Unusual forms of self-harm have been reported that are
directly linked with efforts to maintain AN. For example,
ingesting large quantities of salt [83], scratching [84] and
blood-letting [85]. How these phenomena fall under the
umbrella of wider deliberate self-harm (DSH) phenomena
is unclear as DSH has multiple intended functions [86].
If present, such behaviours are unlikely to come to light
in outpatient assessment settings. Although the conscientious
clinician will assess for them, these may only
be revealed following close monitoring, as occurs in
inpatient settings.