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Anorexia nervosa in adults and adolescents: Medical complications and their management

Philip Mehler, MD
Section Editor
Joel Yager, MD
Deputy Editor
David Solomon, MD


Anorexia nervosa is associated with numerous general medical complications that are directly attributable to weight loss and malnutrition [1]. The complications affect most major organ systems and often include physiologic disturbances such as hypotension, bradycardia, hypothermia, and amenorrhea.

Medical complications account for more than half of all deaths in patients with anorexia nervosa [2]. A systematic review of 42 observational studies (3006 patients with anorexia nervosa) found that the crude rate of all-cause mortality was six percent [3], and a review of 119 case series (5590 patients) found a rate of five percent [4]. Standardized mortality ratios show that the rate of death in anorexia nervosa is 10 to 12 times greater than the rate in the general population [5-7].

The medical complications of low weight in anorexia nervosa and the management of these complications are reviewed here. The evaluation for medical complications and criteria for hospitalizing patients with anorexia nervosa; epidemiology, clinical features, diagnosis, and treatment of anorexia nervosa; and the refeeding syndrome are discussed separately. In addition, the medical complications of binge eating and purging (which can occur in anorexia nervosa) are discussed in the context of the topic that reviews the medical complications of bulimia nervosa and binge eating disorder:

(See "Anorexia nervosa in adults: Evaluation for medical complications and criteria for hospitalization to manage these complications".)

(See "Eating disorders: Overview of epidemiology, clinical features, and diagnosis".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 02, 2016.
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