Anorexia in Children: Diagnostic Evaluation & Management Tool

Anorexia

Clinical History Assessment

Systematic approach to history taking for a child presenting with anorexia or disordered eating

Physical Examination Guide

Systematic approach to examining a child with anorexia or disordered eating

Diagnostic Approach

Initial Assessment

For a child presenting with suspected anorexia nervosa, the initial assessment should include:

Comprehensive evaluation of weight history, eating patterns, and body image concerns
Assessment of medical stability and complications
Psychiatric evaluation for comorbidities and suicide risk
Family dynamics assessment and impact on eating behaviors
Determination of appropriate level of care based on medical and psychiatric stability

Diagnostic Criteria for Anorexia Nervosa

DSM-5 criteria for anorexia nervosa, adapted for children and adolescents:

Criteria	Definition	Special Considerations in Children
A. Energy Restriction	Persistent energy intake restriction leading to significantly low body weight in context of age, sex, developmental trajectory, and physical health	In children, may present as failure to make expected weight gain or maintain growth trajectory rather than weight loss
B. Fear of Weight Gain	Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain	Children may not explicitly express fear but demonstrate behaviors that prevent weight gain
C. Body Image Disturbance	Disturbance in the way one's body weight or shape is experienced, undue influence of body shape/weight on self-evaluation, or persistent lack of recognition of seriousness of low body weight	May be expressed differently in younger children; concrete rather than abstract thinking about body
Specifiers	Restricting type vs. Binge-eating/purging type	Children more commonly present with restricting type

Differential Diagnosis

Category	Conditions	Distinguishing Features
Other Eating Disorders	- Avoidant/restrictive food intake disorder (ARFID) - Bulimia nervosa - Other specified feeding or eating disorder (OSFED) - Rumination disorder	- ARFID: No body image disturbance or fear of weight gain - Bulimia: Normal or above-normal weight, binge episodes - OSFED: Does not meet full criteria for specific disorders - Rumination: Repeated regurgitation without purging intent
Medical Conditions	- Gastrointestinal disorders (celiac disease, IBD, gastroparesis) - Endocrine disorders (diabetes, hyperthyroidism, adrenal insufficiency) - Oncologic conditions - Chronic infections	- Physical symptoms predominate - No body image disturbance - Weight loss despite normal or increased appetite - Laboratory abnormalities specific to medical condition
Psychiatric Conditions	- Major depressive disorder - Anxiety disorders including OCD - Somatic symptom disorder - Schizophrenia with food-related delusions	- Primary symptoms not focused on weight/shape - Depression: Appetite changes with mood disturbance - OCD: Food rigidity not driven by weight concerns - Psychosis: Bizarre food beliefs or delusions
Social/Environmental	- Food insecurity - Neglect or abuse - Selective eating - Cultural/religious food practices	- No body image disturbance - Improvement with food security - History of trauma - Consistent with family/cultural patterns
Developmental	- Normal picky eating - Autism spectrum disorder - Sensory processing disorders - ADHD affecting mealtime behavior	- Longstanding history - No recent weight loss or growth deceleration - No body image concerns - Sensory-specific food aversions

Laboratory Studies

Initial laboratory evaluation for suspected anorexia nervosa:

Test	Potential Findings	Clinical Significance
Complete Blood Count	Leukopenia, anemia, thrombocytopenia	Bone marrow suppression due to malnutrition
Comprehensive Metabolic Panel	Hypokalemia, hypophosphatemia, elevated BUN, low glucose, elevated liver enzymes	Electrolyte disturbances may predict refeeding syndrome risk; organ dysfunction
Thyroid Function Tests	Low T3, normal/low TSH, normal/low T4 (sick euthyroid syndrome)	Adaptive response to starvation; generally resolves with refeeding
Urinalysis	High specific gravity, ketones	Dehydration, starvation ketosis
ECG	Bradycardia, prolonged QTc, arrhythmias	Cardiac adaptation and risk assessment
Gonadotropins and Sex Hormones	Low LH, FSH, estradiol (females) or testosterone (males)	Hypogonadotropic hypogonadism, delayed puberty risk

Advanced Studies

Consider in selected cases based on clinical presentation:

