Identification and Treatment of Eating Disorders in the Primary Care Setting

Abstract

Eating disorders, which are associated with a host of adverse medical morbidities, negative psychological sequelae, and considerable reductions in quality of life, should be diagnosed and treated promptly. However, primary care physicians may find it uniquely challenging to detect eating disorders in their early stages, before obvious physical problems arise and while psychological symptoms are subtle. Although psychological symptoms may dominate the presentation, the physician is an integral member of the treatment team and is in a unique role to diagnose and treat eating disorders. This clinical review surveys the eating disorders literature, identified by searching MEDLINE and PubMed for articles published from January 1, 1983, to September 30, 2009, using the following keywords: anorexia nervosa, bulimia nervosa, eating disorders, eating disorders NOS, binge eating, binge eating disorder, and night eating syndrome. This review also focuses on practical issues faced by primary care physicians in the management of these conditions and other issues central to the care of these complex patients with medical and psychiatric comorbid conditions.

Eating disorders in adult women: biopsychosocial, developmental, and clinical considerations

“…While mental health Advances in Eating Disorders: Theory, Research and Practice clinicians are ill-prepared to address these concerns, medical providers have even less training and exposure to late-life eating disorders. Eating disorders may go undetected until substantial medical and psychological consequences have developed (Sim et al, 2010).…”

Psychological risk factors, cognitive-contextual approaches and neural correlates in eating disorders: an integrative review

“…However, contrary to BN, compensatory behaviour (e.g. vomiting or the use of laxatives) is not present during these episodes of excessive eating [8]. Therefore, it seems that ED individuals have difficulties in the regulation of their emotional state and negative affect and use ineffective eating behaviours to modulate emotion.…”

Experience of an eating disorders out-patient program in an internal medicine hospital

“…This team includes a psychiatrist, physician, psychotherapists, and nutritionists; if needed specific pharmacological treatment should be prescribed [5]. A variety of modalities have been developed for treating EDs depending on the specific illness and the type of intervention thought to be the most efficient and adequate for a specific environment [6][7][8][9].…”