Diagnosis of Eating Disorders
The diagnosis of eating disorders requires a careful and sensitive approach. Since eating disorders involve both physical and emotional components, diagnosis is typically made through a combination of medical evaluation, psychological assessment, and observation of eating behaviours. Early diagnosis improves the chances of successful treatment and recovery.
Doctors usually begin by asking detailed questions about eating habits, weight history, body image, and exercise routines. Patients may be reluctant to disclose certain behaviours due to guilt, denial, or shame, so it’s important for healthcare providers to create a non-judgemental and supportive environment.
A physical examination is often the first step. Doctors look for signs such as low weight, irregular heart rate, dry skin, brittle nails, or swelling in the face or hands. Blood pressure, temperature, and hydration levels may also be assessed. Blood tests can help check for anaemia, electrolyte imbalances, or liver and kidney function issues—all of which are common in individuals with long-standing eating disorders.
In cases of suspected anorexia nervosa, doctors check for extremely low body mass index (BMI), delayed puberty, or menstrual irregularities. For bulimia nervosa, physical signs such as dental erosion, sore throat, and gastrointestinal issues may be present due to repeated vomiting or laxative use. In binge-eating disorder, rapid weight gain and high cholesterol or blood sugar levels might alert the doctor to underlying patterns.
Psychological assessments are also essential. A mental health professional may use structured interviews or questionnaires like the Eating Disorder Examination Questionnaire (EDE-Q) or the SCOFF screening tool to identify disordered thinking, body image concerns, and unhealthy behaviours related to food.
Family members or caregivers can provide valuable insight, especially if the individual is a child or adolescent. Observing food rituals, secretive eating, or extreme focus on weight may prompt a referral for specialist care.
Diagnosis of Eating Disorders
In South Africa, access to formal diagnosis may vary depending on location and healthcare resources. In rural areas or low-income communities, eating disorders may be misdiagnosed as simple weight loss or stress-related issues. Language barriers and stigma may further delay proper assessment.
It’s important to rule out other conditions that could mimic symptoms of eating disorders, such as thyroid disease, diabetes, depression, or gastrointestinal disorders. A holistic view ensures that nothing is overlooked and treatment is appropriately tailored.
Accurate diagnosis of eating disorders enables timely intervention. It also validates the person’s struggle and opens the door to therapeutic support. Without a diagnosis, many individuals suffer in silence—convinced they are simply weak or out of control—when in fact they are battling a real, serious condition.
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