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Eating disorders: Introduction

Signs and symptoms

There are no other psychiatric disorders with as many physical signs and laboratory findings as eating disorders. Obesity is not one of those signs because most people who are overweight do not have a formal eating disorder. It is more likely the normal-weight or underweight woman who may present for help with an undiagnosed eating disorder.

The chief complaint is rarely "I think I have an eating disorder." Rather, she or he (up to 90 per cent of eating disorders occur in women) may ask for help with:

  • constipation, bloating or fluid retention
  • weight-loss advice despite being at normal weight
  • problems with mood instability, anxiety, sleep or concentration

Additionally, the patient may show some of these physical and laboratory findings:

  • marked weight loss
  • bradycardia and hypotension
  • amenorrhea
  • impaired temperature regulation
  • acrocyanosis
  • delayed gastric emptying
  • hair loss, dry skin and growth of lanugo hair
  • hypokalemic, hypochloremic metabolic alkalosis
  • elevated salivary amylase
  • parotid hypertrophy
  • anemia
  • EKG findings including low voltage, T wave inversion, prolonged QTc interval
  • osteoporosis at a young age

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Frequently asked questions

Clinical guidelines

Eating disorders in over 8s: management (NICE guideline CG9, 2004)