Anorexia Nervosa

Emergency room presentations of people with anorexia nervosa

Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS Kristin Anderson, MD Maryrose Bauschka, MD, CEDS Jeana Cost, MS, LPC, CEDS Asma Farooq, MD

Research Asset


People with anorexia nervosa (AN) tend to shy away from engaging in typical primary care provider relationships in order to avoid detection. Therefore, they may seek care for their medical concerns through a local emergency department (ED). Inherently, AN is associated with a litany of medical complications, which become more prevalent as the severity of their eating disorder increases. Notwithstanding the typical young age at the onset of AN, no body system is immune to these medical complications. Thus, ED providers may need to pursue a medical diagnosis in order to explain presenting symptoms in people with AN. In addition to the medical issues, AN is also a serious mental illness with high mortality rates, including deaths by suicide. Therefore, ED providers also need to be familiar with relevant mental health issues for these people. Keywords Emergency room, Medical complications, Electrolyte, Pain, Hypoglycemia

Plain English Summary

People with anorexia nervosa frequent emergency departments to obtain their medical care. It is thus important for emergency department personnel to be familiar with this increasingly common and serious disorder. As opposed to most other mental illnesses, anorexia nervosa is associated with many dangerous medical complications, which become more problematic as the malnutrition and weight loss become more severe. All body systems are adversely afected. The mortality rate of anorexia nervosa is the second highest of all mental disorders, with medical complications and suicide being the top two causes of death. Mandated medical care may occasionally be required to obtain ongoing treatment for people with anorexia nervosa when they present to the emergency department with severe malnutrition and other emergent complications.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…
Written by

Kristin Anderson, MD

Dr. Kristin Anderson was born and raised in the great Hawkeye state of Iowa. She received both her bachelors of science in biomedical engineering and her medical doctorate degree from the University…
Written by

Jeana Cost, MS, LPC, CEDS

Jeana Cost is the Vice President of Operations and Clinical Services of the ACUTE Center for Eating Disorders & Severe Malnutrition. In her role, she is tasked with ensuring an excellent patient…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

Center of Excellence Logo