Patients with anorexia nervosa may present with severe emaciation and complain of cold intolerance or constipation. Amenorrhea is almost always present and may be accompanied by bradycardia, hypotension, and hypothermia. An examination will reveal loss of body fat, dry and scaly skin, and increased lanugo body hair. Parotid enlargement and edema may also occur. Patients may have elevated serum cholesterol levels, depressed levels of luteinizing and follicle stimulating hormones, and an impaired response of luteinizing hormone to luteinizing hormone-releasing hormone. In a few instances, medications such as tricyclic antidepressants, selected serotonin reuptake inhibitors (SSRIs), and lithium carbonate are effective. All cases should be co-managed with a psychiatrist and, a patient should be admitted if she presents with hypovolemia or major electrolyte disorders.