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For Providers
Addressing eating disorders in your patients
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Are eating disorders hiding in your office?
What to look for when identifying an eating disorder
Medically
Around food
Mood
Socially
Around activity
- Rapid weight loss or gain, or failure to gain weight or height according to growth curve
- Vital signs suggesting medical instability
- Bradycardia
- Alopecia
- Cold or bluish extremities
- Enamel erosion or enlarged parotid glands (signs of purging behavior)
- Lanugo
- Russell’s sign (calluses on the knuckles or back of the hand from purging)
- Decreased bowel sounds or palpable stool
- Abdominal pain and/or constipation
- Fainting, fatigue, or dehydration
- Injuries from overexercise
Why Equip is different
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What to do if you’re concerned about a patientEarly intervention is critical for eating disorders. Symptoms can often be more severe than they initially appear.
Start with curiosity when addressing any weight changes — making sure to never blame or shame the patient. For example, ask, “I’ve noticed your weight has changed. Can you tell me what’s been happening?” Use a HAES approach and consider additional health markers to assess the situation.
If you're worried about a patient but aren’t sure if it’s an eating disorder, it’s helpful to refer them to an assessment with experts. Equip offers a free online screener and consultations.
If you think your patient needs eating disorder treatment, take the next step by referring them to specialized care. To refer to Equip, use our HIPAA-compliant referral form, email refer@equip.health, call (855) 460-0516, or use EHR direct messaging. We work with you and your patient to ensure we’re the right fit and get them started as soon as possible.
Learn more about our treatment approach
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For Providers
Medical evaluation guide
Follow these steps to perform a full medical workup for patients who may have an eating disorder.Have your patient stand backward on the scaleWeight numbers can be triggering for patients with eating disorders.
Avoid sharing weight number with your patientInstead, discuss general trends: up, down, stable. A height should be obtained to calculate BMI.
Consider weighing your patient in a gownSometimes, patients with eating disorders may attempt to manipulate their weight by wearing heavy clothing, hiding weights on their body, or drinking a lot of water beforehand. If this is a concern, weigh patients in a gown and consider testing their urine (if it is very dilute, they might be water loading).
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When your patient might need to be admitted to the hospital
We follow the American Psychiatric Association Practice Guidelines and the Society for Adolescent Health and Medicine factors to support hospitalization to determine if a patient may need to be hospitalized for medical stabilization.
BradycardiaHeart rate < 50 beats per minute (daytime) or <45 beats per minute (with sleep)
Orthostatic hypotensionOrthostatic changes in pulse (sustained increase in HR >30 bpm in adults aged >19 years or >40 bpm in adolescents aged <19 years) or sustained decrease of blood pressure (>20 mm Hg systolic or >10 mm Hg diastolic).
HypotensionBlood pressure < 90/45
Severely low body weightLess than 75 percent of the median BMI for age, losing a large percentage of body weight rapidly, or precipitous fall off their growth chart line
Electrolyte deficienciesPotassium <3.5, Phosphorus <3.0, Magnesium <1.8
Prolonged QTc on EKGHeart rate < 50 beats per minute (daytime) or <45 beats per minute (with sleep)
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93%
of surveyed providers are likely to recommend Equip
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Learn more about eating disordersIf you’re looking to grow your understanding of eating disorders, we have several resources that can help.
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Frequently Asked QuestionsWe know how difficult it can be to find treatment that works, is affordable, and fits the needs of your patient and their family.
We’ve done our best to answer family and providers’ most frequent questions so that you can be informed and confident in your choice. If you still have questions, please reach out to us.
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