Eating Disorders on the Rise in Children
Report: Pediatricians Need to Watch for Signs of Anorexia, Bulimia in Girls and Boys
By Bill Hendrick
WebMD Health News
Reviewed by Laura J. Martin, MD


Nov. 29, 2010 -- Eating disorders such as anorexia nervosa and bulimia are on the rise in children and adolescents, and doctors should be on the lookout for signs in their young patients, a new report says.

It’s estimated that 0.5% of adolescent girls in the United States have anorexia nervosa and that 1% to 2% have bulimia, also called bulimia nervosa, says a new report from the American Academy of Pediatrics.

Eating disorders are also increasing rapidly in young males, the report says. Young males now represent up to 10% of all cases of eating disorders.
Eating Disorders Rising Fast in Children

An analysis by the Agency for Healthcare Research and Quality found that hospitalizations for eating disorders in children under 12 increased by 119% between 1999 and 2006, the report says.

The report recommends that pediatricians recognize signs of eating disorders, screen patients for disordered eating behaviors, and be prepared to intervene when necessary. The clinical report is published in the Nov. 29 issue of the journal Pediatrics.
Epidemiology of Eating Disorders Is Changing

“The epidemiology of eating disorders has gradually changed,” write the authors, led by David S. Rosen, MD, MPH, of the University of Michigan Health System.

“There is an increasing prevalence of eating disorders in males and minority populations in the United States, as well as in countries in which eating disorders had not been commonly seen.”

The authors point out that athletes and performers who participate in activities that reward a lean body are subject to increased risk of eating disorders.

The authors write that children who diet are at higher risk of developing eating disorders. The report says pediatricians should closely monitor the height and weight of patients as well as other signs and symptoms of eating disorders, which include pallor, hair loss, dry skin and fatigue, and dehydration.

Patients under 13 with eating disorders are more likely to have other medical or psychological conditions, such as obsessive-compulsive disorder or anxiety problems, the authors say.
Guidelines for Doctors With Young Patients

The researchers also say that blood tests can reveal worrisome signs involving glucose, calcium, and magnesium levels and liver enzymes that can alert doctors to potential problems.

Other studies such as bone density testing may reveal low bone mineral density, which is a frequent complication of eating disorders, the authors write.

The authors offer guidance for pediatricians, saying doctors:

    * Need to be knowledgeable about risk factors and early signs and symptoms of eating disorders
    * Should focus on healthy eating when talking to patients and their parents
    * Should be careful not to accidentally send messages that could lead to excessive dieting or compulsive exercising
    * Should carefully plot weight and height of patients and assess menstrual status in girls during visits
    * Should be aware of treatment resources in the area that they could recommend to children or parents
    * Should push for legislation and policy changes that ensure appropriate services for children with eating disorders, including mental health treatment and nutritional intervention programs