Child and Adolescent Mental Health Services
Information for professionals
Physical – loss of weight, fainting/dizziness, loss of energy, muscle weakness, sleep disturbance, susceptibility to infection, loss of menstruation, constipation/bloating, repeated vomiting, , swollen glands under the jaw or frequent dental problems (if there is repeated vomiting).
Behavioural changes – counting calories, restricting the amount or range of food eaten, eating alone or missing meals, secretiveness, hiding food, frequent visits to the toilet, taking a long time to eat meals, cutting food into small pieces, excessive body-checking, over-exercising, wearing baggy clothes.
Psychological – preoccupation with food and eating, concerns about weight and shape, feeling compelled to restrict intake, fear of eating.
Psychological – low mood, loss of interest, poor concentration, withdrawal, disturbed family relationships
Social/educational – withdrawal from family and friends, loss of interest in activities, poor concentration, difficult family relationships
NB The non-specific signs may also be a feature of other mental health disorders such as depression or anxiety
Atypical eating disorders
Clarification of history and symptoms of eating disorder as above, along with a brief summary of family and personal background. Useful questions (some adapted from the SCOFF questionnaire) include:
If an eating disorder is suspected, physical assessment is indicated to exclude other causes of low weight and identify any physical consequences of the disorder.
This will include weight and height, BP and PR as well as more general examination to exclude other causes of weight loss. For those with low pulse rate (under 50) an ECG may be indicated to identify any serious cardiac abnormalities.
Recommended initial blood investigations include: FBC; ESR/CRP; urea and electrolytes (including phosphate, Mg, Ca); liver function tests, glucose, folate, B12; Iron; coeliac screen, thyroid function tests.
Last updated: 26 March, 2019