Anorexia in Children

Causes

The cause of anorexia in children is not known. A child's genetics and the world around them may play a role.

Risk Factors

Anorexia can occur in girls and boys, but is much more common in girls. Things that raise a child’s risk of anorexia include:

• Family history of eating disorders
• Low self-esteem
• Strong drive to be perfect
• Fear of being overweight
• Feeling pressure to be thin
• Being in things where body image is major issue, such as gymnastics and fashion modeling
• Mood disorders, such as anxiety, or obsessional traits
• History of emotional or sexual abuse

Symptoms

It may not be clear that a person has anorexia. Things they may do or feel early on include:

• Feeling or saying they are overweight even if it is not true
• Being obsessed with food
• Putting harsh limits on food or food groups they can eat
• Fearing being overweight even if they are losing weight
• Exercising too much
• Making themselves vomit
• Using laxatives
• Denying they are hungry

Physical signs may include:

• Changes in weight, such as slow weight gain or weight loss
• Loss of menstrual periods or delay in the start of periods
• Feeling cold, especially in the hands and feet
• Changes in body temperature
• Hair loss and/or growth of fine hair on the body
• Fainting or severe lightheadedness
• Constipation
• Fatigue and muscle weakness

Body Dysmorphia

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Diagnosis

The doctor will ask about symptoms and health history. A physical exam and a psychological test will be done. The diagnosis will be based on information from questions and the exam.

Tests may be done to see what health problems the child may have. Tests may include:

• Blood tests—to look for changes in electrolytes, vitamins, and other important nutrients
• Electrocardiogram (EKG)—to look for heart changes
• Bone density test—to check the health of bones

Treatment

The goals of treatment are to help the child:

• Making sure the child is getting good nutrition
• Talking about feelings and thoughts linked to anorexia
• Finding and treating any problems caused by poor food intake

It may take months or even many years to fully manage anorexia. Treatment often includes one or more of:

Nutritional Support

Some dietitians focus on eating disorders. They can help set weight and calorie goals. They can also sort through wrong nutrition information that a child with anorexia may have learned. They can also help a child relearn hunger cues.

Nutrition may need to be given through a tube. It is often only needed for those with very bad nutrition problems. It may be used at the start of treatment or for those with a long-term problems.

Therapy

Therapy can address harmful thought patterns, anxiety, and poor self-esteem. The goal is to help them have a better attitude about food and body image.

Treatment may include more than one type of therapy. Some options are:

• Family therapy—Family can play a big role in how children think about and recover from anorexia. Proper support from family can be helpful.
• Cognitive behavioral therapy—Focuses on thought patterns to create a self-image that is healthier and more real.
• Interpersonal therapy—To help balance relationship concerns with others.

Medicine

Antidepressants may help some children.

Hospitalization

Severe anorexia can cause more serious health problems. A hospital stay may be needed. The care team will give needed nutrition or track problems such as heart disorders. Treatment in the hospital may help children when other things have not worked.

Prevention

The cause of anorexia is complex. It cannot always be prevented. Family habits can play a role in helping a child have a good self-image. Helpful habits include:

• Praise a child's inner qualities instead of how they look on the outside.
• Send good messages about eating. Do not make mean comments about your own body in front of your child.
• Do not go on diets at home. Instead, focus on eating a healthy diet that has whole grains, fruits, and vegetables.
• Try to eat meals as a family.
• Discuss media images of bodies and other messages with your children so they can see why they may be harmful.