Eating Disorder Discovery

Eating disorder discovery is not as simple as it may seem. Individuals with advanced anorexia appear emaciated, but those with bulimia may range from average weight to being obese. The range of eating disorders, and how they manifest themselves, makes eating disorder discovery difficult.

So if you suspect someone has an eating disorder, how does eating disorder discovery take place?

Before patients are admitted, Walden's Psychiatric Admissions Team (PAT) assesses them and determines appropriate treatment based on their eating disorder symptoms and other criteria. The eating disorder discovery process is based on DSM-IV criteria for patient placements.

Causes of eating disorders vary, but there are usually a number of contributing factors that manifest themselves in symptoms that become evident during eating disorder discovery. A traumatic event, which may have taken place years before the eating disorder manifests itself, is often a cause of the disorder. Such events may include:

• Sexual abuse or rape
• Emotional abuse
• Parents' divorce
• Death of a loved one
• Physical violence

Other eating disorder symptoms include low self-esteem and a need to gain control.

Eating Disorder Discovery For Anorexia

Eating disorder discovery for anorexia is based on vital signs and other medical criteria. Symptoms may include: an EKG with acute changes caused by electrolyte disturbance, ischemia or other factors; hypotension; body temperature below 96 F.; arrhythmia, dehydration, or medical complications that require intensive monitoring, such as intestinal atony with an obstruction, nutritional anemia, impaired renal function, fluid imbalance or an exercise-induced injury.

Other symptoms that become evident during eating disorder discovery include abnormal lab values in any of the following areas: Na+ <125 mEq/L, K+ <3.0 mEq/L, C1 <86 mEq/L, CO2 <20 or >35 mEq/L, BUN >25, serum creatine >2.0, AST >50, ALT >55, albumin <3.0, phosphorus <3.4 for those 20 or younger or <2.5 for those older than 20, magnesium <1.5, calcium <8.0 or >10.7, or glucose <60.

Eating Disorder Symptoms For Bulimia

Bulimia is a condition where sufferers typically purge food they have eaten by self-induced vomiting, use of laxatives or other means. Some do not purge, but compensate for eating by over-exercising or fasting. Purging is not necessarily used to lose weight. It may be used to demonstrate control or for punishment.

A larger percentage of people have bulimia than have anorexia. Approximately 4% of college-aged women are bulimic. About 20% of bulimics are male.

Eating disorder discovery for bulimia is more difficult than eating disorder discovery for anorexia. Most bulimics are not underweight and many are overweight, because of binge eating.

Eating disorder discovery is based on many of the same symptoms as anorexia. Causes may include a traumatic event, genetics and more. Bulimics have low self-esteem. Low self-esteem can result in a distorted image of one's body and a perceived need to lose weight. Some people perceive bulimia as a way to cope with problems when they feel out of control.

Long-term symptoms that are often found during eating disorder discovery may include laxative addiction; electrolyte imbalances, which can cause heart failure; ulcers; bowel damage; inflammation and sometimes tearing of the esophagus, and tingling in the hands and feet. Depression and other psychiatric disorders are often found during eating disorder discovery.

Eating Disorder Discovery For Other Eating Disorders

Individuals who do not fit into defined criteria for anorexia or bulimia, but who are found during eating disorder discovery to require medical attention for an eating disorder are medically classified as having eating disorders not otherwise specified (EDNOS).

Symptoms may be identical to those for anorexia or bulimia, but the disorder may not be advanced to the point where the individual meets all established medical criteria. Treatment should begin regardless.

Other types of disorders, such as binge eating disorder, may also be identified during eating disorder discovery. Eating disorder symptoms for binge eaters include uncontrollable, excessive eating, followed by feelings of shame and guilt. Unlike those with bulimia, binge-eaters typically do not purge their food.

Other common symptoms often found during eating disorder discovery, regardless of the type of disorder, that may require inpatient care include:

• Emaciation or malnutrition
• Medical complications, such as orthostasis, dehydration, electrolyte imbalances, minor cardiac arrhythmias
• Severe psychological distress, such as major depression with suicidal ideation or self-mutilation, impulse control problems or post-traumatic stress disorder
• A binge-purge cycle that is either severe enough to cause medical complications or that cannot be contained in an outpatient setting and, if continuing, would result in severe medical complications
• Significant abuse of laxatives, diuretics or ipecac
• Eating disorder symptoms that are severe enough to prevent the individual from functioning in daily life activities
• Behavior that cannot be successfully treated with antidepressants or psychotropic medications on an outpatient basis
• Failure of outpatient treatment to reduce eating disorder symptoms
• Assessment showing the need for 24-hour-a-day skilled nursing observation, intervention and support to reduce the severity of medical, nutritional and psychiatric symptoms

To learn more about Walden Behavioral Care's programs for anorexia recovery, contact Walden at 781-647-6700 or Info@waldenbehavioralcare.com.