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PEDIATRICS Vol. 111 No. 1 January 2003, pp. e98-e108

REVIEW ARTICLE

Children and Adolescents With Eating Disorders: The State of the Art

Ellen S. Rome, MD, MPH, FAAP*, Seth Ammerman, MD{ddagger}, David S. Rosen, MD, MPH§, Richard J. Keller, MD||, James Lock, MD, Kathleen A. Mammel, MD#, Julie O’Toole, MD, MPH**, Jane Mitchell Rees, MS, RD, CD{ddagger}{ddagger}, Mary J. Sanders, PhD, Susan M. Sawyer, MBBS, MD, FRACP§§, Marcie Schneider, MD||||, Eric Sigel, MD¶¶ and Tomas Jose Silber, MD, MASS##

* Section of Adolescent Medicine, Division of Pediatrics, Children’s Hospital at the Cleveland Clinic Foundation, Cleveland, Ohio; and Pennsylvania State University School of Medicine, Pennsylvania
{ddagger} Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Stanford, California
§ Section of Teenage and Young Adult Health, University of Michigan Medical School, Ann Arbor, Michigan
|| Phillips Academy, Andover, Massachusetts; Harvard Medical School, Boston, Massachusetts; and Children’s Hospital, Boston, Massachusetts
Division of Child Psychiatry, Stanford University School of Medicine, Stanford, California
# Adolescent Pediatrics, William Beaumont Hospital, Royal Oak, Michigan
** Kartini Clinic for Disordered Eating, Oregon Health Sciences University, Portland, Oregon; and Emanuel Children’s Hospital
{ddagger}{ddagger} Departments of Health Services and Pediatrics, Maternal Health Child Program and Adolescent Medicine Section, Maternal Child Health Program, University of Washington School of Public Health, Seattle, Washington
§§ Centre for Adolescent Health, Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Melbourne, Australia
|||| Yale University School of Medicine, New Haven, Connecticut; and Greenwich Hospital, Greenwich, Connecticut
¶¶ University of Colorado School of Medicine, Adolescent Medicine Clinic at Children’s Hospital, Denver, Colorado
## George Washington University School of Medicine and Health Sciences, Adolescent Medicine Fellowship Program, Children’s National Medical Center, Washington, DC

--> Background. Eating disorders in children and adolescents remain a serious cause of morbidity and mortality in children, adolescents, and young adults. The working knowledge of pathophysiology, recognition, and management of eating disorders continues to evolve as research in this field continues.

Objectives. This article builds on previous background and position papers outlining issues relevant to the care of the adolescent patient with an eating disorder.

Methods. The eating disorder special interest group from the Society for Adolescent Medicine recognized the need to update the state of the art published guidelines for the care of the adolescent patient with an eating disorder. This article was a multidisciplinary, group effort to summarize the current knowledge of best practice in the field.

Results. This article summarizes newer findings on pathogenesis and etiology, prevention and screening, risk factors, nutritional issues, care from the primary care clinician’s perspective, appropriate use of a multidisciplinary team, and issues of managed care and reimbursement.

Conclusions. Primary prevention combined with early recognition and treatment helps decrease morbidity and mortality in adolescents with eating disorders.

Key Words: adolescent • child • eating disorder • anorexia nervosa • bulimia nervosa

Abbreviations: AN, anorexia nervosa • BN, bulimia nervosa • ED-NOS, Eating disorder-not otherwise specified • BMI, body mass index

Received for publication Nov 13, 2001; Accepted Oct 30, 2002.




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