Weight is useful information, but it is not the whole assessment for a possible eating disorder.
A current weight does not tell you how much someone has lost, how quickly that change occurred, what their eating and exercise patterns look like, or whether they are experiencing medical complications. Looking at current weight in isolation can lead to delayed care or can cause patients to completely go untreated.
This matters because eating disorder related medical risk does not occur only at a low weight. Research in adolescents has found medical instability across a range of body weights, including patients who were not considered underweight by BMI (Brennan et al., 2023). Additionally, being able to identify an eating disorder earlier contributes to recovery.
A more complete assessment might consider:
- Weight history: What has changed, and over what period of time?
- Eating patterns: Is the patient restricting, avoiding foods, purging, binge eating, or skipping meals?
- Exercise: Has activity increased, become compulsive, or continued despite illness or injury?
- Compensatory behaviors: Is the patient vomiting, fasting, or using other behaviors to compensate for eating?
- Medical symptoms: Are there changes in heart rate, blood pressure, energy, gastrointestinal symptoms, menstrual function, or other areas of health?
- Thoughts about food and weight: How much time and attention are being spent on eating, weight, shape, or fear of weight gain?
None of these questions can give you a definitive answer in isolation, but together they can help a provider recognize when further assessment or referral may be appropriate.
Weight is still an important factor in eating disorder care. The issue is what happens when it becomes the default for determining whether or not someone is sick enough to warrant concern.
Build Your Eating Disorder Knowledge
Knowing what to look for is an important part of providing appropriate care. EDPEN offers in-person eating disorder trainings for providers, as well as customized virtual trainings for healthcare teams.
Learn more about EDPEN trainings and find an option that fits your practice or team.
References
Brennan, C., Illingworth, S., Cini, E., & Bhakta, D. (2023). Medical instability in typical and atypical adolescent anorexia nervosa: A systematic review and meta-analysis. Journal of Eating Disorders, 11, 58. https://doi.org/10.1186/s40337-023-00779-y