Paediatric Drugs

, Volume 3, Issue 2, pp 91–99 | Cite as

Eating Disorders in Children and Adolescents

Epidemiology, Diagnosis and Treatment
  • Michael Kohn
  • Neville H. Golden
Therapy In Practice


Eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN) are increasingly prevalent among children and adolescents. Whereas AN has a peak age of onset in early to mid-adolescence, BN typically presents during or after late adolescence. There is a spectrum of eating disorders that can be categorised by the criteria in the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders into AN, BN and ‘eating disorder not otherwise specified (ED-NOS)’.

The key clinical signs of AN are those of protein calorie malnutrition. In BN, signs of purging are also important. Despite marked physical changes, metabolic decompensation occurs late and when present is an indication for hospital admission. During refeeding, electrolyte disturbances, in particular hypophosphataemia, should be serially monitored. For females with AN, restoration of gonadotropins, oestradiol and resumption of menses is a cardinal indicator of nutritional recovery.

Treatment should address the medical, nutritional and psychological needs of children and adolescents with eating disorders. No single professional can be proficient in all spheres. Children and adolescents with eating disorders are best managed by a ‘team approach’. Treatment may occur in a variety of inpatient, daypatient or outpatient settings. The aims of medical treatment are to promote bodyweight gain and nutritional recovery. Psychiatric goals address the psychosocial precipitants, treat comorbid mood symptoms and assist the patient to develop alternative coping skills.

The crude mortality of AN has decreased to around 6%. For children and adolescents, the morbidity from malnutrition is increased because of the biological changes that are interrupted.


Anorexia Nervosa Obsessive Compulsive Disorder Eating Disorder Binge Eating Bulimia Nervosa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Adis International Limited 2001

Authors and Affiliations

  1. 1.Department of Adolescent MedicineThe New Children’s HospitalParramattaAustralia
  2. 2.Division of Adolescent MedicineSchneider Children’s HospitalNew Hyde ParkUSA

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