Medical Monitoring and Management of Eating Disorders for the Child and Adolescent Psychiatrist

Objectives: After this presentation, the audience will have skills needed to carry out the CAP's role in screening, monitoring, and managing medical complications of ED in youth. Methods: The Workshop will first provide a brief overview of physical signs/ symptoms, medical monitoring, and medical management for each of the major diagnostic categories as follows: 1) anorexia nervosa; 2) bulimia nervosa; 3) binge-eating disorder; and 4) avoidant restrictive food intake disorder. Presenters will teach participants how to assess medical appropriateness for various levels of treatment, including the following: 1) medical inpatient care; 2) psychiatric inpatient care; 3) residential care; 4) partial hospitalization; 5) intensive outpatient care; and 6) outpatient care. The Workshop will allow participants the opportunity to discuss an ethical framework and practical approach for the systemic challenges related to medical risks. Clinical vignettes and audience participation will enhance learning opportunities in assessing acuity, involving families in medical decision making, and navigating the healthcare system to help patients gain access to necessary treatments. Presenters will also provide evidence-based updates on several special topics for which there is important newer research, such as refeeding syndrome, "diabulimia" (diabetes co-occurring with bulimia nervosa), and atypical anorexia. There will be vignette-based discussions that allow participants to practice the basic knowledge gained earlier in the Workshop. Results: Participants will be able to appropriately screen for and recognize medical risks and medical sequelae of eating disorders among their patient populations. Attendees will be able to discuss the meaning and implications of these medical issues with families in their practice settings and make recommendations about the level of care needed based on their patient's acuity. Conclusions: EDs are often under-recognized in medical and psychiatric practices, yet they are medically risky problems, with the highest mortality rate of any psychiatric illness. Attendees of this Workshop will develop skills and confidence to recognize the medical sequelae of ED and monitor and/or manage some of those sequelae within the scope of their role as a CAP.