- General: feeling cold
- Skin, hair, nails: alopecia, lanugo hair, acrocyanosis, edema
- Cardiovascular: bradycardia, hypotension
- Gastrointestinal: salivary gland enlargement, slow gastric emptying, constipation, elevated liver enzymes
- Hematopoietic: normochromic, normocytic anemia; leukopenia
- Fluid/electrolyte: increased blood urea nitrogen, increased creatinine, hyponatremia, hypokalemia. Hypokalemia can become life threatening.
- Endocrine: low luteinizing hormone and follicle-stimulating hormone with secondary amenorrhea, hypoglycemia, normal thyroid-stimulating hormone with low normal thyroxine, increased plasma cortisol, osteopenia
- Gastrointestinal: salivary gland enlargement, dental erosion from gastric acid exposure
- Fluid/electrolyte: hypokalemia, hypochloremia, alkalosis (from vomiting), or acidosis (from laxative abuse)
- Other: callus or scar on dorsum of hand (from repeated scraping against teeth during induced vomiting)
| TREATMENT | ||
Eating DisordersANOREXIA NERVOSAMaudsley family-based therapy is effective, with strict behavioral contingencies used when weight loss becomes critical. No pharmacologic intervention has proven to be specifically beneficial, but comorbid depression and anxiety should be treated. Weight gain should be undertaken gradually with a goal of 0.5-1 lb per week to prevent complications from rapid refeeding (fluid retention, congestive heart failure, acute gastric dilatation). Most individuals are able to achieve remission within 5 years of the original diagnosis. BULIMIA NERVOSAEffective treatment approaches include selective serotonin reuptake inhibitors (SSRIs) antidepressants, usually in combination with cognitive-behavioral, emotion regulation, or interpersonal-based psychotherapies. |