Patients who meet any one of the following criteria should be re-fed in the hospital rather than as outpatients (other criteria may pertain, clinical judgment required):

* <75% ideal body weight or Minimum Weight for Health (MWH)*, or ongoing weight loss despite intensive management

* Refusal to eat

* Body fat <10%

* Heart rate <50 per minute daytime; <45 bpm nighttime

* Systolic pressure <90

* Orthostatic changes in pulse (>20 bpm) or blood pressure (>10 mm Hg)

* Temperature <96 F

* Arrhythmia

AAP Admission Criteria: Bulimia Nervosa

* Syncope

* Serum potassium concentration <3.2 mmol/L

* Serum chloride concentration <88 mmol/L

* Esophageal tears

* Cardiac arrhythmias including prolonged QTc

* Hypothermia

* Suicide Risk

* Intractable vomiting

* Hematemesis

* Failure to respond to outpatient treatment

Criteria as of 1 January, 2003. See Pediatrics Vol. 111, pgs. 204-11

MWH* or Minimum Weight for Health (five feet in height):

Girls - 100 lbs., plus 5 lbs. for each additional inch
Boys - 106 lbs., plus 6 lbs. for each additional inch

* PLEASE NOTE: Any calculation of a minimum weight for health (MWH) is an educated guess and should be used only when either a pre-morbid weight is not available, or the premorbid weight corresponds to a BMI greater or equal to 30 or is greater than 90% weight for height. However, if growth curve information is a available, a physician may want to use a number corresponding to previous growth percentiles.