Assessing the Reliability of BMI in Evaluating Anorexia Nervosa Risks
At 20 years of age and standing at a height of 163 cm, I currently weigh approximately 38 kg. After a recent visit to my general practitioner, she assessed my weight and height, calculating a Body Mass Index (BMI) of 14.3. She then communicated her findings in a letter to my psychiatrist, suggesting that hospitalization should be pursued urgently if I do not manage to stabilize my weight. My GP expressed concerns regarding the potential for cardiac arrest, which I find difficult to accept, especially since I feel okay. She measured my blood pressure but did not check my heart rate. Additionally, she ordered a blood test that I should complete unless I end up being hospitalized. I have regular menstrual cycles and am not experiencing any alarming symptoms. My lab results from a month ago, when my weight was 40 kg, were all normal. Currently, I'm taking 40 mg of fluoxetine for depression, and I've noticed an improvement in physical symptoms that I originally attributed to inadequate nutrition, such as chest pressure, fatigue, dizziness, and feeling cold; these have gradually improved alongside my mood. My psychiatrist believes that my GP may have overreacted, considering that my baseline BMI before the onset of my eating disorder was already on the lower end, typically around 17 to 18, with my peak weight being 49 kg. I have been advised that my psychiatrist mishandled the situation, and that I might benefit from switching to a different provider because she dismissed my GP’s concerns, referred to me as a "shrimp" to indicate that I am naturally thin, and did not inquire into my eating behavior. She also downplayed health risks due to my normal lab results. However, I still wonder if my psychiatrist might have a valid point regarding my GP's dramatic approach. So, is my psychiatrist correct that the reactions were exaggerated, or did she indeed handle the matter inappropriately, warranting a change in my medical provider?
Answers (1)
6/17/2025, 2:02:00 PM
OpenHealth AI
It's understandable to feel conflicted about the differing opinions between your general practitioner (GP) and your psychiatrist regarding your weight and health concerns. Given your current BMI of 14.3, which falls significantly below the normal range, both perspectives reflect valid considerations, but let's break this down.
Main Points:
- BMI and Health Risks: A BMI under 18.5 is considered underweight and can lead to serious health issues, even if you feel okay currently.
- Different Perspectives: Your GP is focused on immediate physical health risks due to your weight, while your psychiatrist seems to emphasize comfort and prior health status.
- Need for Comprehensive Evaluation: It’s key to evaluate both physical and psychological health holistically.
Explanation:
Your BMI of 14.3 indicates malnutrition and puts you at a higher risk for severe consequences, including cardiac issues, due to the stress on your body. Cardiac arrest can happen even in seemingly healthy individuals when they are significantly underweight. While you may be feeling okay now, maintaining that low weight can be unsafe in the long term.
On the other hand, it’s essential for your mental health care to involve professionals who understand your individual history and how your body responds. The comments made by your psychiatrist, like referring to you as a “shrimp,” may indicate a dismissive attitude which could be concerning for supportive care.
Next Steps:
- Complete Blood Tests: Make sure to undergo the blood tests your GP ordered. This can help assess your overall health and key markers that might be affected by low weight.
- Keep a Symptom Diary: Document any physical or emotional symptoms you experience daily. This could include mood changes, physical discomfort, and any other relevant experiences.
- Consider a Nutritional Assessment: Seek an evaluation from a dietitian who specializes in eating disorders. They can help create a meal plan that gradually increases your intake in a healthy way.
- Assess Your Support System: Reflect on how your current healthcare team supports you. If you feel either the GP's or psychiatrist's understanding is lacking, consider seeking additional opinions or changing providers if needed.
Final Thoughts:
It's vital to prioritize your health, both physically and mentally. Balancing the advice from both your GP and psychiatrist can be tricky, but remember that the goal is your well-being. If you feel comfortable, discuss your concerns with both professionals to create a unified and supportive care plan moving forward. It's crucial that you feel safe and supported in your recovery.
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