Ep 202 Eating Disorders: Common, Commonly Missed, Mismanaged and Misunderstood

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 18 February 2025

⏱️ 88 minutes

🔗️ Recording | iTunes | RSS

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Summary

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients don’t always fit the stereotype—many appear “healthy,” have normal BMI, or present with vague GI, cardiac, or neurological symptoms. Missing the diagnosis has important consequences. The earlier an eating disorder is identified and the earlier that appropriate treatment is initiated the better the long term outcomes. In this episode, with the expertise of Dr. Samantha Martin and Dr. Jennifer Tomlin, we’ll break down the essential clinical clues, screening questions, red flags, and subtle exam findings that can help Emergency Physicians diagnose eating disorders early and initiate treatment to decrease mortality and long term morbidity in these young patients. Eating disorders need to be thought of as both a psychiatric condition and medical condition to optimize the pick up rate and appropriate management. Missing or mismanaging eating disorders in the ED means missing an opportunity to save a life and prevent long term morbidity... Please consider a donation to EM Cases to ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.0	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.9	EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research
0:21.1	and education. The opinions expressed on this podcast are intended for information and education
0:24.3	purposes only and should not be used to diagnose treat or prevent any medical condition, nor should
0:26.5	they be used as a substitute for medical advice from qualified practicing physician.
0:28.6	This episode is brought to you by easy recess to the resuscitation assistant.
0:32.6	This amazing app has drug dosing, equipment size calculation, treatment algorithms, all in under
0:37.4	three clicks.
0:38.8	Rapid access to life-saving critical info in a user-friendly interface.
0:43.4	Try the app for free with the promo code EMCases, or visit easy recess.com slash EMCases.
0:51.3	That's easy resus.com slash EMC-A-S-E-S.
0:58.4	Here are some numbers. The mortality rate from eating disorders is 10 to 15 percent.
1:05.9	So that's one in 10 or more people die from their eating disorder.
1:11.6	And eating disorders might be more prevalent than you think as well.
1:14.6	About 2 or 3% of North Americans have an eating disorder.
1:18.6	And this ends up equating to about a million people in Canada and about 10 million people in the U.S.
1:24.6	So what's the bottom line?
1:26.6	Eating disorders are everywhere and can be fatal, and they have the highest mortality rate
1:32.0	of any psychiatric illness.
1:34.3	So the obvious question then is, why the heck don't ED docs learn about eating disorders?
1:41.7	I'll leave this question for you to think about and just say this for now.
	...

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