ENDOCRINOLOGY OF ANOREXIA-NERVOSA

The endocrine dysfunctions that occur in anorexia nervosa are secondary phenomena, resulting from the disturbance in behaviour. Their presentation is different from that of any primary endocrine disease, and their occurrence should not lead to difficulties in differential diagnosis. The current practice of submitting anorexia nervosa patients, who present with amenorrhoea and 'unexplained' weight loss, to exhaustive endocrine investigations, appears unwarrented. Anorexia nervosa is a clinical diagnosis which can usually be made by careful attention to history taking and physical examination and there is usually little need for laboratory tests of endocrine function. If such tests are performed and yield positive results of the type outlined above, they should be interpreted as evidence supporting the diagnosis rather than as a justification for further investigation. The patient should be referred for appropriate psychiatric treatment at the earliest opportunity and should not be confirmed in a medical sick role by unnecessary concentration on the endocrinological sequelae of weight loss.