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Ask the Mental Health Expert Archives 2001-2004

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Serious Eating Disorder

Q. If someone who has been purging 1-3 times/day almost every day for 2 1/2 years got a general checkup and a blood test, would there be any evidence of it? Would the doctor be able to detect it? This individual doesn't want to say anything to the doctor. If the purging stopped for 1 week, would the blood work be more normal? The individual managed to hold down a decent 400 cal/day.

A. The first thing I would want to say to this individual is that he or she needs to be open and honest with the doctor, and get help with what sounds like a very serious eating disorder. Self-induced vomiting (as often occurs in bulimia nervosa or anorexia nervosa) may cause serious disturbances in body chemistry that can create potentially dangerous cardiac problems. Gastric rupture and pneumonia are also possible complications.

If left untreated, these can be life-threatening. Depending on the individual's food and liquid intake, and how often he/she is purging, some chemical abnormalities may be detectable by routine laboratory testing, while others may not be. I do not think it would be helpful to be more specific. By the way, 400 calories per day isn't even close to what a healthy individual needs--most people need at least 1200 calories per day to maintain proper nutrition. The message is: this individual needs to get professional help, and soon, beginning with a medical evaluation!

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October 2001

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