Early-onset anorexia nervosa: a scoping review and management guidelines

Area of Science:

• Pediatric Endocrinology
• Child Psychiatry
• Eating Disorder Research

Background:

• Anorexia nervosa (AN) is a severe eating disorder with psychological and physiological impacts.
• Early-onset anorexia nervosa (EOAN) is a distinct subtype affecting younger children, with unique epidemiological and clinical features.
• Current understanding and treatment protocols for EOAN are limited, necessitating further investigation.

Purpose of the Study:

• To synthesize existing literature on EOAN, focusing on its epidemiology, clinical specificities, diagnosis, treatment, and prognosis.
• To identify gaps in current knowledge regarding EOAN.
• To inform the development of preliminary guidelines for harmonizing EOAN diagnosis, treatment, and follow-up.

Main Methods:

• A scoping literature review was conducted from 2010-2021.
• Databases searched included PubMed, Web of Science, PsycInfo, and Cochrane.
• Keywords focused on "anorexia nervosa" and terms related to early onset (e.g., "prepubertal").

Main Results:

• The review included 42 records, with limited data specifically on EOAN treatment and prognosis.
• Existing international guidelines often adapt adolescent AN strategies for children, lacking robust evidence.
• While literature on EOAN's epidemiology and clinical features is growing, specific research protocols for this age group are scarce.

Conclusions:

• Further research is crucial to validate child-specific care strategies for EOAN.
• Developing age-appropriate recommendations with a higher level of evidence is essential.
• Targeting the specific determinants and clinical characteristics of EOAN will improve patient outcomes.