Eating disorders are seen most commonly in women of reproductive age but can be challenging to diagnose because many affected patients have a normal physical examination and body mass index (BMI). Because the reproductive axis is sensitive to the disruptions caused by restricted and irregular nutrition, patients with eating disorders often present with primary gynecologic symptoms. This observation likely accounts for the fact that half of all patients with an eating disorder are diagnosed by a primary care provider rather than a mental health specialist.1
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