Eating disorders among children and adolescents are on the rise

Are eating disorders among children and adolescents in Sacramento on the rise? It appears that children and adolescents in Sacramento and in the United States as a group are being diagnosed with eating disorders at a higher rate.  A Clinical Report released November 29, 2010 by Pediatrics: the Official Journal of the American Academy of Pediatrics showed that eating disorders among children and adolescents have increased significantly in recent decades. 

It is not known why eating disorders among children and adolescents are on the rise.  Many experts hypothesize that the prevalence of obesity among this group has dramatically increased and is accompanied by further emphasis on dieting and weight loss among children and adolescents.

The report revealed that there is an increasing prevalence of eating disorders among minorities and males in the United States.  It is estimated that approximately 0.5% of adolescent girls in the U.S have anorexia nervosa and 1%-2% meet the criteria for bulimia nervosa.   What I found truly shocking is that 5%-10% of all cases of eating disorders occur in males!  This may be due to the social acceptance of men spending hours at the gym trying to attain the perfect physique, however; this can lead to serious repercussions on the body.  Medical complications that result from eating disorders can be severe and may include dehydration, amenorrhea or menstrual irregularities, suicide, mood symptoms, cognitive deficits, inability to maintain normal body temperature, and irreversible cardiomyopathy.

The report also showed that a large portion of individuals with eating disorders do not meet the criteria for a formal diagnosis as detailed in the Diagnostic and Statistical Manual of Mental Disorders, IV-TR.  These children and adolescents have what is diagnosed as “partial syndromes” or Eating Disorder Not Otherwise Specified (ED NOS). These individuals have the same physical and psychological consequences as those who have symptoms severe enough to meet the diagnostic threshold.  Athletes and performers, particularly those who are rewarded for having lean bodies (gymnasts, runners, wrestlers, dancers and models) are more prone to fall within this category.

Onset

Anorexia Nervosa usually begins in mid-to-late adolescence (14-18 years).  The onset of this disorder rarely occurs in females over age 40.  The onset of anorexia nervosa may be associated with a stressful life event.  Bulimia Nervosa usually begins in late adolescence or early adult life.  The binge eating frequently begins during or after an episode of dieting.

Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders, IV-TR (DSM, IV-TR) the essential features of anorexia nervosa are that the individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body.  Anorexia nervosa has two subtypes: the restricting type in which weight loss is accomplished primarily through dieting, fasting, or excessive exercise and the binge-eating/purging type in where the individual has regularly engaged in binge eating or purging (or both). Most individuals who binge eat; also purge themselves through self-induced vomiting or the misuse of laxatives, diuretics or enemas.   The essential features of bulimia nervosa are binge eating and inappropriate compensatory methods to prevent weight gain (i.e. vomiting misuse of laxatives and diuretics).  In addition, the self-evaluation of individuals with bulimia nervosa is excessively influenced by body shape and weight.  According to the DSM, IV-TR, binge eating appears to be characterized more by an abnormality in the amount of food consumed than by the craving for a specific kind of food, such as carbohydrate.

Many individuals with anorexia nervosa and bulimia nervosa manifest depressive symptoms such as depressed mood, social withdrawal, irritability, insomnia and diminished interest in sex.  Obsessive-compulsive features, both related and unrelated to food, are often prominent.

Risk Factors

Risk factors for developing an eating disorder among children and adolescents include genetics, dieting, and neuroendocrine abnormalities.  The report indicated that an interaction between genetic predisposition, environmental factors and personal experience increase the likelihood of children and adolescents developing eating disorders.

Treatment

The range of treatment options for eating disorders can include family-based therapy (Maudsley), pharmacotherapy and/or intensive outpatient and inpatient programs.  In Sacramento, Summit Eating Disorders and Outreach Program is the only medically-supervised comprehensive treatment program in Sacramento, serving both adolescents and adults suffering from anorexia, bulimia and binge-eating disorders.  Located at 601 University Avenue #225, Summit has been providing comprehensive and collaborative treatment for patients with eating disorders for the past 10 years.  Summit’s philosophy incorporates healing the mind, body and spirit.   In addition to providing comprehensive medical, nutrition and psychological care, yoga, meditation, Pilates, Mindfulness training, Art Therapy, therapeutic meals, health education and life skills training is also offered to patients and their families.

I am not an expert in anorexia or bulimia nervosa nor am I trained in treating individuals with eating disorders; therefore, if you or a loved one is suffering from an eating disorder or have symptoms of disordered eating and/or unhealthy dieting, please seek help.  There are many resources available to help heal from this disorder.  It is very important that the family unit as a whole be treated and incorporated in the patient’s treatment because research shows that active family involvement in treatment leads to a better chance of full recovery and lower incidents of relapse.

Be blessed, be well…