Investigation	Clinical Utility	When to Consider
Bone Mineral Density (DEXA)	Assess for osteopenia/osteoporosis	Duration of illness >6-12 months, amenorrhea >6 months, fracture history
Brain MRI	Rule out intracranial pathology	Atypical presentation, neurological symptoms, rapid onset
Celiac Disease Screening	Rule out celiac disease	GI symptoms, family history, atypical presentation
Inflammatory Markers (ESR, CRP)	Assess for inflammatory conditions	Fever, GI symptoms suggesting IBD or other inflammatory condition
Cortisol Level	Rule out adrenal insufficiency	Hypotension, electrolyte abnormalities, excessive fatigue

Diagnostic Algorithm

A stepwise approach to diagnosing anorexia nervosa in children:

Evaluate medical stability (vital signs, hydration status, electrolytes)
Assess nutrition status (weight, height, BMI percentile/BMI-for-age z-score)
Growth chart review (document deviations from expected growth trajectory)
Medical evaluation to rule out organic causes of weight loss
Psychiatric assessment focusing on body image, eating behaviors, and comorbidities
Family assessment including family history of eating disorders, family dynamics
Apply DSM-5 criteria with developmental considerations for children
Determine level of care needed based on medical stability, psychiatric status, and support system

Management Strategies

General Approach to Management

Key principles in managing anorexia nervosa in children and adolescents:

Early intervention: Outcomes improve with earlier treatment initiation
Family-based approach: Parents/caregivers as primary agents of change
Multidisciplinary team: Coordinated care between medical, psychiatric, and nutritional specialists
Medical stabilization: Address life-threatening complications first
Nutritional rehabilitation: Carefully planned weight restoration
Psychotherapy: Address cognitive, emotional, and behavioral aspects
Long-term monitoring: Continued follow-up for relapse prevention

Levels of Care

Level	Indications	Components
Inpatient Medical Hospitalization	- Heart rate <50 bpm daytime, <45 bpm nighttime - Systolic BP <90 mmHg - Temperature <35.5°C (95.9°F) - Orthostatic changes (HR increase >20, BP drop >10 mmHg) - <75% ideal body weight with acute food refusal - Electrolyte imbalances - Acute medical complications	- Medical stabilization - Supervised refeeding - Monitoring for refeeding syndrome - Initial psychiatric assessment - Family education
Residential Treatment	- Medically stable but requiring 24-hour supervision - Failed outpatient treatment - Severe malnutrition without acute medical issues - Psychiatric comorbidities requiring intensive treatment - Inadequate home support system	- 24-hour care in non-hospital setting - Structured eating and treatment program - Individual, group, and family therapy - Educational services - Transitional care planning
Partial Hospitalization Program (PHP)	- Medically stable - Requires supervision for most meals - >80% ideal body weight - Adequate family support - Stepping down from higher level of care	- Day treatment (6-12 hours daily, 5-7 days/week) - Supervised meals and snacks - Individual, group, and family therapy - Medical monitoring - Nutritional counseling
Intensive Outpatient Program (IOP)	- Medically stable - Can manage some meals independently - >85% ideal body weight	- Treatment 3-4 hours per day, 3-5 days/week - 1-2 supervised meals - Individual and family therapy - Group therapy - Nutritional counseling
Outpatient Treatment	- Medically stable - >85% ideal body weight - Able to gain weight in less structured setting - Strong family support system - Motivation for recovery	- Weekly therapy sessions - Medical monitoring (frequency based on status) - Nutritional counseling - Family-based treatment - Coordination with primary care provider

Nutritional Rehabilitation

Aspect	Approach	Evidence and Considerations
Initial Caloric Prescription	- Inpatient: Start 1200-1600 kcal/day (higher with close monitoring) - Outpatient: Usually begin at or slightly above estimated current intake - Consider 30-40 kcal/kg/day initially	- Start lower for severely malnourished patients - Historically conservative approach evolving toward higher initial calories - Monitor for refeeding syndrome in first 5-7 days - Consider medical stability in determining start point
Caloric Advancement	- Inpatient: Increase by 200-300 kcal every 24-48 hours - Outpatient: Increase by 200-300 kcal every 3-7 days - Goal is 2500-3000+ kcal/day for weight restoration	- Rate depends on medical stability and refeeding tolerance - Higher rates of weight gain associated with better outcomes - Target weight gain: 0.2-0.5 kg/week (outpatient), 1-2 kg/week (inpatient) - Slower advancement for patients at high refeeding risk
Meal Structure	- 3 meals + 2-3 snacks daily - Balanced macronutrients (50-55% carbs, 25-30% fat, 15-20% protein) - Supervision during and after meals - Time limits for meal completion	- Regular eating pattern restores metabolic function - High structure initially, gradually decreasing - Variety of foods important for nutritional adequacy - Avoid "diet" foods, artificial sweeteners
Supplements	- Multivitamin with minerals - Calcium (1300-1500 mg/day) and Vitamin D (800-1000 IU/day) - Phosphorus supplementation if at risk for refeeding - Consider high-calorie supplements as needed	- Address common deficiencies in malnutrition - Support bone health - Supplement until adequate intake from food - Phosphorus, potassium, magnesium critical during refeeding
Target Weight	- Growth chart-based approach - For prepubertal: Restore to previous growth percentile - For adolescents: BMI ≥50th percentile or return to previous growth trajectory - Return of menses as physiological marker (females)	- Individualized based on previous growth pattern - Must account for linear growth in children - Return of menses requires body fat ~17-22% - May need to exceed previous weight if previous state was malnourished

