Anorexia nervosa in adults: Evaluation for medical complications and criteria for hospitalization to manage these complications
- Philip Mehler, MD
Philip Mehler, MD
- Chief Medical Officer, Eating Recovery Center
- Executive Medical Director, ACUTE, Denver Health
- Professor of Medicine, University of Colorado
Anorexia nervosa is associated with numerous medical complications that are directly attributable to caloric restriction and weight loss (table 1) . A medical evaluation is necessary to assess patients for these complications and determine whether hospitalization is necessary.
Medical complications account for more than half of all deaths in patients with anorexia nervosa, and the rate of mortality is high . A review of 119 case series (5590 patients) found the crude rate of all-cause mortality was 5 percent . Standardized mortality ratios show that the rate of death in anorexia nervosa is approximately 5 to 10 times greater than the rate in the general population [4-6].
The evaluation for medical complications and criteria for hospitalization of patients with anorexia nervosa is reviewed here. The medical complications of anorexia nervosa and their management; the epidemiology, pathogenesis, clinical features, treatment, and outcome of anorexia nervosa; the refeeding syndrome in patients with anorexia nervosa; and the medical complications of bulimia nervosa and binge eating disorder are discussed separately.
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