Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- 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
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
- CBC
- serum chemistry
- thyroid function tests
- liver function tests
- blood glucose
- urinalysis
- Sit Up-Stand-Squat (SUSS) test
Investigações a serem consideradas
- 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 tratamento
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
Declarações
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
Declarações
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.
Agradecimentos
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.
Declarações
PSP and AMI declare that they have no competing interests.
Revisores
Heather Thompson-Brenner, MD
Director
Eating Disorders Program Center for Anxiety and Related Disorders
Psychology Department
Boston University
Boston
MA
Declarações
HTB declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
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 Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Bulimia nervosa
- Avoidant-restrictive food intake disorder (ARFID)
- Depression
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