Eating Disorders in Adolescents: Recommendations, Diagnosis Changes
(HealthDay News) — A new review presents recommendations for the management of eating disorders (EDs) in children. In addition, other research indicates that there has been a recent increase in the prevalence of eating disorders not otherwise specified who do not meet weight criteria (EDNOS-Wt), relative to anorexia nervosa (AN). The review and study have been published online August 25 in Pediatrics.
Kenisha Campbell, MD, MPH, and Rebecka Peebles, MD, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, reviewed EDs in children and adolescents. The authors note that EDs are frequently undiagnosed and many adolescents are untreated and do not recover or recover only partially. EDs present differently in pediatric populations and are not caused by families or chosen by patients. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers can be effective. Cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Primary care providers have a key role in treatment success.
Melissa Whitelaw, from The Royal Children's Hospital in Melbourne, Australia, and colleagues examined the changing incidence of EDNOS-Wt with that of AN in a six-year retrospective cohort study involving 99 adolescents, of whom 73 had AN and 26 had EDNOS-Wt. The researchers found that EDNOS-Wt represented 8% of admissions in 2005; this number had increased to 47% by 2009. In 41 and 39% of AN and EDNOS-Wt patients, respectively, hypophosphatemia developed. The lowest pulse rate was 45.1bpm in AN and 47.1bpm in EDNOS-Wt patients.
"Despite not being underweight, EDNOS-Wt patients experienced a similar profile of life-threatening complications of weight loss as patients who have AN," Whitelaw and colleagues conclude.