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Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, are psychological pathologies characterized by disordered relationships with food. Eating disorders are challenging to diagnose in the ED because physical manifestations may be subtle and historical features may not be elicited unless the disorder is suspected from medical complications or comorbidities. It is important for the emergency physician to recognize these conditions, however, because they are among the most deadly of psychiatric illnesses.1 The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders refines the diagnostic criteria of eating disorders from the previous edition (Table 291-1).2

TABLE 291-1Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Criteria for Eating Disorders

There are two subtypes of anorexia, restrictive and binge/purge, with crossover between the two subtypes.3 Patients with a predominantly ...

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