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Primary Care
Please note: Eating disorders develop in men, women, girls, and boys. For ease in reading, we have used "she" and "her" in the text below.
Professional treatment for an eating disorder generally includes medical care and monitoring,
nutrition counseling,
psychotherapy, and
medication.
Eating disorders can result in physical problems warranting immediate medical attention. But the idea is to prevent these complications from developing to begin with. The role of the primary care physician (internist, pediatrician, adolescent medicine specialist) is to evaluate the individual at-risk for an eating disorder, educate her about her condition, initiate interdisciplinary treatment and monitor her throughout the course of her illness, consulting medical specialists if necessary.
Pre-adolescents, adolescents and some adults with eating disorders present for medical evaluation not because they want to but because others—roommates, athletic coaches, parents—bring them. The older teenager or adult who does initiate a visit to her primary care doctor will not necessarily discuss her eating habits; instead, she is likely to request help for abdominal pain or another symptom that might or might not be related to her disordered eating. Or she may have a “physical” without mentioning a word about her extreme weight control practices (severe food restriction, binge eating, or purging). Many physicians screen for eating disorders during routine office visits by posing a few salient questions such as “How do you feel about your current weight?” “Do you eat in secret?” “Are you comfortable with your eating habits?” How an individual responds to these sorts of preliminary inquiries helps the doctor determine whether further assessment is needed.
There is no one diagnostic test that indicates whether or not an individual has an eating disorder. Instead, the doctor puts together many pieces of information—patient interview, physical exam, lab findings—to create an overall picture. In addition to setting up treatment, the doctor will work with the patient—and often with her family—to enhance her motivation to regain her health.
References
Detection of bulimia in a primary care setting
Freund, K.M., Graham, S.M., Lesky, L.G., and Moskowitz, M.A. Detection of bulimia in a primary care setting. Journal of General Internal Medicine 1993; 8: 236-242.
Diagnosis of eating disorders in primary care
Pritts, S.D., Susman, J. Diagnosis of eating disorders in primary care. American Family Physician 2003; 67 (2): 297-304.
Children and adolescents with eating disorders: the state of the art
Rome, E.S., Ammerman, S., Rosen, D.S., Keller, R.J., Lock, J., Mammel, K.A. ,O’Toole, J., Rees, J.M., Sanders, M.J., Sawyer, S.M., Schneider, M., Sigel, E., Silber, T.J. Children and adolescents with eating disorders: the state of the art. Pediatrics 2003; 111(1): e98-e108.
This page was last updated on October 10, 2007.
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