Psychotherapeutic Interventions

Intervention	Description	Evidence Level
Family-Based Treatment (FBT)/Maudsley Approach	- Parents take control of refeeding - Three phases: (1) Weight restoration, (2) Returning control to adolescent, (3) Establishing healthy identity - Typically 15-20 sessions over 6-12 months - Separates illness from child's identity	- Strong evidence; first-line psychotherapy for adolescents - Most effective for illness duration <3 years - Superior outcomes compared to individual therapy in RCTs - Particularly effective for younger patients (under 18)
Cognitive Behavioral Therapy-Enhanced (CBT-E)	- Focuses on modifying eating disorder thoughts and behaviors - Addresses over-evaluation of shape and weight - Targets perfectionism, low self-esteem, interpersonal difficulties - Systematic approach to normalized eating	- Good evidence for adolescents, especially older teens - Alternative when FBT isn't feasible or effective - More effective after initial weight restoration - Adaptation for adolescents available (CBT-E)
Adolescent-Focused Therapy (AFT)	- Individual therapy focusing on autonomy, self-efficacy, identity - Targets developmental challenges of adolescence - Addresses eating disorder as manifestation of emotional regulation difficulties - Builds coping skills and self-awareness	- Moderate evidence; less effective than FBT in direct comparisons - May be alternative when family approach not possible - Better suited to older adolescents - May be combined with family sessions
Dialectical Behavior Therapy (DBT)	- Focuses on emotional regulation skills - Mindfulness techniques - Distress tolerance - Interpersonal effectiveness	- Limited evidence specifically for anorexia - More evidence for bulimia and binge eating - Useful for comorbid emotional dysregulation - May be adjunctive treatment
Group Therapy	- Peer support and skill-building - Psychoeducation - Cognitive-behavioral skills practice - Body image work	- Effective as adjunct to individual and family therapy - Reduces isolation and stigma - Best implemented after initial weight restoration - Risk of contagion effects needs monitoring

Pharmacological Management

Limited evidence for medication efficacy in anorexia nervosa:

Medication Class	Potential Indications	Evidence and Considerations
Antipsychotics (Olanzapine, Aripiprazole, Risperidone)	- Severe anxiety around meals - Obsessive thinking about food/weight - Agitation during refeeding - Weight gain promotion	- Limited evidence; most for olanzapine - Small studies suggest modest benefit for weight gain - Monitor for metabolic side effects - Low doses typically used - Not first-line treatment
Selective Serotonin Reuptake Inhibitors (SSRIs)	- Comorbid depression or anxiety - Prevention of relapse after weight restoration - Obsessive-compulsive features	- Limited efficacy during acute malnutrition - More effective after weight restoration - May help with maintenance of recovery - Fluoxetine most studied - Risk of QTc prolongation with electrolyte abnormalities
Anxiolytics (Benzodiazepines)	- Acute anxiety surrounding meals - Severe distress during weight restoration - Short-term use only	- Limited evidence - Risk of dependence - May worsen cognitive impairment in malnutrition - Not recommended as routine treatment - Very short-term use for specific situations only
Zinc Supplementation	- Adjunctive treatment during nutritional rehabilitation - May enhance weight gain and mood	- Some evidence for increased rate of weight gain - Low risk intervention - Typically 15-50 mg elemental zinc daily - Deficiency common in anorexia nervosa
Hormonal Therapy	- Consideration for bone health in females - Not for induction of menses	- Oral contraceptives not recommended - May mask return of natural menses - No proven benefit for bone density in anorexia - Weight restoration is primary approach for bone health - May falsely reassure about physiological recovery

