When is it Necessary to Hospitalize?

Identifying Outcome

  • Expected Outcomes
    • The patient will restore healthy eating patterns and normalize physiological parameters related to body weight and nutrition
    • Eating 100% of meals without bingeing, purging, or engaging in other compensatory behaviors for anorexia nervosa and bulimia nervosa patients.
    • Obese patients should be encouraged to leave something on their plate at the end of a meal (no more than 5% and no less than 2%)
  • Short-Term Goals
    • The patient will identify cognitive distortions about food, weight, and body shape
    • The patient will develop a week’s worth of menus for nutritionally balanced meals
    • The patient will accurately describe body dimensions
    • The patient will exercise in moderate amounts only when nutritionally and medically stable
    • The patient will demonstrate positive family interactions and successful movement toward the achievement of separation and individuation issues
    • The patient will be able to describe the complications and medical sequelae of the eating disorder behavior

When is it Necessary to Hospitalize?

  • Medical
    • Need for extensive evaluation
    • Excessive weight loss: >25% of body weight over 3 months
    • HR <40 beats/min or >110 beats/min
    • Temperature <97.0 F
    • SBP: 70 mmHg or marked orthostatic hypotension
    • Severe dehydration or vomiting blood
  • Psychiatric
    • Risk of suicide or self-mutilation
    • Severe depression
    • Substance abuse
    • Psychosis
    • Family crisis
    • Failure to comply with treatment contract or poor motivation
    • Inadequate response to outpatient treatment