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Spotting Eating Disorders in the ER

 Spotting Eating Disorders in the ERIdentifying eating disorders in teens and getting treatment are often difficult tasks. A new study seeks to leverage location, in this case hospital emergency rooms, to spot undiagnosed eating disorders among teens and help steer them to treatment.

In the study, University of Michigan researchers screened more than 940 teens and young adults aged 14 to 20 years old for eating disorders, as part of their visit to the U-M Emergency Department for any non-psychiatric reason.

They found that 16 percent — more than one in every six — had indications of an eating disorder. Those that did were also much more likely to also show signs of depression and substance abuse — conditions that often go hand-in-hand with eating disorders.

In a surprise finding, researchers discovered that more than one-quarter of the patients with signs of eating disorders were male.

Another significant finding was that contrary to most people’s perceptions of eating disorders, the patients who screened positive for eating disorders in the ER were more than three times as likely to be obese than those without eating issues.

Although anorexia nervosa is the most commonly known eating disorder, and calls to mind images of unhealthily skinny teens, bulimia and binge eating are also eating disorders — and are known to be associated with overweight and obesity.

Suzanne Dooley-Hash, M.D., who led the study, works as an emergency physician at U-M. She started the effort because she had a sense that eating disorders were more common among ER patients than the care teams there might think – it’s just that no one was asking about it.

For many teens and young adults, ER visits are more common than regular doctor visits — or the only form of medical care they get. In fact, teens who received public assistance of some sort were more likely to have signs of eating disorders in the ER study population.

Experts believe screening for eating disorders in the ER and coordinating care for at-risk teens to receive treatment after they leave the ER, could be an effective way of stemming problems before they become even more serious.

Similar approaches have been taken for drug and alcohol abuse, risky driving, and other risky behaviors.

However, researchers acknowledged that the study represents patients from one hospital, located in a university town, and said further research would be needed to confirm the findings’ applicability before any interventions are designed.

“They come in for other things, and it’s up to health care providers to know what to look for,” said Dooley-Hash, an assistant professor of emergency medicine who has worked to educate her fellow emergency physicians about eating disorders and how to spot high-risk teens.

“ER teams can be equipped to refer patients for care, just as we do for substance abuse. It could be a wakeup call, a teachable moment, a chance to tell them they need to seek help and direct them to resources.”

She notes that many teens with eating disorders may come to their physician or an ER with stomach-related complaints but not want to acknowledge that their symptoms are related to an eating issue.

Many go undiagnosed for years. On the other end of the spectrum, she says she has seen teens die in the ER after struggling with eating disorders and the depression and suicidal tendencies that often accompany them.

While treatment for eating disorders is not a surefire thing, and can take years, the earlier a patient is diagnosed the better their chances are, she says.

The results are published in the November issue of the International Journal of Eating Disorders.

Source: University of Michigan

Teenager meeting with a doctor photo by shutterstock.

Spotting Eating Disorders in the ER

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Spotting Eating Disorders in the ER. Psych Central. Retrieved on September 29, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 20 Nov 2012)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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