Eating disorder differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

BINGE EATING DISORDER

Binge Eating must be differentiated from:

• Bulimia nervosa which exhibit compensatory behavior after eating to prevent weight gain. The compensatory behavior in Bulimics can be laxative abuse, self-induced vomiting or fasting.
• Kleine-Levin syndrome which is associated with excessive sleep along with episodes of binges.
• Mood Disorder which has psychological features in addition to binge eating episodes.
• Anxiety disorder which is associated with binge eating during episodes.

BULIMIA NERVOSA

Bulimia nervosa is diagnosed only after excluding the medical causes of vomiting and excessive bowel activity. These  medical conditions does not exhibit the features of binge eating or excessive preoccupation of weight and body image.
Bulimia Nervosa must be differentiated from: 

• Biliary disease which will cause nausea and vomiting. It can be excluded by elevated bilirubin or transaminases in metabolic profile.
• Irritable bowel syndrome which present with increased frequency of bowel movements but does not present with episodes of binge eating.
• Neurological conditions which can cause vomiting; therefore, a detailed neurological examination should be done.

ANOREXIA NERVOSA

The core feature of AN is weight loss or low BMI. The patient may not accept the avoidance of food or may not disclose the motives or a particular behavior. Therefore, it can challenging for a provider to know the exact cause of low BMI. The organic and other psychological causes should be ruled out.

• A diabetic patient may attempt to restrict the insulin to lower the calories.
• A patient with tumor limit the food intake and lose weight.
• Depression should be ruled out by its other diagnostic features.
• Chronic fatigue syndrome and post viral syndrome also limit food intake.

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases	Clinical manifestations						Para-clinical findings							Gold standard	Additional findings
	Symptoms			Physical examination
							Lab Findings			Imaging			Histopathology
	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3
Differential Diagnosis 1
Differential Diagnosis 2
Differential Diagnosis 3
Diseases	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3	Histopathology	Gold standard	Additional findings
Differential Diagnosis 4
Differential Diagnosis 5
Differential Diagnosis 6