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Vol 36, (8) 577–672

Eating disorders in adolescents

Aranzazu Gonzalez MBBS, is Fellow in Adoelscent Medicine, Centre for Research into Adolescents' Health (CRASH), Department of Adoelscent Medicine, Westmead Hospital, New South Wales.

Michael R Kohn FRACP, FACPM, is Senior Staff Specialist, Centre for Research into Adolescents’ Health (CRASH), Department of Adolescent Medicine, The Children’s Hospital at Westmead, New South Wales.

Simon D Clarke FRACP, FACPM, is Senior Consultant Paediatrician in Adolescent Medicine, and Director, Adolescent Medical Unit, Centre for Research into Adolescents’ Health (CRASH), Department of Adolescent Medicine, Westmead Hospital, New South Wales.

BACKGROUND The overall prevalence of eating disorders among children and adolescents is rising – the younger age group are more likely to present with anorexia nervosa (AN), while the older adolescent can present with either AN or bulimia nervosa (BN). However, eating disorders exist as part of a spectrum and general practitioners will encounter many adolescents that have an eating disorder that do not yet fulfil diagnostic criteria for either AN or BN.

OBJECTIVE This article aims to provide an overview of assessment and principles of management of eating disorders in the adolescent patient.

DISCUSSION General practitioners are key in recognising and offering early intervention in cases of incipient eating disorders or problem dieting behaviour. The physical findings of AN are those of protein calorie malnutrition, while in BN, they reflect chronic purging. Failure of outpatient management requires hospitalisation for nutritional rehabilitation with close monitoring of fluid and electrolyte status to prevent the development of refeeding syndrome. Family involvement is vital, particularly in the younger patient, with ongoing family therapy offering the best outcomes.

Publication Date: 6 August 2007
Authorised By: Australian family physician