Anorexia nervosa is a difficult disease to treat effectively. Inpatient treatment in facilities with specialized expertise heightens the chance for success. Patients with the most severe degrees of anorexia nervosa are especially in need of hospitalization. Authorization from insurers can be a barrier to admitting these patients to reputable treatment facilities. Therefore, familiarity with accurate markers of disease severity is important to understand in order to effectively advocate for these patients. Albumin, a commonly used marker for nutritional status is surprisingly normal even in patients with severe anorexia nervosa. Understanding that albumin levels do not correlate with the severity of anorexia nervosa is an important lesson to understand in the process of facilitating the most effective care settings for patients with severe anorexia nervosa.