Medical Management of Eating Disorders: An Update

Ulrich Voderholzer; Verena Haas; Christoph U. Correll; Thorsten Körner


Curr Opin Psychiatry. 2020;33(6):542-553. 

In This Article


Medical comorbidities and complications are frequent in individuals with eating disorders, requiring clinical attention. As an example, Figure 1 shows the frequency of selected medical findings in a large sample of adult inpatient-residential eating disorder patients.[4]

Figure 1.

Frequency of medical findings in anorexia nervosa and bulimia nervosa (according to Mehler et al. [4]). Definition of abnormal findings: low albumin: less than 25 mg/dl; vitamin D deficiency: less than 30 ng/ml; metabolic alkalosis: more than 29 mEq/l; hypokalemia: less than 3.6 mEq/l; hyponatremia: less than 135 mEq/l; hypophosphatemia: less than 2.7 mg/dl; hypoglycemia: less than 60 mg/dl; prolonged QTc: more than 500 ms; bradycardia: less than 60 bpm; tachycardia: more than 100 bpm; osteoporosis: T score/Z score more than −1.

Clearly, to improve short-term and long-term outcomes in individuals with eating disorders, the specific eating disorder must be diagnosed and treated according to existing guidelines. However, at the same time the treatment team must assess for and manage physical abnormalities that are often prevalent and often the direct consequence of the specific eating disorder. Table 1 summarizes medical findings and their suggested management in eating disorders, as well as serious complications and risk of fatality.