Integrated Care for Eating Disorder Evaluation, Diagnosis, and Treatment

A recent article in the American Family Physician journal examines the evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. Eating disorders are serious, life-threatening conditions that are often associated with additional physical and mental illnesses. Depressive symptoms, suicide, obsessive compulsive disorder, anxiety, and substance use disorders are common in people with eating disorders. In particular, anorexia nervosa is associated with overuse injuries and stress fractures, osteoporosis, and potentially fatal arrhythmias.

Family physicians and multidisciplinary care teams play an important role in addressing eating disorders. Annual health examinations and sports physicals provide an opportunity for physicians to screen patients for eating disorders. The article contains resources useful for family physicians, including:

  • The SCOFF Questionnaire: Screening for Eating Disorders in Adults – The questionnaire contains five questions for physicians to ask patients. “Yes” answers to more than two questions indicate the likelihood of anorexia nervosa or bulimia nervosa. Questions are adapted from the SCOFF Questionnaire to be applicable to adolescents.
  • Selected Clinical Signs of Eating Disorders – Signs of anorexia nervosa and bulimia nervosa are listed with their underlying pathologies. Additional information about clinical presentations of eating disorders can be found within the text.
  • SORT: Key Recommendations for Practice – Clinical recommendations are given, along with evidence ratings and related references.

One of the clinical recommendations is that “an interdisciplinary team approach is needed for the treatment of eating disorders.” Adolescents with anorexia nervosa benefit from family-based treatment, nutritional intervention, and weight restoration. Antidepressants and Cognitive Behavioral Therapy are indicated for treating bulimia nervosa. By working closely with eating disorder specialists, dieticians, and other members of the care team, family physicians can “fill a central role in the monitoring and treatment of eating disorders.” The recommendation for interdisciplinary treatment underscores the importance of primary care and behavioral health integration.

Read the full-text article Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa.