Doctors, an essential part of the team.
Eating Disorders are more common than one would think. They are seen not only in the bodies of those suffering; in many secretive individuals they can remain undetected for years. Great emotional pain, shame and fear create isolation, and long-term behaviors lead to severe medical complications. However, eating disorders are highly treatable. Successful treatment requires effective medical management, psychological support and family involvement.
Consistent medical monitoring is imperative in the treatment of clients of have an eating disorder. A holistic team approach will include community doctor, dietitian, clinician and when applicable, the psychiatrist. Consultation is also coordinated with St. Paul’s and BC Children’s Hospital when required. It is requested that the community doctor’s role does not end when the client is referred. The doctor is asked to monitor the client on a regular basis throughout the course of treatment and thereafter.
What To Monitor
Electrolytes
Creatinine, K, CL, Bicarb, Na, Glucose, Ca, PO4, Mg, Check frequently, particularly if the pattern of purging has increased.
Blood Pressure and Pulse
Both lying and standing rates on every visit.
Weight
Weigh on every visit, but turn client’s back to the scale so they do not have to deal with the extreme feelings associated with weight change. Likely best not to discuss weight with the client.
ECG
Check frequently, particularly if there are electrolyte abnormalities. Monitor for chest pains, arrhythmias, fainting, muscle pains, weakness, muscle cramps and dizziness. Acute changes are dangerous and will need to be addressed immediately.
Consider Hospitalization
If the patient experiences severe or rapid weight loss (is less than 75% of their healthy body weight or loses 10-15lbs in 4 weeks). If the pulse differential is greater than 30bpm or the resting pulse is below 45bpm, particularly if accompanied by electrolyte abnormalities or any of the above noted symptoms or prolonged QTc interval (>450), hypokalemia (less than 3 meq/l), tetany, hypothermia, seizures or organic brain syndrome. Also consider admission to hospital if the patient suffering from an eating disorder is pregnant, diabetic or suicidal.