Recognizing Eating Disorders in the ER

Eating disorders are becoming more prevalent than ever, and more and more eating disordered teens are going undiagnosed.  A new study conducted by the University of Michigan looks to spot undiagnosed eating disorders amongst teens and young adults in hospital emergency rooms.  Their hope is to be able to steer those undiagnosed patients into the proper treatment for their eating disorders.

Researchers at the University of Michigan conducted eating disorder screening for more than 940 patients aged 14 to 20 years old as part of their visit to the University of Michigan Emergency Department for any non-psychiatric reason.  More than one in every six patients had signs of an eating disorder.  Those with eating disorder symptoms were also likely to show indications of depression and substance abuse.  Over twenty-five percent of the patients with eating disorder symptoms were male.

Dr. Suzanne Dooley-Hash, an emergency physician at University of Michigan Emergency Department, started the study because she felt that eating disorders were more common among emergency room patients than the doctors there might have thought.  She felt that undiagnosed eating disorders were going under the radar, because no one was asking questions about eating behaviors.

One surprising finding was that the eating disorder patients in the emergency room were more than three times as likely to be obese as the patients who were found without eating disorders.  This is contrary to what the general public thinks of when looking for eating disorder signs.  Most people think of waif-like teenage girls who starve themselves or purge when they think of eating disorders.  Educating emergency room doctors and the public about the reality that eating disorders exist at any and every size could help increase the rate of diagnosing eating disorders before they become fatal.

Most teens and young adults visit emergency rooms more than they visit regular doctors, and sometimes it is the only form of care they receive.  Therefore, researchers believe that screening for eating disorders in the emergency room could help undiagnosed patients find more intensive eating disorder treatment for when they leave the emergency room.

This could save a lot of lives.

According to the American Journal of Psychiatry, eating disorders have the highest mortality rate of any mental disorder.  Also according to the American Journal of Psychiatry, only one in ten men and women with eating disorders receive treatment, and only thirty-five percent of people who receive treatment for eating disorders get treatment at a specialized facility for eating disorders.

Many emergency rooms already screen for drug and alcohol abuse, risky driving, and other risky behaviors.  Emergency room teams are equipped to refer patients for care for substance abuse, so why should they not be equipped to refer people for eating disorder care?  While eating disorder treatment is not a one hundred percent cure and can take many years, the earlier someone is accurately diagnosed the better their survival chances are.

Works Cited

1. Crow, S.J., Peterson, C.B., Swanson, S.A., Raymond, N.C., Specker, S., Eckert, E.D., Mitchell, J.E. (2009) Increased mortality in bulimia nervosa and other eating disorders. American Journal of Psychiatry 166, 1342-1346.
2. Nauert PhD, R. (2012). Spotting Eating Disorders in the ER. Psych Central. Retrieved on November 20, 2012.