Anorexia nervosa in children

What is anorexia nervosa in children?

Children with anorexia typically eat very little and severely limit the types of food they eat. They may also limit the types and quantity of fluids they drink. Usually they are below normal weight and very thin for their age. But many children with eating disorders also have a normal body weight.

Eating disorders like anorexia start in the brain. The disorder affects how a child thinks and behaves toward food. For example, a child with anorexia may believe they are overweight, even though they are actually normal weight or even underweight.

What are the signs and symptoms of anorexia nervosa in children?

Children and teens with anorexia often take extreme measures to lose weight. Talk to your pediatrician and consider taking your child to a psychiatrist who treats eating disorders.

Symptoms may include:

• Extreme thinness

• Distorted view of body shape and weight, such as denying how thin they are

• Extra concern about weight and body image

• Losing weight quickly or in large amounts

• Frequent and intense exercise

• Constant dieting and avoiding many foods or entire food groups

• Following very strict rules and habits around eating

• Often moving food around on their plate without eating

• Withdrawing from family meals or social events that involve eating around other people

• Frequently going to the bathroom right after meals (which could mean they are making themselves throw up their food)

• Delayed puberty or girls stopping their period

If anorexia is not treated, children can become very undernourished and develop serious health problems.

These include:

• Anemia (iron deficiency)

• Brain damage

• Brittle hair, nails and bones

• Constant fatigue

• Constipation

• Depression and confusion

• Dry, blotchy or yellow skin

• Dry mouth

• Low blood pressure or slowed breathing

• Organ failure

• Weakness and signs of muscle loss

How is anorexia nervosa in children diagnosed?

Only medical professionals can properly diagnose anorexia. They do this by gathering information about your child’s health and behavior through interviews, tests and exams.

These may include:

• Blood tests such as a complete blood count (CBC), which measure certain substances in the blood to check for disease

• Electrolyte tests, to see whether your child’s body has enough calcium, potassium and other minerals that it needs

• An electrocardiogram (ECG), which measures how well your child’s heart is working

• Tests of the liver and kidneys, which can be damaged from not getting enough nutrients

• A bone density test, which is an X-ray that shows whether your child’s bones have become weak and unhealthy

What causes anorexia nervosa in children?

A child is anorexic because of the way their brain is affected by a lack of food and starvation. This makes them unable to accurately interpret information about their own body and its size.

Many factors play a role in making this happen. These include genetics, stress and social and cultural pressures to have a certain type of body. Children do not choose to be anorexic. And they don’t become anorexic because of your parenting choices.

How is anorexia nervosa in children treated?

At Children’s Health, all questions about anorexia treatments are reviewed by a licensed professional counselor and a physician specializing in the treatment of eating disorders.

Recommendations for care are based on each child’s symptoms and are made after careful review by a psychiatrist and therapists. Some children are treated in outpatient care and some benefit from staying in the hospital until the eating disorder is under control. This is usually because they also have other health problems, such as malnutrition or depression. We create a treatment plan based on each child’s individual needs.

Treatment may include:

• A combination of individual, group and family therapy to help your child develop healthier eating behaviors

• Art, music and recreation therapy to teach children and adolescents new ways to cope with stress

• Nutritional counseling with a dietitian, who can help you and your child develop plans for healthy eating

• Medical treatment to help restore the right balance of nutrients to your child’s body

• Medication to help with depression or anxiety, if needed, so your child is better equipped to address their eating disorder