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anorexia

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A friend recently told me her granddaughter has an eating problem which is of

recent onset. She had been losing weight and told her mother she had a problem

with eating. She was taken to her physician who told her to eat 1,000 calories

per day and made the diagnosis of anorexia nervosa. At that point no referrals

anywhere!

On f/u 2 weeks later the MD told the 17 year old she would be hospitalized soon

if no weight gain. At this visit J was told not to exercise at all as a " heart

test showed her heart was working too hard. "

The 15# weight loss has happened over approx. a 2 month period. She is 5'3 "

tall with UBW of 115#. At 99# her family describes her as " very, very thin.

Down from a size 4 to 0. She is very pale, feels weak, has frequent stomach

aches and constipation problems. From what I understand she is managing to eat

1,000 cals per day and has for the last 2 weeks.

I've never worked in ED, but have had contact with students and acquaintances

with anorexia who were of lower BMI and appearing more well than this girl does.

This cardiac problem seems rather dramatic. I keep thinking about thin

surgical patients who had great weight loss in less time and didn't suffer

cardiac problems as a result. Are GI sx common with anorexia nervosa? I guess

I'm wondering if there is an underlying medical problem that is causing the

anorexia rather than the other way around.

I think I might need to hear the dx of anorexia nervosa made by an ED therapist

before I feel comfortable that this girl is getting appropriate medical care.

Thoughts and opinions welcome.

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