The Assessment Process: Refining the Clinical Evaluation of Patients with Eating Disorders

Eating disorder (ED) patients often experience a host of related medical problems. Beyond the information obtained from medical records, a thorough evaluation by an experienced medical professional, throughout treatment, is strongly recommended. Clinicians without medical training should be familiar with the basics of the medical issues commonly associated with ED. Self report is also a source of data regarding the presence and severity of physical problems. For instance, individuals who abuse laxatives over extended periods of time may become dependent upon them to stimulate bowel movements. Thus, what may have begun as a method of purging can evolve into a method of self-medicating constipation. Arriving at an estimate of daily caloric intake involves a detailed assessment of consumption over a typical day, although many have difficulty reporting what constitutes a typical day. Most individuals make large errors in estimating food intake, however, and individuals with higher levels of dietary restraint and eating-related pathology tend to be even less accurate. Thus, although many ED patients regularly track their caloric consumption closely, their estimates should not be assumed to be accurate. Even so, obtaining an approximate daily caloric intake is often helpful in estimating the trajectory of weight loss or gain and the degree of dietary restriction.