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Eating Disorder

Child and Adolescent Eating Disorder

The Incidence and prevalence of eating disorder (Anorexia Nervosa, Bulimia Nervosa, Obesity, Eating disorder NOS) has increased over last few decades. Awareness about its negative effect on Physical health (Diabetes, Hypertension, gastrointestinal Symptoms, etc) and mental health (Low self esteem, anxiety, depression, etc) is critical. Early detection and treatment is extremely important to avoid complications.

Epidemiological study indicated that eating disorders has dramatically increased in Children and Adolescent since 1950s. During the past decade Obesity has been on the rise accompanied by further emphasis on dieting and weight loss among Children and Adolescents. Of particular concern is eating disorder impacting children progressively at younger age and increased number of hospital admissions.

Medium of communication spread of information made the world as global village bridging the gap between differences in cultural values. It has its positive and negative effects. Minority communities and males who were usually not affected, eating disorder trend is on the rise among this population group as well.

Causative factors are multifactorial gene and environment. Especially genetic predisposition make the children and adolescent vulnerable to disorder activated at puberty (hormonal changes, etc), resulting producing all the associated symptoms of self image issues, low self esteem, lack of confidence, anxiety and depression etc. This kind of Feelings usually at tender age, can affect personality development and further complicated by expectation achievement mismatch struggle.


  • 0.5 % Adolescent girls meets the Criteria for Anorexia Nervosa
  • 1% to 2% Bulimia Nervosa
  • 5%-10% all cases of eating disorder are Male.
  • Sub threshold cases of eating disorder are between 0.8% to 14% depending upon the Diagnostic criteria used


  • Anorexia Nervosa
  • Bulimia Nervosa
  • Eating disorder NOS ( elective eating, Food Avoidance Emotional Behavior Disorder, etc)
  • Obesity

Major Risk Factors

  • Genes (Genetic predisposition seems be activated during puberty and there is strong evidence of genetic-Environment interaction)
  • Environmental stress
  • Jobs requiring lean body habitus (Dancer, gymnastics, running, wrestling, dance, modeling)


  • Dieting is a risk factor for disordered eating
  • Neuroendocrine Role of Leptin In blood
  • Physical hyperactivity and weight loss has also occurred in Animal Model studies.
  • Caloric Restriction coupled with stress can lead to Bing-Eating and Purging.

Signs and Symptoms

  • Anorexia Nervosa: Restricting eating, excessive use of laxatives, Excessive exercise to lose weight when already underweight which is less than 85% expected body weight.
  • Bulimia Nervosa: Uncontrollable eating for 2 hours when it is not needed after satiety
  • Obesity: Mild , Moderate or severely Overweight


  • AN Less than 85% Expected Body WT
  • BN uncontrolled eating for 2 hour pass satiety
  • Diagnostic Criteria focus on Weight loss, Attitude, Behavior and Amenorrhea
  • Under 13 years usually have co morbid Depression, Obsessive-Compulsive disorder and Anxiety disorder Less focused on Binging


  • Abnormal body image lead to host of mental health Issues,
  • Low self esteem
  • Depression
  • Anxiety
  • Poor School and work Performance
  • Poor social relationship etc


  • Electrolyte Imbalance leading to Mental status change
  • ECG Changes QTC Prolongation, repolarization abnormalities, MI, etc
  • Structural brain changes
  • Low Bone Mineral density
  • Growth Retardation
  • Gastrointestinal Symptoms and skin changes
  • Endocrinological problems

Prevention Strategies

  • Psychoeudcation in School and
  • Pedriatitions Office about Healthy eating and appropriate exercise
  • Cultural approach to weight, Dieting, and body Image
  • Programs for preventing Eating pathologies
  • Health Insurance coverage inclusion of eating disorders

Treatment Options

  • Medical
    Stabilization and nutritional Rehabilitation is Priority
  • Family Based treatment approach
  • Cognitive Behavior Therapy
  • SSRI for Co morbid Depression-Anxiety
  • Atypical Antipsychotics for Disordered thinking


  • Early Detection
  • Family Involvement
  • Appropriate Follow up
  • Key To Success


Should you need additional information or would like to make an appointment with Dr. Tahir, please e-mail us at stahirmd@yahoo.com.
Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advise from th relevent healthcare professional, Writer does not take responsibilitiy of any damage done by the misuse or use of the information.














One Response so far.

  1. Irshad says:

    Thank you very much RW for posting this. I am in receovry from an eating disorder. Believe me it is quite possible to eat that few calories, even fewer. I overexercise and have been for years, especially running. My body has maintained a normal weight on very few calories, running 2 consecutive hours a day, and purging. There are also times I have exercised less and eaten a little bit more and weighed 10-20 lbs less. One’s body will do whatever it can to survive. There are horrible complications from eating disorders. Eating disorders are a viscous cycle. It is always I just want to lose a few more lbs or I am just going to run another mile. Eating disorders aren’t about wanting to look thin. They are bad coping mechanisms. It is best to seek medical attention. There is definately help out there and the sooner that one gets help, the more successful receovry/treatment is. There are psychiatrists who specialize in EDs, nutritionists, social workers/psychologists, and many other medical professionals that work with ED patients to ensure receovry. Recovery doesn’t happen in a few week hospital stay either. It is an ongoing process that is much more difficult than running any race. If anyone knows someone that they think may have an ED, whether it is related to exercise and running or not, give that person your love and support. Encourage them to seek help. There are really some great resources on the internet on how to start seeking help. Ff someone is afraid to even approach their MD there are other people to approach. I am a Registered Nurse and I was afraid of saying it to my doctor. Many people with EDs are actually a normal weight not the stereotypical skeleton. ANAD is a great resource. Psychiatrists or your primary care physician are a great place to start. They can make sure that your medical needs are also being met. Even tell the nurse in your doctors office if you don’t feel comfortable bringing it up to him/her. Speaking from experience, let the person know that you care, are worried about their health/well-being. And DO NOT encourage eating disordered behaviors!!!! Many people will praise people who overexercise for their stamina and ability to exercise/run. It is sickening. They will praise their weight loss. This validates their eating disorder. I am glad that this girl asked this question. RW does an awesome job in all of their articles. Whether it be an article on just running performance or nutrition, it encourages PROPER behaviors and nutrients. I absolutely love this site. I see other fitness magazine related sites promote drastic low-cal diets and other inappropriate diets and exercise. RW is amazingly wonderful! Thank you for posting this so others can see that eating disorders are real, other there, and yes a problem for many runners.

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