[Eating disorders in childhood and early adolescence]

During childhood and early adolescence, eating disorders are mainly of the restrictive type and general practitioner plays a central role in treatment. Parental counseling and medical care should be administered to selective and restrictive children without growth retardation. When growth and puberty are delayed a multidisciplinary approach is recommended. Somaticians, psychiatrists and psychotherapists will work together in the fight against the eating disorder. Family approaches yielded the best results in the management of these disorders for the younger subjects but individual therapies are also recommended. If vitamin and calcium supplements are necessary, it is not the case for psychotropic medications, which can have a dangerous impact if nutritional status is not stabilized. Outcome of selective and restrictive disorders in childhood is good however picky eaters need special care because of the risk of anorexia nervosa in later adolescence. Outcomes of prepubertal anorexic patients seem to be better than those of pubertal anorexic subjects but it is not the case for subjects affected by very-early-onset anorexia nervosa.