Eating Disorder Diagnosis

While eating disorders are normally identified through simple observation, such as people eating massive amounts of food or being extremely thin, it is not always easy to determine the underlying causes. Extreme weight loss can be caused by conditions ranging from cancer to anorexia, just as obesity can be caused by various disorders. So a thorough physical as well as a psychological evaluation is important in diagnosing eating disorders.

Anorexia Nervosa

Symptoms that are associated with anorexia include:

• Excessive concern with their body shape and weight
• Having an eating disorder as an infant or as a child
• Wanting to be "perfect"
• Having a distorted body image – thinking they are fat even though they are too thin
• Fear of becoming fat or gaining weight, even though they are already underweight
• Amenorrhea – not having a menstrual period for several months

People with anorexia might give themselves extreme limits on the food they eat or make themselves vomit after eating too much. Some behaviors seen in anorexic people are:

• They cut their food into tiny pieces or move their food around on the plate instead of actually eating it
• They exercise constantly, no matter what the weather is like, how hurt they are, or how busy their schedules are
• They go straight to the bathroom after eating
• They do not want to eat in public
• They take pills to force themselves to urinate (diuretics or water pills), to have bowel movements (laxatives or enemas), or to reduce their appetites (diet pills)

Signs of anorexia include:

• Yellow, blotchy and dry skin Slow or confused thinking, bad judgment or poor memory
• Dry mouth
• Depression
• Extreme sensitivity when it comes to cold temperatures (having to wear many layers of clothes just to stay warm)
• Weak bones
• Loss of muscle and body fat

Complications of anorexia include:

• Swelling or bloating
• Weakening of bones
• Dangerous heart palpitations or irregular heartbeat
• Reduction in white blood cells that fight infections
• Extreme dehydration
• Extreme malnutrition
• Seizures because of a loss of fluids associated with repeated vomiting or diarrhea
• Thyroid problems that can lead to constipation or an intolerance of cold weather
• Tooth decayand loss of enamel from vomiting

Before diagnosing anorexia, other causes of muscle wasting and weight loss need to be ruled out. Medical problems that have similar symptoms are:

• Inflammatory bowel disease
• Celiac disease
• Addison’s disease

Tests to rule out other causes and evaluate the damage that the weight loss has already done include:

• Albumin level
• Complete blood count (CBC)
• Bone density tests
• Electrolytes
• Electrocardiogram (ECG or EKG)
• Kidney, thyroid and liver function tests
• Urinalysis
• Total protein level

Bulimia

People with bulemia usually eat a lot of high-calorie foods in secret and then end up feeling disgusted by their actions. This, in turn, makes them want to purge their food to prevent gaining weight. Their purging methods might include:

• Forced vomiting
• Excessive exercise
• The use of enemas, laxatives, or diuretics (water pills)
• People with bulimia are usually at a normal weight range, but think they are overweight. Since their weight range is still considered normal, though, other people might not even notice that they have an eating disorder.

Some symptoms of bulimia include:

• Compulsive exercise
• Regular bathroom visits after meals
• Discarding of laxative, diet pill, emetic, or diuretic packages
• Sudden food binges
• Dental tests might show gum infections, like gingivitis, or cavities. Teeth enamel might be pitted or decaying due to the regular presence of vomit and stomach acid in the mouth.

Physical examinations might also show:

• Broken eye blood vessels (due to the strain that comes with forced vomiting)
• A dry mouth
• Swollen salivary glands
• Pimples and rashes
• Small calluses and cuts on the finger tips from forced vomiting
• Blood tests might show dehydration or hypokalemia, as well.