Mental Disorders and Learning Disabilities in Children and Adolescents: Eating Disorders

Eating disorders are common. The typical onset of eating disorders is in mid- to late adolescence, affecting females more often than males. However, rates of eating disorders are increasing among younger children, males, and minority groups. Warning signs include abrupt changes in weight or growth percentiles, a preoccupation with calories or weight, altered eating habits, excessive exercise, loss of menses, pubertal delay, and a distorted perception of body size. For patients with eating disorders that include dietary restriction (eg, anorexia nervosa, avoidant restrictive food intake disorder), common short-term medical sequelae include weight loss, bradycardia, hypotension, fatigue, and irritability. Effects on growth and bone health may be irreversible. In patients with disorders that involve binge eating or purging behaviors (eg, bulimia nervosa, binge-eating disorder), common issues include significant weight fluctuations, gastrointestinal dysfunction, and electrolyte disturbances. Most children and adolescents with eating disorders can be treated with outpatient management with medical monitoring, psychotherapy, and support from a dietitian. Family-based treatment is the recommended approach for adolescents with anorexia nervosa. Some patients need medical or psychological stabilization in the hospital, and others benefit from day management or residential programs for additional structure and support.