Eating disorders in adolescence

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Target exams

Red flags

• Medical instability — severe bradycardia, orthostatic hypotension, hypothermia, hypoglycaemia, electrolyte crisis, prolonged QTc, or rapid weight loss — requires urgent paediatric medical assessment and often admission
• Refeeding syndrome risk — hypophosphataemia, oedema, arrhythmia during nutritional rehabilitation; protocolised refeeding with electrolyte and ECG monitoring
• Active suicidal ideation, intent or plan — elevated mortality includes suicide; same-day risk assessment and safety planning
• Atypical anorexia nervosa with significant restriction or rapid weight loss at a 'normal' BMI — do not discharge on weight alone
• Purge-related medical risk — hypokalaemia, metabolic alkalosis, arrhythmia, Mallory-Weiss, aspiration — even when BMI is normal
• Inability to eat or drink with life-threatening restriction and impaired capacity — escalate legal and medical pathways under local statutes