Medical Emergencies in Eating Disorders
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11-Mar-2026
Eating disorders* are relatively common and unfortunately patients who “look well” can have a significant mortality risk. MEED.org.uk have national risk tools to recognise those that would benefit from admission, which fit with our local mental health teams, and agreed by both acute medicine and paediatrics
(*anorexia nervosa, bulimia nervosa, binge eating or avoidant restrictive food intake disorder)
Risk Assessment
RED indicators
Anyone with one or more RED’s is high risk and should be considered for admission MEED
- BMI <13/<70% mBMI
- Recent weight loss >1 kg/week for 2 weeks in an underweight patient
- HR (awake) <40
- Recurrent syncope with standing BP <90 systolic (<0.4th percentile for age) and postural drop >20 mmHg (or increase HR >30 [>35 if <16])
- Fluid refusal or signs of dehydration
- Temperature <35.5°C tympanic/35°C axillary
- Long Qt or other ECG abnormalities
- Low Glu/Na/K/Ca/PO4/Alb
- Low WCC, Hb <10
- Acute food refusal/very low calorie intake per day
- Physical struggles with carers over nutrition
- High levels of uncontrolled exercise (>2 hours/day)
- Daily purging behaviours
- Self-harm
- Moderate–high risk suicidal ideas.
