Weight Loss
A basic workup should be performed before attributing the loss to mental health, and attempts to increase caloric intake are insufficient, and an eating disorder is not suspected, refer the patient to a registered dietitian and/or a gastroenterologist.
Abstract
When considering weight loss, consider the possibility of an error in recorded weights.Obtain a thorough dietary history. Consider inaccuracy, especially if an eating disorder is possible.A basic workup should be performed before attributing the loss to mental health. Consider the following assessments: complete blood cell count, comprehensive metabolic panel, C-reactive protein, erythrocyte sedimentation rate, tuberculin test, rapid plasma reagin test, HIV test, tissue transglutaminase plus immunoglobulin A, thyrotropin plus free thyroxine, stool guaiac test/culture/ova/parasites, and urinalysis.Close follow-up is mandatory. Admission criteria if an eating disorder is considered can include less than 75% of the ideal body weight, a supine heart rate less than 50 beats/min, a temperature less than 35.6°C, a systolic blood pressure less than 90 mm Hg, arrhythmia, and orthostatic vital signs.If findings from the workup are negative, attempts to increase caloric intake are insufficient, and an eating disorder is not suspected, refer the patient to a registered dietitian and/or a gastroenterologist.