What is Involved in Making a Diagnosis of Anorexia?

A diagnosis of anorexia nervosa is made only after the symptoms of anorexia have come to a doctor’s attention by the patient or by concerned loved ones. Besides extreme weight loss, some symptoms may include hair loss, skipped menstrual periods, memory deficits and depression. A diagnosis of anorexia ultimately depends on a physical examination, as well as a full psychological evaluation.

Most people who are suffering from anorexia nervosa do not seek medical attention. In their minds, they are completely normal and healthy. Beyond believing that they need to lose more weight, a person with anorexia does not suspect the presence of an underlying mental health condition.

A diagnosis of anorexia usually only happens after key symptoms have prompted a doctor’s visit or have prompted an intervention by concerned friends and family members. By the time this does occur, several physical symptoms are usually present which may include osteoporosis, dangerously low blood pressure, irregular or nonexistent menstrual periods, hair loss, dry skin, brittle finger and toe nails, stomach bloating and cardiovascular issues. Although hair is lost from a lack of nutrition, individuals with anorexia also tend to develop very thin, cottony hair all over their bodies, known as downy hair. Behavioral symptoms, such as depression, suicidal thoughts, obsessive exercising and a strict avoidance of calories are often common.

After a physical exam, but prior to a final diagnosis of anorexia, a doctor will also order a psychological evaluation. This is because the physical symptoms of this disease are simply a manifestation of a mental condition causing an individual to hold a distorted view of herself or himself. Besides laboratory tests for anemia and bone density, as well as testing to assess organ functioning, a battery of psychological tests are also administered to try to understand and resolve the cause of a person’s body image issues.

A diagnosis of anorexia may lead to hospitalization if a person is too malnourished to undergo treatment as an outpatient. In many cases, the malnourishment caused by this disease leads to life-threatening complications, which cause a person to be brought to the hospital for emergency care. Often, this is the result of an irregular heart rhythm, low blood pressure, organ failure or a loss of consciousness.

A SCOFF questionnaire is one of the tools used in making a final diagnosis of anorexia. As part of the questionnaire, patients are asked if they feel sick due to a full stomach, if they ever feel a loss of control over the amount of food they eat, whether they have lost a set amount of weight recently, whether or not they believe they are fat, and if food or thoughts about food govern their lives. A diagnosis of anorexia is not made on these questions alone, but when combined with the results of laboratory tests, they are reviewed by doctors to determine if a diagnosis of anorexia is, in fact, the cause of the patient’s physical and behavioral symptoms.