OB-GYNs can help identify eating disorders in adolescentsJune 11, 2018 /
By Reuters Staff
NEW YORK (Reuters Health) - Obstetrician-gynecologists should be prepared to recognize eating disorders in their adolescent patients and refer them for additional treatment, according to a new "opinion" from the American College of Obstetricians and Gynecologists (ACOG).
"Although formal diagnosis and treatment of eating disorders in adolescents are complex and outside the scope of practice for most general obstetrician-gynecologists, it is important that health care providers be comfortable with recognizing and screening at-risk patients," Dr. Nancy Sokkary of Navicent Health and Mercer School of Medicine in Macon, Georgia, and colleagues write.
Eating disorders can lead to menstrual cycle disturbances and decreased cognitive function, the Committee on Adolescent Health Care notes in the opinion, published in the June issue of Obstetrics & Gynecology. Other gynecological manifestations can include pelvic pain, atrophic vaginitis and breast atrophy.
"Simply asking the patient how she feels about her weight, what she is eating, how much she is eating, and how much she is exercising can help identify at-risk patients," according to the guideline. "Parents also can provide important insight into a patient's eating habits."
Findings on physical examination that suggest a patient may be bulimic include tooth decay, parotid enlargement and calluses on the knuckles, the authors note, while dermatologic signs of anorexia nervosa can include xerosis and "lanugo-like body hair."
"Although obstetrician-gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization," they write. "For patients suspected of being at risk of an eating disorder who do not meet criteria for immediate hospitalization, the obstetrician-gynecologist should make the proper referral."
The goal of eating-disorder treatment is to restore normal eating patterns and BMI, the authors write, while weight gain is also the most effective way to restore patients' bone mineral density (BMD).
"Further research is needed to define best practices, including management of low BMD, menstrual irregularities, and pregnancy prevention," they conclude.
Dr. Sokkary was not available for an interview by press time.
Obstet Gynecol 2018.
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