking a complete clinical history is the most powerful tool for diagnosing eating disorders.

Pritts, S. D., & Susman, J. (2003). Diagnosis of eating disorders in primary care. American Family Physician, 67(2), 297-304.

Physical Exam

Vitals

Blood pressure and heart rate should be measured at every appointment*:

  • If low weight
  • If vital signs are concerning
  • If patient has expressed symptomatic concerns

*Measure orthostatic vitals (compare lying down AND standing)

When to Refer

Raise concern if:

  • Orthostatic changes in pulse are >30 BPM
  • Orthostatic change in systolic blood pressure are >20 mmHg
  • HR ≤ 50bpm daytime
  • HR ≤ 45bpm overnight

 Weight

Weight should be measured in a consistent way:

  • Best to weigh in a gown with no undergarments with patient’s back to the scale.
  • Remind patients that weight is just one piece of data used to monitor health and progress towards recovery.

Determining a Treatment Goal Weight (TGW):

  • Attempt to establish the patient’s previous baseline trajectory using data from their growth chart
  • Consider other relevant information including current and history of menstrual status, degree of eating disorder symptoms, and physical activity

Diagnostic and Laboratory Considerations: What to look for

Download PDF (According to the AED Report 2016)

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