How to manage patients with eating disorders in the inpatient setting

Case Dr. Wimberly A 25-year-old female pharmacy student is brought to the emergency department by her parents after a presyncopal episode while at home for a school break. Her parents are concerned that she has lost quite a bit of weight over the last year. Initial vitals are notable for HR 38 and supine BP 110/70. Upon standing, BP decreases to 85/60 and HR increases to 115.  Labs are notable for slightly low potassium and normal serum phosphorus. BMI is 15.2.   Background Eating disorders (EDs) are serious psychiatric illnesses with significant morbidity and mortality. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides diagnostic criteria for six categories of feeding and eating disorders: anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder.1 Patients with AN are further categorized into restricting and binge-eating/purging subtypes. It is common for patients with symptoms of feeding and eating disorders to fall outside the strict diagnostic criteria for the disorders listed above. These patients may be diagnosed with other specified feeding or eating disorder (OSFED) or unspecified feeding or eating disorder (UFED). All eating disorders cause significant emotional and psychological distress and place patients at risk of serious medical complications. For simplicity, this article will focus on medical complications of AN and BN, ...
Source: The Hospitalist - Category: Hospital Management Authors: Tags: Clinical Guidelines Eating Disorders Hospital Medicine Source Type: research