• Aan adolescent daughter (or son) has an unrealistic self-image and seems to be dieting excessively.
• Weight loss is excessive (greater than 10% of normal body weight) and unexplained.
• Weight loss is accompanied by other unexplained symptoms.

The health care provider will obtain your medical history and will perform a physical examination.

Medical history questions documenting weight loss in detail may include the following:

• Time pattern
  • When did the weight loss begin?
  • Has it been sudden or gradual?
• Quality
  • How much weight has been lost?
  • Has appetite decreased?
  • Has amount or kinds of food eaten changed?
  • Has physical activity level increased?
• Aggravating factors
  • Has there been an illness?
  • Have there been dental problems or mouth sores?
  • Have stress or anxiety levels increased?
• Accompanying symptoms
  • Is there vomiting?
  • Is there self-induced vomiting?
  • Is there an apparent increased energy level?
  • Has there been excessive physical exercise?
  • Is there fainting?
  • Is there occasional uncontrollable hunger with palpitations, tremor, and sweating?
  • Has there been a change in vision?
  • Is there increased sensitivity to cold or heat?
  • Is there constipation or diarrhea?
  • Is there increased thirst or drinking?
  • Is there increased urinary output?
  • Has there been any hair loss?
• Aadditional important information
  • What medications/drugs are being taken?
    • Diuretics?
    • Laxatives?
    • Alcohol?
    • "Street drugs"?
  • Has there been severe depression?
  • How is the body image -- are you aware of the weight loss? Are you pleased or concerned?

The physical examination may include a general physical examination and a measurement of the body weight.

Diagnostic tests that may be performed include the following:

• Nutritional assessment
• Blood tests including a chemistry profile

Psychological counseling may be recommended in cases where anorexia nervosa or depression are the cause of the weight loss. In the early stages, anorexia nervosa may be best treated in a hospital with close supervision. Even after anorexia nervosa has apparently been cured, the individual should visit the doctor periodically. Relapse is not uncommon.

For weight loss caused by a chronic illness, tube feeding may be administered in order to maintain nutrition and to prevent edema, poor healing, and muscle wasting.

The patient may be referred to a dietitian for nutritional counseling.