Nutritional and Medical Assessment and Management of Eating Disorders

Patients with eating disorders have abnormal eating patterns and altered nutritional status, in addition to dysfunctional attitudes and perceptions regarding food and body weight. The prevalence of clinical eating disorders in the general population is estimated to be 0.5–1% for anorexia nervosa, 2% for bulimia nervosa, and 2% for binge eating disorder. Both genetic and environmental factors appear to contribute to the risk of developing an eating disorder, which is often perpetuated by poor nutritional status and chaotic eating patterns. Metabolic, nutritional, and clinical abnormalities in both anorexia nervosa and bulimia nervosa occur as a result of starvation and purging behaviors. The primary goal of nutrition intervention in anorexia nervosa is weight restoration, which is also a crucial factor in the prevention of irreversibly compromised bone density. The primary goal of nutritional management of bulimia nervosa is to normalize the patient's eating pattern, which is typically chaotic and characterized by an overall pattern of food rules, restrictions, or dieting, regularly interspersed with episodes of binge eating and purging. Patients with an eating disorder not otherwise specified can have serious eating problems that can adversely affect health status, and the management issues in these patients are similar to those in the patient with anorexia nervosa or bulimia nervosa. Results from long‐term outcome studies suggest that the majority of patients with eating disorders make a full recovery, despite the severity of the disturbances in eating patterns and nutritional status present at diagnosis.