Eating disorders in primary care - diagnosis and treatment

Eating disorders are described by impaired eating behaviors that lead to major disturbances of body weight. The problem of eating disorders concerns about 3-5% of women of western societies and become one of the most important problems of adolescence. Disturbances of regulatory mechanisms of eating trigger both biological and psychological disorders which need to be treated with psychotherapy and pharmacological methods. Clinical examination should be begun with assessment of psychological and somatic state of the patient, including life-threatening disturbances (assessment of BMI, cardiological state and metabolic disturbances). Early recognition and treatment are crucial for the course and prognosis in eating disorders. In anorexia psychological treatment should be introduced after stabilizing somatic state of patient. Pharmacological treatment aims in reducing co-existing symptoms of depression, obsessions, compulsions and anxiety. In bulimia a combined treatment is recommended: cognitive-behavior therapy with Selective Serotonin reuptake inhibitors (SSRI).