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Eating Disorder Medical Instability — RACP Paediatrics MCQ

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HardAdolescent MedicineEating Disorder Medical InstabilityRACP Paediatrics

A 14-year-old girl has been exercising excessively and restricting food. She has lost 8 kg in 2 months. Her BMI is now 16. Vital signs show HR 48, BP 85/55, temperature 35.8°C. What is the medical severity of her presentation?

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Correct answer: A — Medically unstable requiring inpatient medical stabilisation

Medical instability criteria in eating disorders include: HR <50, BP <90 systolic, temp <35.5°C, BMI <75% median, rapid weight loss (>1 kg/week), QTc prolongation, electrolyte disturbance, or syncope. This patient meets multiple criteria and requires inpatient medical stabilisation with cardiac monitoring and carefully supervised refeeding.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Eating Disorders