Eating Disorder Hospitalization Criteria

According to the AAP* patients who meet any one of the following criteria should be re-fed in hospital rather than an outpatient setting (other criteria may pertain, clinical judgment required):  

  • <75% ideal body weight, or ongoing weight loss despite intensive management

  • Refusal to eat

  • Body fat <10%

  • Heart rate <50 per minute daytime; <45 bpm nighttime

  • Systolic pressure <90

  • Orthostatic changes in pulse increase >35 bpm (AAP suggests 20 BPM; we find this low threshold impractical) or blood pressure decrease >10 mm Hg (AAP suggests 20 mm Hg)

  • Temperature <96 F

  • Arrhythmia


AAP Admission Criteria: Bulimia Nervosa

  • Syncope

  • Serum potassium concentration <3.2 mmol/L

  • Serum chloride concentration <88 mmol/L

  • Esophageal tears

  • Cardiac arrhythmias including prolonged QTc

  • Hypothermia

  • Suicide Risk

  • Intractable vomiting

  • Hematemesis

  • Failure to respond to outpatient treatment

*(for AAP guidelines, see “Children and Adolescents With Eating Disorders: The State of the Art” electronic article, Pediatrics, Vol. 111, pp. 204-11, 2003.)

For a discussion on how to determine "ideal" body weight in context of a suspected eating disorder, please read this.

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