The following indicators come significant and common warning signs of anorexia and bulimia. Critical or multiple indicators suggest value of medical, dietary and psychological intervention. The items marked utilizing an asterisk (*) might point to an urgent need for doing this intervention and treatment.
PHYSIOLOGICAL AND MEDICAL INDICATORS
Below 85% of normal body weight range, or BMI below 16%
* Below 70% of normal body weight, or BMI below 14
Unexplained searching for, especially in adolescents
*Electrolyte disturbances such as: serum potassium below 2. 6 mmol/L or you do not 6 mmol/L; repeated points in potassium below 3. 0; serum calcium below 6 mg/dL or over 13 mg/ dL
*EKG problems indicating electrolyte disturbance
Bone marrow suppression shown by neutropenia and anemia
Bradycardia reducing 60
Serum protein or albumin below or above normal, Low T4, accelerated TSH, and/or low LH
*Palpitations
*Syncope or maybe just near-syncope
Dizziness or light-headedness
Amenorrhea (absence of menstruation more than 3 months) or especially irregular menstruation
Dehydration or repeated incredible importance of rehydration in previous 12 months
Chest pain
Hypothermia if not report of cold intolerance
Hair current administration or breakage
Lanugo hair in the house face, neck, back, : arms
Yellowish tinge to hide, purplish-blue hands and feet
Hypercarotenemia
Orthostatic hypertension levels and pulse changes
Dental disorder including enamel erosion
*Esophageal tear / blood in vomit
Swollen / tender parotid glands
Frequent gastroesophageal regurgitate into throat / mouth
Chronic, indigestion / heartburn
Severe constipation
Extreme and / or chronic fatigue / weakness
Brittle bones
Non-focal abdominal pain with usage of food
Abdominal bloating / development of hands, ankles, : feet
Elevated serum amylase -- lipase
Elevated liver enzymes
*Persistent diarrhea, (may be bloody)
*Pancreatitis
*Severe intestinal pain (may indicate opportunity visceral rupture)
DIETARY INDICATORS
Caloric intake much like the patient is body fat deposits 800 kcal / day
*Inability or refusal in order to any food down
Engaging from food games (i. orite., hiding food, hoarding factors, chewing and spitting pastries out, cutting food into tiny pieces, lying as to what food has been had his food, etc. )
Eating the same foods customer hits / rigid food rituals
Limiting food to only vegatables and fruits / eliminating fats and proteins
*Refusing to keep yourself hydrated or consuming less after that 8 oz / morning, or restricting water consumption for 2-7 days
Binging 2 or more times daily on excessive quantities of food
Purging a couple of times daily
Inability to maintain weight
*Rapid diet program; losing more than a few pounds weekly
Unable or hesitant to stop or decrease compelling exercise, exercising more than ever two hours daily, in contrast having extreme feelings from the guilt, inadequacy, or anxiety if struggles to exercise
Spending more than 75% of waking hours why would you food, calories, fat, circulatory system, and weight
Unable to any food plan without stored fat food involvement or excessive food avoidance
Unable to follow a food plan offered by a dietitian without restricting or "bargaining" overall health , wellness eating disorder
Laxative abuse, Abusing over-the-counter fat burners or diet aids, or hazardous drinking of caffeinated drinks
*Inability to do withdraw from laxatives, fat burners, or diuretics
COGNITIVE, EMOTIONAL, ATTITUDINAL, RELATIONAL INDICATORS
Self-injury such while much as cutting, scratching, burning
*Failure of outpatient treatment
Failure to respond psychiatric medications
*Slowness in voice message, inability or severe difficulty to generatte decisions, difficulty in visitor conversation, etc.
Poor amount: inability to focus
Poor memory - inability to recall conversations or marriages after one day
Poor appearing academically or at work
Feeling of pride in fat loss or in being able to deny self of food in order to resist hunger
Significant absence from practice or work
Intense feelings to do with shame and self-disgust located on eating habits
Significant body distortions with associated emotional surprise and anxiety
Intense feelings regarding weakness, guilt, or inadequacy over-eating food, After eating, subsequent restriction or self-punishment to pay for caloric intake
Minimizes or gets angry and safety at loved ones' expressed love eating habits
Inability or unwillingness to eat oriented towards others
Expresses intense and unreasonable fear of gaining weight or "becoming fat"
*Suicidal idealization that's where worsening, or the eating disorder has come to be the means for suicide
*Suicidal gestures or attempts
Other complex, concurrent psychological disorders and/or signals or symptoms (i. e. depression, fear, panic disorder, obsessive uncontrollable disorder, personality disorders, in addition to. )
Long and chronic good reputation eating disorder (over 5 years)
*Short and intense good name for eating disorder with strenuous and rapid deterioration
Obsessive comparing of body shape or size to other women
Avoiding the competition or "pushing away" family at home / friends
Constant lying, rip-off, and secrecy to lie in wait eating disorder
Concurrent and alternating addictions (e. g., pulling, exercise, sexual activity, prescriptions, alcohol, cutting)
*Extreme emotional getting bored, disengagement and numbness
Significant security or withdrawal
Extreme emotional sadness and feelings of hopelessness
Trauma related symptoms that requirement safety and containment
Extreme occurrences of self-contempt and self-hatred
Extreme obsessive thought patterns and/or perfectionism
*Deterioration despite outpatient medical, dietary, and psychological care
Medical Treatment Guidelines
Involve a grouping of professionals including a specialist or therapist, dietitian, shrink, and medical physician
Communicate regularly about team
Baseline initial medical report: Medical history, Physical meeting, CBC, EKG, Creatinine, TSH, Amylase, Urinalysis, DEXA scan
Frequent medical monitoring could be necessary until clear improvement is evident.
Consider the use of SSRIs or other psychiatric medication, particularly if depression or obsessive-compulsive behaviors exist.
Consult a psychiatrist as required.
Assess and address any thoughts of suicide or risk.
Medical leveling, re-nourishment and weight restoration really are a high priority.
(c) Importance for Change, Incorporated, April 2000
Revised: November, 2009
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