When Eating Disorders Impair Medical Students and Clinicians

Anorexia nervosa can affect medical students and young physicians and in Australia guidelines for managing impaired doctors also apply to clinicians with anorexia nervosa (Med J Australia 2004;181(7):372).These professionals may face subtle cognitive dysfunction, depression, and medical effects including osteoporosis, hypotension, and marked fatigue.

One common problem is a significant difference of opinion between the registrants’ views of their ability to function and that of the New South Wales Medical Board and its agents, according to Dr. J. Russell, a psychiatrist who reports to the Board. The Board focuses on protecting the public first, and has established specific objective outcome measures, including body mass index (BMI) or workforce parameter for impaired medical students and clinicians. For example, if a student of physician’s BMI falls below 17.5 kg/m2, monitoring will be ordered. If the registrant’s BMI falls to 15, he or she will be suspended from clinical practice until weight is regained.

Concern about extreme weight loss may overshadow other issues related to distressing early life experiences, including abuse during childhood. These issues may affect the clinician’s motivation for recovery and doctor-patient interactions and must be taken into consideration to help the impaired.