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

Nonlife Threatening Medical Findings and Their Relevance for Management

Many medical findings, especially in anorexia nervosa but also in bulimia nervosa, such as abnormal findings of skin, hair, teeth, bone or endocrine findings, can be frequently observed (Table 1). This includes elevated inflammatory cytokines and oxidative stress markers, predominantly in anorexia nervosa, which are markers of global physical stress that contributes to the overall physical ill-health and predisposes to physical morbidities.[13–15] However, these findings are not acutely life-threatening and are usually reversible with weight restoration and the cessation of purging behavior. Many of these symptoms may impair individual well being and make affected persons looking physically ill and prematurely old. The assessment of various medical symptoms and the confrontation of patients with the link between these subjectively burdensome physical symptoms and disturbed eating behavior can increase the willingness to seek psychotherapeutic treatment for the eating disorder. It is therefore recommended to carefully diagnose all medical findings in patients with eating disorders and to explain these findings to the patients to support their insight into their eating disorder representing a serious condition with the potential for adverse long-term consequences.

This situation is especially true for children and adolescents and their caregivers since eating disorders at this early age may also have serious consequences for growth and development, fertility, bone density and other aspects of future physical ill-health.[16]