Acute food refusal

Acute medical complications of malnutrition (e.g., syncope, seizure, heart failure, pancreatitis)

Arrested growth and development

Behavioral health or medical conditions that limit outpatient management (e.g., severe depression, obsessive compulsive disorder, type 1 diabetes mellitus)

Dehydration

Electrocardiogram abnormalities (e.g., prolonged QTc interval)

Electrolyte disturbances (e.g., hypokalemia, hyponatremia, hypophosphatemia)

Failure of outpatient treatment

Median body mass index ≤ 75% for age and sex

Physiologic instability including autonomic dysfunction

Bradycardia (< 50 beats per minute during the day; < 45 beats per minute at night)

Hypotension (< 90/45 mm Hg)

Hypothermia (< 96°F [35.5°C])

Orthostatic increase in pulse (> 20 beats per minute) or decrease in blood pressure (> 20 mm Hg systolic or > 10 mm Hg diastolic)

Uncontrollable bingeing and purging