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Anorexia Nervosa

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Summary

Anorexia nervosa, or anorexia, is an eating disorder that can cause children to fear weight gain so severely that they lose more weight than is healthy for their age and height.

Expanded Overview

A child with anorexia nervosa may believe they are overweight, even when they are at normal weight or underweight. They may severely restrict the types and amount of food they eat to lose weight. The disorder is marked by an obsession with weight, including fear of weight gain. Children with anorexia are usually below normal weight (very thin) for their age. 

Causes

Even though anorexia is considered a mental health problem, it can cause serious physical health issues for your child. There is no single cause for anorexia, so parents must remember right away to stop looking for causes or blame. Pointing fingers at one another, and especially at your child or teen, can make matters worse.

Researchers continue to study what causes anorexia and other eating disorders to find new ways to help children and adults fight the disorders. For now, research shows that various genetic, social, biological and behavioral causes work together to make some people’s concerns about body image and desire to be thin spiral beyond their control.

Our team of experts can help your child with the medical, nutritional and psychological needs in one setting. We care for children at all levels of health and educate and support you and your family.

Symptoms

Symptoms

Having anorexia makes you see yourself as overweight when you really are thinner than normal. The condition can cause people to exercise and diet to such extremes that their weight is at unhealthy levels. The weight of a child or teen with anorexia can become so low that your child lacks nourishment and can become seriously ill. 

If you believe that your child or a close friend or loved one may have anorexia nervosa, watch for the following symptoms:

  • Extreme weight loss and thinness
  • Constant dieting and avoiding many foods
  • Eating rituals and inflexibility
  • Extreme fear of weight gain
  • Expressions of concern about weight and body image
  • Distorted view of body shape and weight, denial of thinness
  • Delayed puberty or halted menstruation
  • Frequent and intense exercise schedule
  • Consistently moving food around on the dinner plate and really not eating
  • Withdrawing from family meals or social events involving eating around others
  • Frequently going to the bathroom right after meals

Even if you see the symptoms above, you should take your child to a psychiatrist who treats children and adolescents with eating disorders. If the anorexia is not treated, it can lead to more advanced symptoms, such as:

  • Brittle hair, nails and bones
  • Weakness and signs of muscle loss
  • Dry, blotchy or yellow skin
  • Dry mouth
  • Depression and confusion
  • Low blood pressure or slowed breathing
  • Constant fatigue
  • Anemia (iron deficiency)
  • Brain damage
  • Constipation
  • Organ failure
  • Yellow color to skin
Tests and Diagnosis

Tests and Diagnosis

Anorexia usually is diagnosed only after a parent, close friend, doctor or teacher speaks up about their concerns. It is important that parents follow up on those concerns, without worrying about whether you did anything wrong, or the reasons why your child might have anorexia. Parenting mistakes do not cause anorexia, but it is good parenting to help your child address an eating disorder when it is discovered.

There are no laboratory tests to specifically diagnose anorexia. Your child’s doctor might order tests to help doctors diagnose causes for weight loss or find clues of advanced anorexia nervosa, such as:

  • A bone density test is an X-ray exam that measures how thin bones are to determine whether your child has signs of osteoporosis.
  • Blood tests such as a complete blood count (CBC) measure certain substances in the blood to check for signs of anemia (low red blood cell count) or other signs of disease.
  • Electrolyte tests check the balance of certain minerals in the body that provide energy, such as calcium, potassium and sodium. These minerals can become imbalanced with a severely restricted diet and cause problems with your child’s organs.
  • An electrocardiogram (ECG) checks your child’s heart to make sure the electrical activity is functioning as it should.
  • Your child’s doctor might perform tests to check the function of the liver or kidneys.

Psychiatrists evaluate children and teens with anorexia based on their environment, genetics, physical and mental health. They rely on guidelines that describe specific symptoms and medical signs, including the Diagnostic and Statistical Manual, which is published by the American Psychiatric Association.

