Stunting of growth in anorexia nervosa during the prepubertal and pubertal period

The growth charts of 15 patients with anorexia nervosa during the prepubertal and pubertal period were carefully reconstructed. All 15 (13 females, 2 males) had been suffering from anorexia nervosa for at least 6 months prior to referral. Mean age at referral was 13.3 +/- 1.3 years and mean duration of anorectic symptoms was 17 +/- 8 months. In all 15 cases growth arrest had been present for 13 +/- 8.5 months prior to admission. During the follow-up period, catch-up growth to different degrees was observed in the 13 patients (11 females, 2 males) who remained under treatment for at least 1 year. On the assumption that stunting of growth during the prepubertal and pubertal period is a very frequent, if not a constant, sign of anorexia nervosa of 6 months duration or more, it could be considered an additional criterion for diagnosis of the disease. The projected height should be included in the calculation of ideal weight. Since patients with growth arrest are usually referred first to a general pediatrician or a pediatric endocrinologist, it is recommended that a detailed history of caloric intake, as well as the attitude of the patient to food, be obtained in each case in order to confirm the diagnosis of anorexia nervosa.