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Anorexia nerviosa

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Last reviewed: 12 Aug 2025
Last updated: 22 May 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • peso corporal significativamente bajo
  • temor a ganar peso o a ponerse gordo, o comportamientos que interfieren con el aumento de peso a pesar de haber evidencias de que el peso corporal es significativamente bajo
  • imagen corporal distorsionada
  • restricción calórica
  • atracones y/o purgas
  • abuso de laxantes, diuréticos o píldoras adelgazantes
  • amenorrea
  • disminución de grasa subcutánea
Full details

Other diagnostic factors

  • fatiga general, debilidad muscular y mala concentración
  • preocupación significativa con pensamientos sobre la comida
  • hipotensión ortostática
  • síntomas gastrointestinales inespecíficos
  • síntomas y signos cardíacos
  • cambios en el pelo, la piel y las uñas
  • edema postural
  • osteopenia u osteoporosis
Full details

Risk factors

  • sexo femenino
  • adolescencia y pubertad
  • rasgos obsesivos y perfeccionistas
  • exposición a los medios occidentales
  • influencia genética
  • clases socioeconómicas media y alta
  • atleta
  • burlas relacionadas con la apariencia
  • maltrato infantil
  • enfermedad celíaca
  • Diabetes mellitus de tipo 1
Full details

Diagnostic investigations

1st investigations to order

  • diagnóstico clínico
  • hemograma completo (HC)
  • química sérica
  • pruebas de función tiroidea
  • pruebas de función hepática
  • glucemia
  • análisis de orina
  • Prueba Sit Up-Stand-Squat (SUSS)
Full details

Investigations to consider

  • Cuestionario SCOFF (por sus siglas en inglés: sick, control, one, fat, food) )
  • electrocardiograma (ECG)
  • densitometría ósea (radioabsorciometría de doble energía)
  • estradiol en las mujeres
  • testosterona en los hombres
  • prueba de embarazo en orina o suero
Full details

Treatment algorithm

ACUTE

médicamente estable y apto para el tratamiento ambulatorio

clínicamente inestable o fracaso del manejo ambulatorio

Contributors

Authors

Evelyn Attia, MD

Professor of Psychiatry

Columbia University and Weill Cornell Medical College

New York

NY

Disclosures

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

Disclosures

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.

Acknowledgements

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.

Disclosures

PSP and AMI declare that they have no competing interests.

Peer reviewers

Heather Thompson-Brenner, MD

Director

Eating Disorders Program Center for Anxiety and Related Disorders

Psychology Department

Boston University

Boston

MA

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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].Full text

American Psychiatric Association. Practice guideline for the treatment of patients with eating disorders. Feb 2023 [internet publication].Full text

Royal College of Psychiatrists. Medical emergencies in eating disorders (MEED): guidance on recognition and management. Oct 2023 [internet publication].Full text

Hornberger LL, Lane MA, Committee on Adolescence. Identification and management of eating disorders in children and adolescents. Pediatrics. 2021 Jan;147(1):e2020040279.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Anorexia nerviosa images

  • Differentials

    • Bulimia nerviosa
    • Trastorno de ingesta de alimentación selectiva (ARFID)
    • Depresión
    More Differentials

  • Guidelines

    • Determining treatment goal weights for children and adolescents with anorexia nervosa
    • Practice guideline for the treatment of patients with eating disorders
    More Guidelines

  • Patient information

    Anorexia

    Anorexia: preguntas que debe hacer a su médico

    More Patient information

  • Calculators

    Percentiles de índice de masa corporal (IMC) para niños (entre 2 y 20 años)

    Percentiles de índice de masa corporal (IMC) para niñas (entre 2 y 20 años)

    More Calculators
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