The ultimate goal of this website is to ensure that all patients suspected of having anorexia nervosa or bulimia nervosa have adequate diagnostic testing to rule out medical illness. How many cases of AN and BN truly are diagnosed correctly will not be known until this occurs.
Once this does transpire, I suspect that many of the patients currently being funnelled to eating disorder clinics will instead be directed to the GI specialist. Hopefully the morbidity and mortality rates of these disorders will subsequently drop.
I am confident that in the near future, most family physicians will become aware of the changes needed to correctly diagnose patients suspected of having eating disorders. In fact, I would predict that soon every physician will make it a point to diligently test for underlying medical disorders, otherwise risking the possibility of malpractice litigation.
I certainly agree that society must place less focus on physical appearance, and stress the important virtues of sound character, kindness, compassion, patience, self-discipline, ambition, etc. It is unlikely however, that we will soon return to the old days when a woman was judged more for her ability to cook and bear children than for her figure or facial features. We as a society have changed too much. We have mostly lost our ethnicity, our religion, and many of our moral values. In the end however, it may not be our society's preoccupation with thinness that is driving some to starve themselves to death. Rather, it is the belief that this preoccupation is at fault that may have blinded us to the real causes of anorexia and bulimia. When we as a society have removed the blinders unwittingly placed on us by some experts in the psychiatric community, we may finally see things as they are.
Will eating disorders go away when every patient is tested for underlying disorders? Probably not. There is enough dysfunctional eating out their to keep therapists busy for many more years. Maybe my ideas are wrong. Yet they can only be proved wrong by actually performing extensive diagnostic testing. Extensive testing should especially be focused on the worst cases, as these are the most likely to have an underlying medical etiology.
I am sure there are many patients currently in eating disorder programs who have no underlying medical disorder. They may just be genetically predisposed to having a small appetite or small build. Some may have a medical disorder that is difficult, if not impossible to diagnose. Some may truly be so afraid of becoming obese that they cannot eat. One thing is certain, and that is that we cannot assume that all patients diagnosed with AN or BN suffer from mental illness without first making sure they do not have an underlying medical problem.
