Even if an eating disorder is suspected, the first step is a complete physical examination to rule out other illnesses, such as cancer or a chronic infection, particularly if extreme weight loss has occurred. While conducting the examination, the doctor will look for signs of anorexia and bulimia. Indicators of anorexia include dry skin, thinning and brittle hair, low blood pressure, and a slow heart rate all signs that the body is responding to starvation by shutting off or slowing down functions that are not vital to sustaining life. Some anorectics com plain of constipation and intolerance to cold, and may even develop a soft body hair called lanugo as a response to the lower body temperature that occurs when body fat is lost.
Another major symptom of anorexia is the absence of menstruation, due to the loss of body fat and the resulting hormonal changes. Mild anemia, light headedness, and sleep problems also suggest anorexia. In diagnosing bulimia, the physical examination and medical history are also highly important. The doctor will look for damage to the teeth and gums caused by repeated exposure to the stomach acids in vomit. The esophagus may be inflamed due to vomiting, and glands near the cheeks might also be swollen. One or more fingers could be scarred as a result of pushing them down the throat to induce vomiting. And menstrual periods are likely to be irregular. The doctor will ask about dieting and exercise habits, as bulimics frequently diet and exercise incessantly without losing weight and generally regain weight if they do lose it.
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