Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- significantly low body weight
- fear of gaining weight or becoming fat, or behaviors that interfere with weight gain despite evidence of significantly low body weight
- disturbed body image
- calorie restriction
- binge-eating and/or purging
- misuse of laxatives, diuretics, or diet pills
- amenorrhea
- decreased subcutaneous fat
Otros factores de diagnóstico
- general fatigue, muscle weakness, and poor concentration
- significant preoccupation with thoughts of food
- orthostatic hypotension
- nonspecific gastrointestinal symptoms
- cardiac symptoms and signs
- changes to hair, skin, and nails
- dependent edema
- osteopenia or osteoporosis
Factores de riesgo
- female sex
- adolescence and puberty
- obsessive and perfectionist traits
- exposure to Western media
- genetic influence
- middle and upper socioeconomic classes
- athlete
- appearance-related teasing
- childhood maltreatment
- celiac disease
- type 1 diabetes mellitus
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
- CBC
- serum chemistry
- thyroid function tests
- liver function tests
- blood glucose
- urinalysis
- Sit Up-Stand-Squat (SUSS) test
Pruebas diagnósticas que deben considerarse
- Sick, Control, One, Fat, and Food (SCOFF) questionnaire
- ECG
- bone densitometry (dual-energy x-ray absorptiometry)
- estradiol in females
- testosterone in males
- urine or serum pregnancy test
Algoritmo de tratamiento
medically stable and suitable for outpatient treatment
medically unstable or outpatient failure
Colaboradores
Autores
Evelyn Attia, MD
Professor of Psychiatry
Columbia University and Weill Cornell Medical College
New York
NY
Divulgaciones
EA receives royalties from UpToDate and Oxford University Press for authorship and has served as a clinical advisor to Equip Health, Inc.
B. Timothy Walsh, MD
Professor of Psychiatry
Columbia University
New York
NY
Divulgaciones
BTW has received royalties and honoraria for writing, editing, speaking, or consulting from Guilford Publications, McGraw-Hill, Oxford University Press, UpToDate, Wiley, the University of British Columbia, Silverhill Hospital, the University of Alabama, the American Society for Clinical Psychopharmacology, Health Advances, and Dell Medical School.
Agradecimientos
Professor Evelyn Attia and Professor B. Timothy Walsh would like to gratefully acknowledge Dr Pauline S. Powers and Dr Abby M. Irwin, previous contributors to this topic.
Divulgaciones
PSP and AMI declare that they have no competing interests.
Revisores por pares
Heather Thompson-Brenner, MD
Director
Eating Disorders Program Center for Anxiety and Related Disorders
Psychology Department
Boston University
Boston
MA
Divulgaciones
HTB declares that she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
National Institute for Health and Care Excellence. Eating disorders: recognition and treatment. Dec 2020 [internet publication].Texto completo
American Psychiatric Association. Practice guideline for the treatment of patients with eating disorders. Feb 2023 [internet publication].Texto completo
Royal College of Psychiatrists. Medical emergencies in eating disorders (MEED): guidance on recognition and management. Oct 2023 [internet publication].Texto completo
Hornberger LL, Lane MA, Committee on Adolescence. Identification and management of eating disorders in children and adolescents. Pediatrics. 2021 Jan;147(1):e2020040279.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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