Anorexia is an eating disorder characterized by severe restraint in food intake and/or excess physical activity. It is often linked to negative feelings toward body image. Over time, anorexia can cause severe symptoms, such as stunted growth, bone loss, damage to major organs such as the heart, and even death.
The cause of anorexia in children is not known. It appears that genetics and environment play a role.
Anorexia can occur in both girls and boys, but is much more common in girls. Factors that increase your child’s risk of anorexia include:
Family history of eating disorders
Fear of becoming overweight
Pressure to be thin
Employment or activities in which body image concerns dominate, such as gymnastics and fashion modeling
Mood disorders, such as
anxiety, or or obsessional traits
History of emotional or sexual child abuse
Behavioral signs may appear before physical symptoms. They may include:
Distorted self-image of being overweight despite evidence of the opposite
Obsession with food
Restricting food or certain food groups even when thin
Fear of becoming overweight even if the child is losing weight
Excessive exercising to promote weight loss
Denying feelings of hunger
Physical symptoms may include:
Changes in weight, such as slow weight gain or weight loss
Loss of menstrual periods or delay in the beginning of periods
You will be asked about your child’s symptoms and medical history. A physical exam and a psychological evaluation will be done. The diagnosis will be based on information from you and your child and the examination.
If anorexia is suspected or diagnosed, then your child’s doctor may order further tests to determine what effect the anorexia has had on your child’s overall health. Tests may include:
Blood tests—to look for changes in electrolytes, vitamins, and other important nutrients.
Bone density test—to test the health of your child’s bones, especially in girls whose menstrual periods are absent.
Management of anorexia will include:
Assuring adequate nutrition
Addressing the feelings and distorted thoughts causing the condition
Identifying and managing any physical problems caused by poor food intake
The length and intensity of treatment will depend on the individual child. Regular supervision by health care specialist will help to make sure that hydration and nutrient levels have not dropped to dangerous levels during recovery. It may take many years to fully manage anorexia. Treatment should include more than one approach but may include:
You may be referred to a dietitian who will talk to you and your child about practical weight goals and calorie goals. A dietitian will also assure proper weight gain and help your child develop good eating habits.
Severe malnutrition may require the delivery of nutrients through a tube that is passed through the nose and into the stomach.
Therapy can help address factors that may be linked to your child’s anorexia including harmful thought patterns, anxiety, and poor self-esteem. It can also help your child develop a more positive attitude about food and their body image.
Work with your child’s doctor and therapists to determine which therapy may be best for your child. Your child may use more than one type of therapy or try different therapies before the right one is found. Some therapy options include:
Family therapy—Recovery is often more successful if family members take part in therapy. All family members need to understand the disorder to provide the proper support.
Cognitive behavioral therapy
—To help your child develop a healthier and more realistic self-image. The therapist will help your child find new ways to think about his or her body and diet.
Anorexia nervosa in children. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/anorexia_nervosa_in_children_90,P02554/. Accessed August 23, 2017.
Campbell K, Peebles R. Eating disorders in children and adolescents: state of the art review. Pediatrics. 2014 Sep;134(3):582-592. Available at: http://pediatrics.aappublications.org/content/134/3/582.long#content-block.
Eating disorders: what families need to know. University of Michigan Health System website. Available at: http://www.med.umich.edu/yourchild/topics/eatdis.htm. Updated October 2010. Accessed August 23, 2017.
Kids and eating disorders. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/kid/health_problems/learning_problem/eatdisorder.html#cat20081. Updated July 2015. Accessed August 23, 2017.
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