Body Weight Parameters at the Initial Visit for Eating Disorders in Adolescents: Are These the Markers of Serious Complications?

Objective: Eating disorders (ED) are psychiatric disorders often accompanied by medical complications. This study aimed to identify the complications in ED patients during hospital admission and their relationship with body weight (BW). Material and Methods: Patients diagnosed with ED per DSM-5 criteria seen at least once in the adolescent department were included. Digital medical records were used to obtain patient information. Body mass index (BMI), BMI percentile, and percentage of BW by height (IBW%) were calculated to analyze their association with medical complications. Results: Our study included 144 patients, 140 (97.2%) females and 4 (2.8%) males. Of the patients; 94 were analysed as Anorexia Nervosa (AN), 28 as Atypical AN and 17 as Bulimia Nervosa (BN). At least one cardiac complication was detected in 29.3% (39), gastrointestinal complications in 54.2% (78), hypoglycaemia in 18.2% (26), secondary amenorrhoea in 34.5% (48) and 45.8% (66) received inpatient treatment. Patients with IBW%<75 exhibited significantly higher rates of hypoglycemia, bradycardia, low sT3, amenorrhea, and hospitalization compared to those with IBW% ≥ 75 (p<0.001). Bone mineral density (BMD) was significantly inversely associated with Z-score, time to ED diagnosis and duration of amenorrhoea (p=0.006; p=0.044; p=0.032, respectively). Conclusion: Our findings show that at least one medical complication frequently develops in ED patients at the initial evaluation. Patients with AN and BN, which usually start in adolescence, may frequently present to paediatric outpatient clinics with medical complaints. The role of internal physicians in the early diagnosis of ED is important to prevent serious complications in these patients.