Examination
Key points for examination include:
Weight – It is important to get an accurate weight of the patient, and this can be a sensitive issue. It should be performed in light clothing, without shoes.
BMI – Calculate and plot on BMI chart.
% median BMI – due to variations in weight and height as children and young adolescents grow and go through puberty, calculating % median BMI is advised to give a measurement in context of that patient’s weight and height.
Cardiovascular – as weight loss impairs cardiac function, a thorough cardiovascular exam is required, including:
Muscle wasting and strength
- sit-up test – sitting up from lying down without using hands
- squat test – rising to standing from a squat position without using hands
General exam
- Temperature
- Hydration
- Abdominal exam
- Evidence of complications e.g. lanugo hair, dental erosion
- Evidence of deliberate self harm