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Tests and diagnosis
By Mayo Clinic staffWhen doctors suspect someone has anorexia, they typically run many tests and exams to help pinpoint a diagnosis, rule out medical causes for the weight loss, and also check for any related complications.
These exams and tests generally include:
- Physical exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; checking your skin and nails for dryness or other problems; listening to your heart and lungs; and examining your abdomen.
- Laboratory tests. These may include a complete blood count (CBC), and more specialized blood tests to check electrolytes and protein as well as functioning of your liver, kidney and thyroid. A urinalysis also may be done.
- Psychological evaluation. A doctor or mental health provider will ask about your thoughts, feelings and eating habits. You may also be asked to complete psychological self-assessment questionnaires.
- Other studies. X-rays may be taken to check for broken bones, pneumonia or heart problems. Electrocardiograms may be done to look for heart irregularities. Bone density testing may be done to check your bone health. Testing may also be done to determine how much energy your body uses, which can help in planning nutritional requirements.
Diagnostic criteria for anorexia
To be diagnosed with anorexia, you generally must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.
DSM diagnostic criteria for anorexia are:
- Refusal to maintain a body weight that is at or above the minimum normal weight for your age and height
- Intense fear of gaining weight or becoming fat, even though you're underweight
- Denying the seriousness of having a low body weight, or having a distorted image of your appearance or shape
- In women who've started having periods, the absence of a period for at least three consecutive menstrual cycles
Some medical professionals believe these criteria may be too strict or don't accurately reflect symptoms in some people. Some people may not meet all of these criteria but still have an eating disorder and need professional help.
- Eating disorders. Diagnostic and Statistical Manual of Mental Disorders, DSM IV-TR. Arlington, Va.: American Psychiatric Association; 2000. http://psychiatryonline.com/content.aspx?aID=3617. Accessed Oct. 19, 2011.
- Forman SF. Eating disorders: Epidemiology, pathogenesis and clinical features. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2011.
- Walsh BT, et al. Eating disorders. In: Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9100636. Accessed Oct. 20, 2011.
- Anorexia nervosa. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/psychiatric_disorders/eating_disorders/anorexia_nervosa.html. Accessed Oct. 19, 2011.
- Breuner CC. Complementary, holistic, and integrative medicine: Eating disorders. Pediatrics in Review. 2010;31;e75.
- Grave RD. Eating disorders: Progress and challenges. European Journal of Internal Medicine. 2011;22:153.
- Ranzenhofer LM, et al. Eating disorders. In: South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=8150394. Accessed Oct. 20, 2011.
- Murphy R, et al. Cognitive behavioral therapy for eating disorders. Psychiatry Clinics of North America. 2010;33:611.
- Sim LA, et al. Family-based therapy for adolescents with anorexia nervosa. Mayo Clinic Proceedings. 2004;79:1305.
- Forman, SF. Eating disorders: Treatment and outcome. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2011.
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