A 17-year-old female patient presents for a routine health visit. She has lost 15% of her body weight since her last visit 6 months ago, despite a reported increase in food intake. Her mother expresses concern about her excessive exercise and preoccupation with her body image. During the review of systems, the patient admits to feeling cold all the time, experiencing abdominal pain, and noticing hair thinning. Based on these findings, which of the following conditions should the medical assistant be most concerned about?
The patient presents with significant weight loss, a reported increase in food intake, excessive exercise, and a preoccupation with body image, as well as signs of metabolic disturbance such as feeling cold, abdominal pain, and hair thinning. These are classic signs of anorexia nervosa, an eating disorder characterized by an intense fear of gaining weight and a distorted body image, leading to restrictions on caloric intake and often excessive physical activity.
The other options, while they may present with some similar symptoms, are less consistent with the clinical picture described. Binge eating disorder is characterized by recurrent episodes of eating an abnormally large amount of food in a short time period without compensatory behaviors, and bulimia nervosa involves binge eating followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, or excessive exercise, but weight is often maintained at or above normal. Pica is an eating disorder that involves eating non-nutritive substances and is not related to a fear of weight gain or body image distortion.
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