Eating Disorders Community

Assessment of an Eating Disorder

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Assessing The Situation

Once it is suspected that someone has an eating disorder, there are several ways of assessing the situation further, from a personal as well as a professional level.Once it is suspected that someone has an eating disorder, there are several ways of assessing the situation further, from a personal as well as a professional level. This chapter will review assessment techniques that can be used by loved ones and significant others, in addition to those used in professional settings. Advances in our understanding and treatment for anorexia nervosa and bulimia nervosa have resulted in improvements in assessment tools and techniques for these disorders. Standard assessments for binge eating disorder are still being developed because less is known about the clinical features involved in this disorder. An overall assessment should ultimately include three general areas: behavioral, psychological, and medical. A thorough assessment should provide information on the following: history of body weight, history of dieting, all weight loss - related behaviors, body image perception and dissatisfaction, current and past psychological, family, social, and vocational functioning, and past or present stressors.

ASSESSING THE SITUATION IF YOU ARE A SIGNIFICANT OTHER

If you suspect that a friend, relative, student, or colleague has an eating disorder and you want to help, first you need to gather information in order to substantiate your concerns. You can use the following checklist as a guide.

CHECKLIST OF OBSERVABLE AND NONOBSERVABLE SIGNS OF AN EATING DISORDER


  • Does anything to avoid hunger and avoids eating even when hungry
  • Is terrified about being overweight or gaining weight
  • Obsessive and preoccupied with food
  • Eats large quantities of food secretly
  • Counts calories in all foods eaten
  • Disappears into the bathroom after eating
  • Vomits and either tries to hide it or is not concerned about it
  • Feels guilty after eating
  • Is preoccupied with a desire to lose weight
  • Must earn food through exercising
  • Uses exercise as punishment for overeating
  • Is preoccupied with fat in food and on the body
  • Increasingly avoids more and more food groups
  • Eats only nonfat or "diet" foods
  • Becomes a vegetarian (in some cases will not eat beans, cheese, nuts, and other vegetarian protein)
  • Displays rigid control around food: in the type, quantity, and timing of food eaten (food may be missing later)
  • Complains of being pressured by others to eat more or eat less
  • Weighs obsessively and panics without a scale available
  • Complains of being too fat even when normal weight or thin, and at times isolates socially because of this
  • Always eats when upset
  • Goes on and off diets (often gains more weight each time)
  • Forgoes nutritious food on a regular basis for sweets or alcohol
  • Complains about specific body parts and asks for constant reassurance regarding appearance
  • Constantly checks the fitting of belt, ring, and "thin" clothes to see if any fit too tightly
  • Checks the circumference of thighs particularly when sitting and space between thighs when standing