Background
Both Anorexia nervosa and bulimia nervosa are more common adolescent females.
Diagnosis
Definition
Diagnosis is made clinically using DSM-V criteria.
H&P (Pertinent H&P findings including med review & key vital signs)
-Common presentation:
-Clinical Manifestations:
-Associated Conditions: MDD, other psychiatric disorders.
-Risk factors.
-Red flags.
-Complications:
Ddx & Etiology
Diagnostic studies (labs/imaging/etc)
Assess severity/acuity: Severity is based on BMI (per DSM-V). AAP has criteria for admission.
Treatment
Family-based therapy helps.
Severity of anorexia
Mild = BMI >17.0 kg/m2,
Moderate = BMI of 16.0–16.99 kg/m2,
Severe = BMI of 15.0–15.9 kg/m2,
Extreme = BMI <15.0 kg/m2
Pearls and links
- Sinus bradycardia is very common, likely 2/2 to vagal nerve hyperactivity from an attempt to decrease how much the heart is working in a low-calorie setting.
- Sinus tach may be seen during refeeding.
Further Reading / Reference
Am Fam Physician. 2015 Jan 1;91(1):46-52. Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa. https://www.aafp.org/afp/2015/0101/p46.html