Doctor Adrienne Pollard

Age: 38

Specialty: Family medicine

Place of work: Family medicine office shared practice with 4 other family physicians.

Although BMI is a good indicator for an eating disorder, patients can have other symptoms of an eating disorder before their BMI would indicate a need for concern.

Anorexia nervosa often develops after a patient has gone on a diet. A diet and healthy weight loss can often be a trigger for developing an eating disorder in populations already susceptible.

Healthy weight loss is usually 1-2lbs per week.

Forceful vomiting may tear the surface of the esophagus, usually at the junction of the esophagus and the stomach. Bright red blood may be vomited, initially with gastric contents.

A rare but very serious condition occurs when there is a complete rupture of the wall of the esophagus from forceful vomiting. Treatment is immediate transfer for emergency care: IV fluids and consideration of endoscopy and surgery.

Lacking energy and cold intolerance are common symptoms of anorexia nervosa. Other symptoms to look for at this time are hair loss, dry skin, lanugo, and blue mail beds.

Other things to ask about: preoccupation with weight and shape, unrealistic goal weight, feeling overweight, etc.

Note that the patient's vitals have decreased, including her HR and BP, and the addition of other symptoms and conditions listed.

The weight cutoff for anorexia nervosa is having a BMI below 17.5.

Jane's BMI is still considered normal and healthy but the rapid decrease should be a cause for concern and warrant investigation.