Physicians generally diagnose eating disorders based on the patient’s symptoms and eating habits. During an initial consultation, a physician will record the patient’s weight and perform a thorough physical examination including:

• Checking vital signs, such as heart rate, blood pressure and temperature
  
  
• Evaluation of patient’s skin, abdomen and teeth
  
  
• Neurological examination to evaluate other potential causes of weight loss or vomiting, such as a brain tumor

A physician will also compile a comprehensive medical history including family history of physical and psychological disorders (e.g., depression, obsessive-compulsive disorder) as well as inquire into the patient’s history of dieting and/or eating patterns. Some of the questions a physician may ask include:

• Have you recently lost more than 14 pounds (6.35 kg) in a three-month period?
  
  
• Do you believe you are fat when others say you are too thin?
  
  
• Would you say that food dominates your life?
  
  
• Do you make yourself sick because you feel uncomfortably full?
  
  
• Do you ever eat in secret?
  
  
• Does your weight affect the way you feel about yourself?

In addition, a physician may order diagnostic tests to identify any signs of complications of eating disorders including malnutrition, anemia (reduced blood cell count), unusual heart rhythms, digestive problems (e.g., constipation, diarrhea), bone density loss or changes in the menstrual cycle.

Additional diagnostic tests may include:

• Blood tests. Laboratory analyses – including a complete blood count (CBC) – of blood samples to measure levels of hormones, enzymes, proteins, electrolytes, vitamins and other substances. Blood tests assess the function of various organ systems including the liver, kidney, thyroid and pituitary glands as well as the ovaries (female reproductive glands).
  
  
• Urinalysis. Chemical examination of a patient’s urine sample to screen for urinary tract infections, kidney disease and diseases of other organs that result in the appearance of abnormal metabolites (break-down products) in the urine.
  
  
• Electrocardiogram (EKG). This test measures the pattern of electrical impulses generated by the heart. During the procedure, electrodes (devices that detect electrical impulses) are attached to the patient’s chest. The electrical impulses are then recorded on a graph. In patients with eating disorders, an EKG can help detect irregular heartbeats and identify the presence of any damage to the heart.
  
  
• Imaging tests (e.g., x-ray, CAT scan, MRI). These tests are useful in detecting the presence of any damage in the chest, digestive tract, brain and other organs caused by eating disorders. For example, a chest x-ray may reveal whether the eating disorder has damaged the heart muscles by reducing the size of the heart.
  
  
• Bone density test. During this test, a physician may use a device called a sonometer to pass painless sound waves through the bones to measure the density of the bones and check for signs of bone mass loss (osteoporosis).