Medical Complications Management

Complication	Management Approach	Monitoring Recommendations
Refeeding Syndrome	- Daily monitoring of phosphorus, magnesium, potassium first week - Pre-emptive phosphorus supplementation for high-risk patients - Gradual caloric advancement with close monitoring - Thiamine supplementation	- Daily electrolytes for 5-7 days in severe cases - Monitor for edema, heart failure - ECG monitoring if electrolyte abnormalities - Follow until stable with advancing nutrition
Cardiovascular Complications	- Bradycardia: Usually resolves with nutrition - QTc prolongation: Correct electrolytes, avoid QTc-prolonging medications - Orthostatic hypotension: IV fluids if severe, gradual increase in activity - Heart failure (rare): Cardiology consultation, fluid management	- Serial ECGs with significant bradycardia - Daily vitals including orthostatics - Cardiac monitoring for severe cases - Consider echocardiogram with structural concerns
Bone Health Concerns	- Weight restoration as primary intervention - Calcium and vitamin D supplementation - Weight-bearing exercise only after significant weight restoration - Consider bisphosphonates only in severe, persistent cases (rare in children)	- DEXA scan after 6-12 months of illness - Repeat DEXA every 1-2 years if abnormal - Monitor vitamin D levels - Track fracture history - Follow growth and pubertal development
Growth and Development	- Adequate nutrition to resume growth velocity - Monitor pubertal progression - In severe cases, endocrinology consultation - Focus on weight restoration to resume development	- Regular height/weight measurements on growth chart - Tanner staging assessment - Bone age X-ray if growth concerns - Regular menstrual history in females
Gastrointestinal Issues	- Early satiety: Small, frequent meals - Constipation: Adequate fluids, fiber, occasional gentle laxatives - Gastroparesis: Prokinetic agents rarely needed - Superior mesenteric artery (SMA) syndrome: Nutritional rehabilitation, possible nasojejunal feeding	- Abdominal examinations - Monitor bowel pattern - Consider gastric emptying study for severe symptoms - Abdominal imaging if SMA syndrome suspected

Special Considerations in Children

Growth and development: Target weight must account for expected linear growth
Cognitive development: Concrete thinking affects understanding of illness and treatment
Family involvement: Even more essential than in adolescents
School integration: Plan for continued education during treatment
Age-appropriate communication: Adapt explanations to developmental level
Greater medical vulnerability: Children decompensate more rapidly than adolescents
Different presentation: Body image concerns may be less articulated in younger children

Introduction to Anorexia in Children

Anorexia in children refers to a loss of appetite or a decreased desire to eat, which is distinct from the eating disorder anorexia nervosa. It is a common symptom that can be associated with various underlying conditions, ranging from minor illnesses to more serious medical issues. Understanding the causes, proper assessment, and management of anorexia in children is crucial for healthcare providers to ensure optimal growth, development, and overall health in pediatric patients.

This comprehensive guide aims to provide doctors and medical students with a structured approach to evaluating and managing anorexia in pediatric patients, covering etiology, clinical assessment, diagnostic evaluation, management strategies, and potential complications.

Etiology of Anorexia in Children

The causes of anorexia in children can be broadly categorized as follows:

Acute Illnesses:
- Viral infections (e.g., common cold, influenza)
- Bacterial infections (e.g., strep throat, pneumonia)
- Gastroenteritis
Chronic Medical Conditions:
- Inflammatory bowel disease (Crohn's disease, ulcerative colitis)
- Celiac disease
- Chronic liver or kidney disease
- Congenital heart disease
- Cystic fibrosis
Endocrine Disorders:
- Diabetes mellitus
- Hypothyroidism
- Addison's disease
Neurological Conditions:
- Brain tumors
- Increased intracranial pressure
- Autism spectrum disorders
Psychological Factors:
- Depression
- Anxiety disorders
- Stress
Medications:
- Stimulants (e.g., for ADHD)
- Chemotherapy drugs
- Antibiotics
Nutritional Deficiencies:
- Iron deficiency anemia
- Zinc deficiency
Environmental Factors:
- Food insecurity
- Feeding difficulties or oral motor issues
- Parental feeding practices

