The following indicators sound significant and common symptoms of anorexia and bulimia. Critical or multiple indicators suggest the importance of medical, dietary and physical intervention. The items marked while an asterisk (*) may suggest an urgent need to be able to intervention and treatment.
PHYSIOLOGICAL AND MEDICAL INDICATORS
Below 85% of regular body weight range, or BMI below 16%
* Below 70% of regular body weight, or BMI below 14
Unexplained learn how to, especially in adolescents
*Electrolyte disturbances just like: serum potassium below some. 6 mmol/L or more than 6 mmol/L; repeated dips in potassium below 3. 0; serum calcium below 6 mg/dL or higher 13 mg/ dL
*EKG abnormalities indicating electrolyte disturbance
Bone marrow suppression indicated by neutropenia and anemia
Bradycardia following 60
Serum protein or albumin above or below normal, Low T4, enhanced TSH, and/or low LH
*Palpitations
*Syncope / near-syncope
Dizziness or light-headedness
Amenorrhea (absence of menstruation for more than 3 months) or publicly irregular menstruation
Dehydration or repeated wish of rehydration in previous 12 months
Chest pain
Hypothermia if they are not report of cold intolerance
Hair damages or injuries or breakage
Lanugo hair that are on your face, neck, back, and one arms
Yellowish tinge to your dogs skin, purplish-blue hands and feet
Hypercarotenemia
Orthostatic bp and pulse changes
Dental mistake including enamel erosion
*Esophageal tear / blood in vomit
Swollen as well as tender parotid glands
Frequent gastroesophageal regurgitate into throat / mouth
Chronic, indigestion / heartburn
Severe constipation
Extreme less irritating chronic fatigue / weakness
Brittle bones
Non-focal abdominal pain with consumption of food
Abdominal bloating / swelling of hands, ankles, and one feet
Elevated serum amylase and various other lipase
Elevated liver enzymes
*Persistent looseness of the bowels, (may be bloody)
*Pancreatitis
*Severe tummy pain (may indicate expected visceral rupture)
DIETARY INDICATORS
Caloric intake according to the patient is listed below 800 kcal / day
*Inability or refusal in order to keep any food down
Engaging the least bit food games (i. ice., hiding food, hoarding food, chewing and spitting diet out, cutting food returning to tiny pieces, lying as to what food has been another alteration, etc. )
Eating the same foods day to day / rigid food rituals
Limiting food to only fruit and veggies / eliminating fats and proteins
*Refusing to drink water or consuming less accompanied by 8 oz / incident, or restricting water wearing for 2-7 days
Binging two or more times daily on excessive quantities of food
Purging some times daily
Inability to maintain weight
*Rapid health and fitness; losing more than handful of pounds weekly
Unable or unwilling to stop or decrease ridiculous exercise, exercising more from the two hours daily, and even having extreme feelings manufactured by guilt, inadequacy, or anxiety if cannot exercise
Spending more than 75% of waking hours taking into consideration the food, calories, fat, human body, and weight
Unable to enjoy a food plan without in height food involvement or excessive food avoidance
Unable in order to a food plan distributed by a dietitian without restricting or "bargaining" about the eating disorder
Laxative abuse, Abusing over-the-counter diet pills or diet aids, or alcohol abuse of caffeinated drinks
*Inability make a sale withdraw from laxatives, diet pills, or diuretics
COGNITIVE, EMOTIONAL, BEHAVIORAL, RELATIONAL INDICATORS
Self-injury such being cutting, scratching, burning
*Failure of outpatient treatment
Failure to answer psychiatric medications
*Slowness in guessed, inability or severe difficulty to produce decisions, difficulty in automatic tracking conversation, etc.
Poor discipline: inability to focus
Poor memory - wherewithal to recall conversations or connections after one day
Poor sensible academically or at work
Feeling of pride in obesity loss or in being able to deny self of food in order to resist hunger
Significant absence from practice or work
Intense feelings of capital shame and self-disgust components eating habits
Significant body frame distortions with associated emotional soreness and anxiety
Intense feelings of an weakness, guilt, or inadequacy ingesting food, After eating, subsequent restriction or self-punishment to make up for caloric intake
Minimizes as well as gets angry and defending at loved ones' expressed stress about eating habits
Inability or unwillingness to eat just before others
Expresses intense and unreasonable concern with gaining weight or "becoming fat"
*Suicidal idealization specifically worsening, or the eating disorder has turned into a the means for suicide
*Suicidal personal habits or attempts
Other complex, concurrent psychological disorders and/or spots (i. e. depression, hysteria, panic disorder, obsessive compulsive disorder, personality disorders, and the like. )
Long and chronic reputable name eating disorder (over 5 years)
*Short and intense track record of eating disorder with competitive and rapid deterioration
Obsessive comparing of body size or shape to other women
Avoiding enterprises or "pushing away" the children / friends
Constant lying, deception, and secrecy to disguise eating disorder
Concurrent and mixing up addictions (e. g., ripping, exercise, sexual activity, narcotics, alcohol, cutting)
*Extreme emotional remove yourself, disengagement and numbness
Significant remoteness or withdrawal
Extreme emotional tremendous sadness and feelings of hopelessness
Trauma related symptoms that need safety and containment
Extreme a feeling of self-contempt and self-hatred
Extreme obsessive conduct and/or perfectionism
*Deterioration despite hospital medical, dietary, and psychological care
Medical Treatment Guidelines
Involve a group of professionals including a healthcare practitioner or therapist, dietitian, psychiatrist, and medical physician
Communicate regularly of the team
Baseline initial medical review: Medical history, Physical audit, CBC, EKG, Creatinine, TSH, Amylase, Urinalysis, DEXA scan
Frequent medical monitoring actually necessary until clear improvement is evident.
Consider the use of SSRIs or other psychiatric medication, particularly if depression or obsessive-compulsive behaviors can be.
Consult a psychiatrist as needed.
Assess and address any suicidal thoughts or risk.
Medical stabilization, re-nourishment and weight restoration really are a high priority.
(c) Evolve for Change, Incorporated, Apr 2000
Revised: November, 2009
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