Identification of patients with eating disorders. The signs and symptoms of anorexia nervosa and bulimia nervosa

  • L. Uyeda
  • I. Tyler
  • J. Pinzon
  • C. Laird Birmingham
Original Research Peaper


The optimal medical assessment of an eating disorder patient depends on a knowledge of the associated signs and symptoms, many of which are rarely seen in general medicine. Some of these signs are diagnostic of eating disorders. This paper presents a systematic review of the history and physical examination, including the special signs and symptoms in tabular form. In addition, the significance of the signs and symptoms of eating disorders is reviewed.

Key words

Eating disorders anorexia nervosa bulimia nervosa physical signs history assessment diagnosis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC, American Psychiatric Association, 1994.Google Scholar
  2. 2.
    Abraham S., Llewellyn-Jones D.: Eating Disorders: The facts, 4th ed. Oxford, NY, Oxford University Press, 1997, pp. 56–63.Google Scholar
  3. 3.
    Crowther J.H., Sherwood N.E.: Assessment. In: Garner D.M., Garfinkel P.E. (Eds.), The handbook of treatment for eating disorders, 2nd ed. New York, NY, The Guilford Press, 1997, pp. 34–49.Google Scholar
  4. 4.
    Fisher M., Golden N.H., Katzman D.K., Kreipe R.E., Rees J., Schebendach J., Sigman G., Ammerman S., Hoberman H.M.: Eating disorders in adolescents: A background paper. J. Adolesc. Health, 16, 420–437, 1995.PubMedCrossRefGoogle Scholar
  5. 5.
    Chawla A., Somani R.: Essentials of clinical examination: Handbook, 2nd ed. University of Toronto, 1999, p. 7.Google Scholar
  6. 6.
    Bryant-Waugh R., Knibbs J., Fosson A., Kaminski Z., Lask B.: Long term follow-up of patients with early onset anorexia nervosa. Arch. Dis. Child., 143, 1322–1327, 1989.Google Scholar
  7. 7.
    Lawrence S., Neinstein L., Kaufman F.R.: Normal physical growth and development and psychosocial development in normal adolescents. In: Neinstein L. (Ed.), Adolescent health care: A practical guide, 3rd ed. Pittsburgh, PA, Williams & Wilkins, 1996, pp. 3–60.Google Scholar
  8. 8.
    Nussbaum M.P.: Anorexia Nervosa. In: McAnarney E., Kreipe R., Orr D., Comerci G., (Eds.), Textbook of adolescent medicine. Philadelphia, W.B. Saunders Company, 1992, pp. 536–546.Google Scholar
  9. 9.
    Coupey S.M.: Anorexia Nervosa. In: Friedman S., Fister M., Schonberg K., Alderman E., (Eds.), Comprehensive adolescent health care, 2nd ed. St. Louis, Mosby-Year Book, 1998, pp. 247–268.Google Scholar
  10. 10.
    Ehrman W.H., Matson S.C.: Approach to assessing adolescents on serious or sensitive issues. Pediatr. Clin. North Am., 45, 189–204, 1998.PubMedCrossRefGoogle Scholar
  11. 11.
    de Zwaan M., Mitchell J.E.: Medical complications of anorexia nervosa and bulimia nervosa. In: Kaplan A.S., Garfinkel P.E. (Eds.), Medical issues and the eating disorders: The interface. New York, Brunner/Mazel Publishers, 1993, pp. 60–100.Google Scholar
  12. 12.
    Hellstrom I.: Oral complications in anorexia nervosa. Scand. J. Dental Res., 85, 71–86, 1977.Google Scholar
  13. 13.
    Gupta M.A., Gupta A.K., Haberman H.F.: Dermatologic signs in anorexia nervosa and bulimia nervosa. Arch. Dermatol., 123, 1386–1390, 1987.PubMedCrossRefGoogle Scholar
  14. 14.
    Mitchell J.E., Pomeroy C., Adson D.E.: Managing medical complications. In: Garner D.M., Garfinkel P.E. (Eds.), The handbook of treatment for eating disorders, 2nd ed. New York, The Guilford Press, 1997, pp. 383–393.Google Scholar
  15. 15.
    Palla B., Litt I.F.: Medical complications of eating disorders in adolescents. Pediatrics, 81, 613–623, 1988.PubMedGoogle Scholar
  16. 16.
    Cohen L.B., Field S.P., Sachar D.B.: The superior mesenteric artery syndrome: The disease that isn’t, or is it? J. Clin. Gastroenterol., 7, 113–116, 1985.PubMedCrossRefGoogle Scholar
  17. 17.
    Harris R.T.: Eating disorders: Diagnosis and management by the internist. South. Med. J., 79, 871–878, 1986.PubMedCrossRefGoogle Scholar
  18. 18.
    Kim-Sing A., Birmingham C.L.: Clinical use of magnesium supplementation. Can. J. Hospital Pharmacy, 43, 161–166, 1990.Google Scholar
  19. 19.
    Kreipe R.E., Comerci G.D.: Assessment of weight loss in the adolescent. Ross Laboratories, 8, 1988.Google Scholar

Copyright information

© Editrice Kurtis 2002

Authors and Affiliations

  • L. Uyeda
    • 1
  • I. Tyler
    • 1
  • J. Pinzon
    • 2
  • C. Laird Birmingham
    • 1
  1. 1.University of British ColumbiaCanada
  2. 2.British Columbia Children’s HospitalVancouverCanada

Personalised recommendations