Clinical Assessment of Anorexia in Children

History Taking:
- Onset and duration of appetite loss
- Dietary habits and recent changes
- Associated symptoms (fever, weight loss, fatigue)
- Developmental history
- Medical history, including recent illnesses
- Medication use
- Family history
- Psychosocial factors
Physical Examination:
- Growth parameters (height, weight, BMI)
- Vital signs
- General appearance and nutritional status
- Oral examination (dentition, oral mucosa)
- Abdominal examination
- Neurological examination
- Skin examination (for signs of nutritional deficiencies)
Red Flag Symptoms:
- Significant weight loss or growth faltering
- Signs of malnutrition
- Persistent vomiting
- Chronic diarrhea
- Neurological symptoms (headache, visual changes)
- Signs of chronic illness (pallor, lymphadenopathy)

Diagnostic Evaluation of Anorexia in Children

Laboratory Tests:
- Complete blood count
- Comprehensive metabolic panel
- Erythrocyte sedimentation rate and C-reactive protein
- Thyroid function tests
- Iron studies
- Celiac disease screening
- Urinalysis
Imaging Studies:
- Chest X-ray (if respiratory symptoms present)
- Abdominal ultrasound or CT (if abdominal pathology suspected)
- Brain MRI (if neurological symptoms present)
Specialized Tests (as indicated):
- Endoscopy and colonoscopy
- Swallowing studies
- Nutritional assessments
- Psychological evaluation

Management of Anorexia in Children

Treat Underlying Cause:
- Appropriate management of identified medical conditions
- Adjustment of medications if drug-induced
Nutritional Support:
- Dietary counseling and meal planning
- Encourage small, frequent meals
- Nutrient-dense foods and beverages
- Consider nutritional supplements
Behavioral Interventions:
- Establish regular meal and snack times
- Create a positive eating environment
- Avoid force-feeding or excessive pressure
- Encourage family meals
Pharmacological Interventions (used cautiously):
- Cyproheptadine (appetite stimulant)
- Megestrol acetate (in specific cases, e.g., cancer-related anorexia)
Psychological Support:
- Counseling or therapy for underlying psychological issues
- Family therapy if indicated
Monitoring and Follow-up:
- Regular weight checks and growth monitoring
- Reassessment of nutritional status
- Adjustment of management plan as needed

Complications of Anorexia in Children

Growth Faltering: Failure to meet expected growth milestones
Malnutrition: Deficiencies in essential nutrients
Weakened Immune System: Increased susceptibility to infections
Delayed Puberty: In cases of chronic malnutrition
Cognitive and Developmental Delays: Especially in young children
Electrolyte Imbalances: Particularly in severe cases
Psychological Impact: Low self-esteem, anxiety about eating
Osteopenia or Osteoporosis: Due to inadequate calcium and vitamin D intake
Anemia: Often due to iron or vitamin B12 deficiency

Questions and Answers

General Knowledge and Diagnosis

What is the primary characteristic of anorexia nervosa in children?
Severe restriction of food intake leading to significantly low body weight
At what age does anorexia nervosa typically begin to manifest in children?
Usually during early to mid-adolescence, but can occur in children as young as 7 or 8
What is the female-to-male ratio for anorexia nervosa in children?
Approximately 10:1, with females being more commonly affected
Which diagnostic criteria must be met for a diagnosis of anorexia nervosa in children?
Restriction of energy intake, intense fear of gaining weight, disturbance in body image perception
How is "significantly low weight" defined in children with anorexia nervosa?
Below the 5th percentile for age and gender, or a BMI below the 5th percentile
What are the two subtypes of anorexia nervosa?
Restricting type and binge-eating/purging type
Which medical complications are commonly associated with anorexia nervosa in children?
Bradycardia, hypotension, hypothermia, electrolyte imbalances, and osteoporosis
What is the mortality rate associated with anorexia nervosa?
Approximately 5-10%, one of the highest mortality rates among psychiatric disorders
Which comorbid psychiatric conditions are frequently seen in children with anorexia nervosa?
Depression, anxiety disorders, and obsessive-compulsive disorder
What is the role of genetic factors in the development of anorexia nervosa?
Twin studies suggest a heritability of 50-80%, indicating a strong genetic component

