Emergency room presentations of people with anorexia nervosa

Plain English summaryPeople with anorexia nervosa frequent emergency departments to obtain their medical care. It is thus important for emergency department personnel to be familiar with this increasingly common and serious disorder. As opposed to most other mental illnesses, anorexia nervosa is associated with many dangerous medical complications, which become more problematic as the malnutrition and weight loss become more severe. All body systems are adversely affected. The mortality rate of anorexia nervosa is the second highest of all mental disorders, with medical complications and suicide being the top two causes of death. Mandated medical care may occasionally be required to obtain ongoing treatment for people with anorexia nervosa when they present to the emergency department with severe malnutrition and other emergent complications. People with anorexia nervosa (AN) tend to shy away from engaging in typical primary care provider relationships in order to avoid detection. Therefore, they may seek care for their medical concerns through a local emergency department (ED). Inherently, AN is associated with a litany of medical complications, which become more prevalent as the severity of their eating disorder increases. Notwithstanding the typical young age at the onset of AN, no body system is immune to these medical complications. Thus, ED providers may need to pursue a medical diagnosis in order to explain presenting symptoms in people with AN. In addition to the medical issues, AN is also a serious mental illness with high mortality rates, including deaths by suicide. Therefore, ED providers also need to be familiar with relevant mental health issues for these people.