Hospitalizations of children younger than 12 years rose by 119% from 1999 to 2006, a report issued by the American Academy of Pediatrics (AAP) revealed in the journal Pediatrics. Overall, including all age groups, the same period saw a 15% increase in hospitalizations for eating disorders.

The typical profile for an at-risk individual (child) is no longer useful, the authors stress. The AAP urges doctors and pediatricians to screen all children, adolescents and pre-adolescents for anorexia, bulimia and other eating disorders. The screening should occur during routine check-ups.

It is a myth that only Caucasian, well-off females are at risk, David S. Rosen, MD, from the University of Michigan in Ann Arbor and team wrote.

If an individual has a compulsion to eat or not eat, and that compulsion has a negative effect on their physical and mental health, they probably have an eating disorder. Anorexia Nervosa (Anorexia) and Bulimia Nervosa (Bulimia) are the most common types of eating disorders.

Anorexia Nervosa is a psychological disorder; the individual has a distorted body image and an unreasonable fear of becoming fat, so they deliberately try to lose weight. Most of anorexia nervosa patients are female, but males can also suffer from it.

Bulimia Nervosa is also defined as a psychological disorder. There are regular episodes of serious overeating, followed by feelings of guilt. This can result in extreme reactions, such as doing lots of exercise, crash dieting, and deliberately vomiting (purging).

Eating disorders have progressively and steadily been affecting younger and younger children, as well as boys, and children from minority groups, the researchers inform.

Depending on how an eating disorder is defined, up to 14% of children may be affected at some time. Of growing concern are children involved in competitive sports, such as athletics, running and gymnastics.

The results of the anti-obesity drive over the last few years – focusing on eating habits and losing weight – may have unintentionally contributed towards an increase in eating disorders, the authors add.

Doctors should focus on healthy eating when counseling families. When dealing with overweight/obesity it is vital that building self-esteem forms part of a treatment program.

The authors wrote:

    “Care needs to be taken not to inadvertently enable excessive dieting, compulsive exercise, or other potentially unhealthy weight-management strategies.”

As part of a child’s routine check-up, their weight should be monitored, as well as BMI (body mass index), height, girls should be tracked for their menstrual status. The health care professional should also seek to find out what the child’s eating habits are, as well as their body image.

If a patient has abnormal weight concerns, is dieting excessively, is losing weight or not developing (growing) properly, they should be assessed for an eating disorder and be monitored closely.

Signs of amenorrhea may be an indication of an eating disorder in girls. Amenorrhea has two meanings: 1. Primary amenorrhea – menstruation never occurred, it fails to occur at puberty. 2. Secondary amenorrhea – menstruation begins, but then ceases.

Younger children may not have the typical signs of an eating disorder. There might not be significant weight loss or body image problems. A younger child with an eating disorder is more likely to have growth problems. Pre-adolescent boys are just as likely to have an eating disorder as girls of the same age.

If a non-specialist GP (general practitioner, primary care physician) is not comfortable with the assessment aspects of eating disorders, he/she should refer to child to a specialist.

The authors point out that with appropriate treatment and monitoring, the vast majority of children with an eating disorder eventually make a full recovery.

Other examples of eating disorders, apart from anorexia nervosa and bulimia nervosa are binge eating disorder, rumination disorder, diabulimia, food maintenance syndrome, female athlete triad, pica, night eating disorder, and orthorexia nervosa.

“Clinical Report-Identification and Management of Eating Disorders in Children and Adolescents”
PEDIATRICS (doi:10.1542/peds.2010-2821)

Written by Christian Nordqvist