Restriction of intake leading to significantly low weight, intense fear of weight gain and disturbed body image.
Investigations
- • Weight, BMI, sit-up–squat–stand test
- • U&E, phosphate, magnesium, glucose, FBC, LFT
- • ECG for bradycardia and prolonged QTc
- • DEXA if amenorrhoeic >1 year
Management
- • Specialist eating-disorder service referral
- • Psychological therapy (CBT-ED, MANTRA, family therapy for young people)
- • Cautious refeeding 5–10 kcal/kg/day if high risk
- • Thiamine and multivitamins before feeding
- • Daily phosphate, potassium and magnesium for first week
Complications
- • Refeeding syndrome — hypophosphataemia, arrhythmia, cardiac failure
- • Osteoporosis
- • Infertility
Clinical pearls
- • Highest mortality of any psychiatric disorder
- • Rapid weight loss matters more than absolute BMI for admission decisions
Related in WardRound
Educational — verify locally.
