What Your Doctor Should Look For In Your Child
Because of the range of medical complications and consequences of any level of eating disorder symptoms, it’s important to have your child evaluated regularly by her pediatrician while she is at risk. Some doctors are well versed in the specific health concerns that go along with anorexia and bulimia symptoms.
The Maudsley Parents newsletter shared some information I found helpful about what a doctor should look for when you suspect your child has an eating disorder.
However, it’s frequently surprising to parents how many highly competent doctors fail to recognize symptoms and/or don’t take them seriously. It’s not unusual for a well-meaning doctor to reassure a parent long past the point when the child needs help. Other doctors might not be aware exactly what to check for, or what tests should be run when assessing a child with eating disorder symptoms.
So if you suspect your child has symptoms of an eating disorder, make sure you ask the doctor to do these four things:
1. Rule out any other medical cause of weight loss, appetite loss, missed period or other physical symptoms (e.g. light-headedness, fainting) you suspect are related to an eating disorder. This can be done via lab tests and/or a physical (see number 3).
2. Obtain reliable measurements of height and weight and see how these current measurements compare to
your child’s typical position on the growth chart in past years (teenagers should be continuing to gain weight at a fairly consistent rate given their history. Maintaining the same weight, even without any loss, might be cause for concern if their height/weight ratio has changed significantly)
3. A complete physical (e.g., assessment of weight for height, blood pressure, heart rates, body temperature)as well as specific laboratory tests to check for signs of malnutrition, binge eating and/or purging. These examinations help assess the degree of illness, its chronicity, as well as rule out other possible organic reasons for symptoms.
4. High priority tests you should be sure to request include:
• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel (CMP) especially all tests of electrolytes (sodium, potassium,
bicarbonate and chloride) as well as calcium and tests of kidney function (BUN and creatinine)
• Serum Magnesium
• Thyroid Panel
• Transthyretin (Prealbumin)
Your doctor will be able to give you much more detail about what each test measures and what the results mean.