The Importance of Screening for Eating Disorders

Oftentimes, primary providers are the first line of defense against eating disorders. They can be the first to notice the early signs and discover an eating disorder since they see their patients regularly. Identifying these symptoms can help interrupt these mental disorders from developing further. 

In this article, we will discuss the importance of early screening and detection, the warning signs of eating disorders, and what to ask your patients when conducting screenings. 

The Importance of Early Screening

Nine percent of the population in the United States are affected by eating disorders. They can affect any gender, race, or age. Eating disorders don’t have a specific look. They come in all shapes and sizes. We can’t tell whether someone has an eating disorder by looking at them. We know health and illness can exist at every size. If providers learn to make changes to end the stigma by noticing the warning signs and asking appropriate questions, it can be the one thing that saves a person who may be suffering.

Symptoms may be minimal at the start of an eating disorder, but they can grow worse over time and can even become life-threatening if left untreated. When a patient shows any signs of an eating disorder, it is important that providers address the issues and connect the patient with eating disorder professionals as soon as possible. Many times the patient may not fully know that they have an eating disorder or that their relationship with food or exercise is concerning. Therefore, it is important to be there for the patient, ask appropriate questions, and if you see signs of eating disorders, connect the patient with help. The earlier the treatment, the better the outcome. 

Signs of Eating Disorders in Patients

When interacting with your patients, it is always important to look for eating disorder warning signs and notice any symptoms that could be related to an eating disorder. Signs could include, but are not limited to:

• Significant weight loss or gain
• Failure to gain weight
• A slow or irregular heartbeat
• Low blood pressure
• Complaints of nausea, stomachaches, bloating, or constipation
• Complaints of dizziness, weakness, or fatigue
• Swollen salivary glands
• Dry or pale skin
• Thinning hair
• Brittle nails
• Abrasions or scarring on the knuckles or back of hands

Co-Occurring Mental Conditions 

Eating disorders often occur with another illness. They commonly co-exist with substance abuse, anxiety, trauma, or depression, as well as other mental conditions. For many patients, having a second or third condition alongside the eating disorder may complicate recovery. It is important that every issue is addressed in treatment. If treatment does not address the patient’s other mental health issues, such as obsessive-compulsive disorder, anxiety, or depression, treatment will not be as successful. This is why eating disorders require a full treatment team of professionals who treat the whole person with comprehensive care.

Questions to Ask Your Patient

It is important that each provider discuss and ask questions about food. While providers regularly ask about a patient’s history, substance abuse, depression, anxiety, and sexual behaviors, they often shy away from asking questions related to food and eating. It is so important to ask every patient you see. With 28.8 million Americans having an eating disorder in their lifetime, if you don’t ask, you’ll miss it. If you do ask, you could save a patient’s life. 

Remember to be compassionate when discussing signs of disordered eating or eating disorders with your patients. Some patients may have never discussed these concerns with anyone before. While these may be difficult topics for someone with an eating disorder, starting the conversation is the best way to determine if the patient has any issues.

First, have a discussion involving:

• Relationships with food
• Preoccupation with food
• Distorted body image
• Worry of weight gain or body shape
• Sudden changes to diet
• What diets or fasting methods they may be partaking in
• Food or mealtime avoidance
• Obsession with exercise
• Self-induced vomiting
• Hoarding food
• Eating in secret
• Any disturbances with eating behaviors 

If the patient seems to have difficulty with this discussion, additional questions should then be asked. On our website, we have an assessment quiz that can help determine if additional care is needed for a patient. The questions include:

1. Do they worry about their weight and body shape more than other people?
2. Do they avoid certain foods for reasons other than allergies or religious reasons?
3. Are they often on a diet?
4. Do they feel that their weight is an important aspect of their identity?
5. Are they fearful of gaining weight?
6. Do they often feel out of control when they eat?
7. Do they regularly eat what others may consider to be a large quantity of food at one time?
8. Do they regularly eat until feeling uncomfortably full?
9. Do they hide what they eat from others, or eat in secret?
10. Do they often feel fat?
11. Do they feel guilty or depressed after eating?
12. Do they vomit at least once per week?
13. Do they use their insulin in ways not prescribed to manage their weight?
14. Do they take any medication or supplements to compensate for eating or to give themselves permission to eat?
15. Do they exercise for the sole purpose of weight control?
16. Have people expressed concern about their relationship with food or their body?

If you answer “yes” about your patient to two or more questions, then there is strong evidence that an eating disorder is present. It is important to refer these patients to an eating disorder specialist as soon as possible. A specialty program such as Veritas Collaborative will be able to pinpoint the issue, provide a diagnosis, and connect the client to the level of care they specifically need. 

Please remember to ask questions about eating disorders in all your patients. Early screening and detection can and will save lives.

If you believe a patient is suffering from an eating disorder, please give us a call at 612-402-3061 as soon as possible.