Although eating disorders are on the psychiatric spectrum, they can have serious associated medical complications. Patients with eating disorders may present with complaints common to the emergency department such as abdominal pain, chest pain, syncope, or palpitations, but management of these conditions in eating disordered patients can pose a challenge. This issue provides a systems-based approach to the history, physical examination, evaluation, and treatment of acute complications of eating disorders, with a specific focus on the pathophysiology and management differences between an otherwise healthy patient and a patient with an eating disorder.