Answered

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Based on everything you’ve read, which symptoms could indicate an eating disorder that might not be detectable by measuring BMI? What subjective and objective observations could you use to help detect other eating disorders in a clinical setting like the one described in this scenario?

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Answer:

Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, parotid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia).  Explanation:

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