The anorectic and obese adolescent

In view of the menstrual disturbances involved, gynaecologists frequently come into contact with girls suffering from eating disorders that can rapidly evolve into anorexia nervosa. The ability to make a precocious diagnosis of the severity of both physical and psychopathological involvement, to offer clear explanations of the links between reproductive function and energy availability and to motivate psychotherapy can be of paramount importance for the prognosis. Similarly, obese adolescents might require counselling for menstrual disorders or alleged endocrine dysfunction. Knowledge of the markers of metabolic impairment and of the possible therapeutic approaches to essential obesity is a necessary complement to the management of the more usual conditions related to overweight, such as polycystic ovary syndrome. Presented here is an overview of recent evidence on the pathogenesis, endocrine profile, short- and long-term health repercussions, therapeutic strategies and clinical trials regarding these two opposing pathologies, both related to unhealthy eating behaviour and also to psycho-relational problems.