Treatment / Prevention

Treatment

The first step in treating someone who has anorexia is to help the teen or child recognize and admit the problem. Anorexia nervosa is a complex eating disorder that requires treatment from a team of professionals.

Denial of anorexia is part of the disorder’s effect on the brain. Psychiatrists evaluate your child to help develop the best type of treatment possible. A team of psychologists and licensed therapists can help your child or teen accept the problem and then work on strategies to manage it.

Children and their parents must remember not to cast blame or find fault when going through the initial phases of anorexia diagnosis and treatment. Anorexia is a problem in your child’s brain, and it can’t be treated by trying to force your child into eating more.

Our goal is to help your child get better by working as a team with you, your child and family. Treatments include:

  • Medical treatment to regain health. Doctors and nurses help restore balance to your child’s body gradually, especially if weight loss is severe.
  • Dietitians help children and their parents focus on new, normal eating behaviors.
  • Therapists provide psychotherapy for your child and family to eventually replace old behaviors with new ones.
  • Art, music and recreation therapy can teach children and adolescents new ways to cope with stress.

Our professionals specialize in treating children and teens, including children under age 12 and boys. We help your child with the medical, nutrition and psychological needs in one setting, and educate and support you and your family. Some approaches to treating anorexia require that parents take over responsibility for feeding their child.

Most treatment approaches combine attention from medical specialists and psychotherapy designed for children and teens who have anorexia. Some children and adolescents can receive all their treatment for anorexia as outpatients. Others must be admitted to the hospital until their health and anorexia improve. We offer all levels of treatment, and can provide care for your child as he improves and moves from one level to another.

Prevention

The causes of anorexia are complex. Parents and their children cannot necessarily prevent anorexia nervosa. The best parents can do is model behavior that reflects acceptance of all body images and health, and regularly serve nutritious family meals without obsessing over calorie intake and weight. They also can watch for early warning signs in their children and loved ones, such as excessive interest in weight loss or websites that promote anorexia and underweight body types.

If you think your child might have symptoms of anorexia, approach your child positively, and be persistent if the problem worsens. Treatment of anorexia is a long-term process and requires commitment from your child, you and your entire family.

Resources

Resources

For more information about anorexia nervosa in children and adolescent, please visit the following sites:

FAQs

FAQs

Do boys and men get anorexia?

Anorexia might be more common in girls and women, but eating disorders also affect boys and men. Some boys and men have anorexia and extreme weight loss. Others have different eating disorders or muscle dysmorphia, in which they work too hard to bulk up their muscles.

How do I approach a friend or child who might have anorexia?

Remember that anorexia affects the brain and that people who have the disorder don’t see themselves as you do. Avoid being judgmental or overbearing when you bring up your concerns about someone’s behavior or appearance. Simply ask how you can help and offer to accompany your friend or child to a specialist for more information.

Can my child take medications to treat anorexia?

Some antidepressant, antipsychotic and mood-stabilizing medicines can be used to help people with anorexia as part of a treatment program that also involves therapy and nutrition counseling. None of these medications changes your child’s view of body image or desire to lose weight, however. And some of these medications can cause serious side effects in children and teens.

Do parents cause anorexia?

No, parents do not cause children to have anorexia. Eating disorders are mostly genetic, and the causes are many and complex. Children and adolescents with eating disorders come from all types of families. Anorexia is a problem in the brain, not a result of poor parenting.

Can counseling help children with anorexia?

Children and teens who have anorexia often need individual, group and family counseling to help them overcome the eating and exercise behaviors that have become routine. The therapy may focus on different goals, depending on each individual and the stage of the therapy.

Why involve the family in anorexia treatment?

Your child or teen benefits when your entire family understands how anorexia affects them and how to help them cope with their eating disorder. If part of the family follows the advice and treatment plan your professionals recommend, but some family members criticize your child or teen, sabotage your eating plan or fail to work as part of the team, it makes it harder for your child to manage anorexia long term.