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intermediateanorexia nervosalevel of caremedical stabilizationeating disorderinpatient criteria
A 19-year-old woman with anorexia nervosa, restricting type, presents with a BMI of 15.2, resting heart rate of 48 bpm, blood pressure of 88/54 mmHg, and serum potassium of 3.1 mEq/L. She has been in outpatient treatment for 3 months with no weight gain and eats approximately 600 calories per day with compulsive daily exercise. She denies suicidal ideation. According to APA guidelines, what is the most appropriate level of care?
Explanation
Eating disorder level-of-care decisions are primarily driven by medical stability indicators. APA guidelines identify bradycardia below 50 bpm, significant hypotension, electrolyte abnormalities, and BMI below approximately 15 as criteria requiring inpatient medical stabilization. Failure of outpatient treatment with progressive medical deterioration demands escalation to a higher level of care, not continuation of the failing approach.
Key Takeaway
Anorexia nervosa with bradycardia below 50, hypotension, hypokalemia, and BMI below 15 requires inpatient medical stabilization before transition to residential eating disorder treatment.