Assessment and Evaluation

What should be included in the initial assessment of a child suspected of having anorexia nervosa?
Comprehensive medical history, physical examination, mental status evaluation, and nutritional assessment
Which growth parameters are crucial to evaluate in children with suspected anorexia nervosa?
Height, weight, BMI, and their respective percentiles for age and gender
What specific physical signs should be looked for during the examination of a child with anorexia nervosa?
Bradycardia, orthostatic hypotension, hypothermia, lanugo hair, and muscle wasting
Which laboratory tests are typically recommended in the initial evaluation of anorexia nervosa in children?
Complete blood count, comprehensive metabolic panel, thyroid function tests, and ECG
What is the significance of checking luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in adolescents with anorexia nervosa?
To assess for hypogonadotropic hypogonadism, a common complication of severe malnutrition
Which eating disorder-specific assessment tools can be used in children and adolescents?
The Eating Disorder Examination (EDE) and the Eating Disorder Inventory for Children (EDI-C)
What is the importance of assessing bone health in children with anorexia nervosa?
To detect and prevent osteoporosis, as low bone mineral density is a common complication
How should suicidal ideation be assessed in children with anorexia nervosa?
Through direct questioning and validated screening tools, as suicide risk is elevated in this population
What is the role of family assessment in the evaluation of a child with anorexia nervosa?
To understand family dynamics, identify potential stressors, and assess the family's ability to support treatment
How often should medical monitoring be conducted in children with anorexia nervosa?
Frequency depends on severity, ranging from daily in severe cases to weekly or bi-weekly in less severe cases

Treatment and Management

What is the primary goal of treatment for anorexia nervosa in children?
Weight restoration and normalization of eating patterns
Which treatment approach has shown the most evidence for effectiveness in children and adolescents with anorexia nervosa?
Family-based treatment (FBT), also known as the Maudsley approach
What are the three phases of family-based treatment for anorexia nervosa?
Weight restoration, returning control over eating to the adolescent, and establishing healthy adolescent identity
In what situations is inpatient treatment typically recommended for children with anorexia nervosa?
Severe malnutrition, medical instability, suicidal ideation, or failure of outpatient treatment
What is the recommended rate of weight gain for children and adolescents with anorexia nervosa during the refeeding process?
0.5-1 kg per week for outpatients and 1-1.5 kg per week for inpatients
What is refeeding syndrome and why is it a concern in the treatment of anorexia nervosa?
A potentially fatal shift in fluids and electrolytes that may occur when refeeding a malnourished patient
Which electrolyte should be closely monitored during the initial refeeding process?
Phosphate, as hypophosphatemia is a key feature of refeeding syndrome
What is the role of cognitive-behavioral therapy (CBT) in the treatment of anorexia nervosa in children?
To address distorted thoughts about body image, weight, and eating behaviors
Are there any FDA-approved medications for the treatment of anorexia nervosa in children?
No, there are currently no FDA-approved medications specifically for anorexia nervosa
What is the recommended approach for treating comorbid depression in children with anorexia nervosa?
Prioritize weight restoration, as depressive symptoms often improve with nutritional rehabilitation
How should amenorrhea be managed in adolescent girls with anorexia nervosa?
Focus on weight restoration, as menses typically resume with achievement of healthy weight
What is the recommended method for reintroducing physical activity in recovering anorexia nervosa patients?
Gradual reintroduction under medical supervision, only after significant weight restoration
How should parents be involved in the nutritional rehabilitation of their child with anorexia nervosa?
Parents should be empowered to take control of the child's eating, planning and supervising all meals
What is the typical duration of treatment for anorexia nervosa in children and adolescents?
Treatment often lasts 1-3 years, with the first year focused on weight restoration and normalizing eating patterns
How should school personnel be involved in the management of a child with anorexia nervosa?
Educate school staff about the condition, develop a plan for meals and physical activity, and address academic accommodations if needed

Prevention and Long-term Outcomes

What are some evidence-based strategies for preventing anorexia nervosa in children?
Promoting positive body image, media literacy, and healthy eating and exercise habits
Which groups of children are at higher risk for developing anorexia nervosa?
Athletes, dancers, models, and children with a family history of eating disorders
What is the role of primary care physicians in the prevention of anorexia nervosa?
Regular screening for eating disorders, monitoring growth patterns, and providing education on healthy eating
What percentage of children with anorexia nervosa achieve full recovery?
Approximately 50-60% achieve full recovery, with early intervention improving outcomes
What are some common long-term health consequences of childhood-onset anorexia nervosa?
Osteoporosis, growth delay, fertility issues, and increased risk of other psychiatric disorders

Disclaimer

The notes provided on Pediatime are generated from online resources and AI sources and have been carefully checked for accuracy. However, these notes are not intended to replace standard textbooks. They are designed to serve as a quick review and revision tool for medical students and professionals, and to aid in theory exam preparation. For comprehensive learning, please refer to recommended textbooks and guidelines.