Eating Disorders in Children and Adolescents: State of the Art Review

Abstract

This is the 3rd in our series on Adolescent Health. abstract Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. Many adolescents go untreated, do not recover, or reach only partial recovery. Higher rates of EDs are seen now in younger children, boys, and minority groups; EDs are increasingly recognized in patients with previous histories of obesity. Medical complications are common in both full and subthreshold EDs and affect every organ system. No single cause of EDs has emerged, although neurobiological and genetic predispositions are emerging as important. Recent treatment paradigms acknowledge that they are not caused by families or chosen by patients. EDs present differently in pediatric populations, and providers should have a high index of suspicion using new Diagnostic and Statistical Manual, 5th edition diagnostic criteria because early intervention can affect prognosis. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers has emerged as particularly effective; cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Pharmacotherapy is useful in specific contexts. Full weight restoration is critical, often involves high-calorie diets, and must allow for continued growth and development; weight maintenance is typically inappropriate in pediatric populations. Physical, nutritional, behavioral, and psychological health are all metrics of a full recovery, and pediatric EDs have a good prognosis with appropriate care. ED prevention efforts should work toward aligning with families and understanding the impact of antiobesity efforts. Primary care providers can be key players in treatment success.

Nutritional Status, Dietary Practices and Physical Activities of Adolescents in Public and Private Schools of Karachi, Pakistan

“…Adolescents also tend to suffer from a variety of eating disorders i.e., anorexia nervosa, bulimia nervosa as well as depression, anxiety and psychological stress. 12 In developing countries including Pakistan, adolescents' health and nutrition is largely under-researched and has been ignored due to the silent nature of nutritional problems, undocumented evidence of life threatening epidemics, less assertive attitude of adolescents, muted political interest and financial constraints. Lack of data on adolescents' nutritional status, dietary practices and physical activities also make it difficult to draw the attention of Government officials, program managers and policy makers to formulate and develop appropriate adolescent specific strategies for addressing their nutritional and socio-psychological needs.…”

Photo editing: enhancing social media images to reflect appearance ideals

“…At a time when self-identity is forming, using social media to understand societal beauty standards may create additional pressure for young people to alter their images (Krayer et al, 2007). This may be particularly harmful because adolescence is a time when body image concerns and disordered eating often starts to develop, especially in females (Campbell and Peebles, 2014;Voelker et al, 2015).…”

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

“…More recently, studies have found an increase in the frequency of ED among boys [3][4][5] . A study conducted in Australia with a sample of 101 children and adolescents treated in an ED program found that 25% (1:4) of the participants were boys 6 .…”

“…Studies from the 1980s and 1990s have indicated a girl/boy proportion of 10-12:1 among patients with ED admitted to outpatient treatment or inpatient unit 2 . However, international studies have shown that the epidemiology of this pathology has changed in the last decades [3][4][5] .…”