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Group Events |
Eating Disorders Screening and Diagnosis |
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Recovery-World |
Eating Disorders Screening and Diagnosis A complete medical assessment is important when diagnosing eating disorders. Talk with your doctor about performing specific laboratory tests. (Compiled for the National Eating Disorders Association by Margo Maine, PhD) With eating disorders, the most important first step toward diagnosis and recovery is to have a complete assessment. This includes a medical evaluation to rule out any other physical cause for the symptoms, to assess the impact the illness has had to date, and to determine whether immediate medical intervention is needed. (See Table 1 for specific tests.) Equally important is the mental health assessment, preferably by an eating disorder expert to provide a full diagnostic picture. Many people with eating disorders have other problems as well, including depression, trauma, obsessive-compulsive disorder, anxiety, or chemical dependence. This assessment will determine what level of care is needed (inpatient, outpatient, partial hospital, residential) and what professionals should be involved in the treatment. Also, please note: to find local resources for treatment visit the "Referral" area of this web site-- www.NationalEatingDisorders.org. TABLE 1--Recommended Laboratory Tests Standard Complete Blood Count (CBC) with differential Urinalysis Complete Metabolic Profile: Sodium, Chloride, Potassium, Glucose, Blood Urea Nitrogen, Creatinine, Total Protein, Albumin, Globulin, Calcium, Carbon Dioxide, AST, Alkaline Phosphates, Total Bilirubin Serum magnesium Thyroid Screen (T3, T4, TSH) Electrocardiogram (ECG) Special Circumstances 15% or more below ideal body weight (IBW) Chest X-Ray Complement 3 (C3) 24 Creatinine Clearance Uric Acid 20% or more below IBW or any neurological sign Brain Scan 20% or more below IBW or sign of mitral valve prolapse Echocardiogram 30% or more below IBW Skin Testing for Immune Functioning Weight loss 15% or more below IBW lasting 6 months or longer at any time during course of eating disorder Dual Energy X-Ray Absorptiometry (DEXA) to assess bone mineral density Estadiol Level (or testosterone in males) TABLE 2--Criteria for Level of Care Inpatient Medically Unstable Unstable or depressed vital signs Laboratory findings presenting acute risk Complications due to coexisting medical problems such as diabetes Psychiatrically Unstable Symptoms worsening at rapid rate Suicidal and unable to contract for safety Residential Medically stable so does not require intensive medical interventions Psychiatrically impaired and unable to respond to partial hospital or outpatient treatment Partial Hospital Medically stable Eating disorder may impair functioning but not causing immediate acute risk Needs daily assessment of physiological and mental status Psychiatrically stable Unable to function in normal social, educational, or vocational situations Daily bingeing, purging, severely restricted intake, or other pathogenic weight control techniques Intensive Outpatient/Outpatient Medically stable No longer needs daily medical monitoring Psychiatrically stable Symptoms in sufficient control to be able to function in normal social, educational, or vocational situations and continue to make progress in recovery. |