NEDA TOOLKIT for Parents
Eating disorders among children and adolescents
From the Finnish Medical Society Duodecim
Brief Summary
Bibliographic Source
Finnish Medical Society Duodecim. Eating
disorders among children and adolescents. In:
EBM Guidelines. Evidence- Based Medicine
[Internet]. Helsinki, Finland: Wiley Interscience.
John Wiley & Sons; 2007 Mar 28 [Various].
Major Recommendations
The levels of evidence [A-D] supporting the
recommendations are defined at the end of the “Major
Recommendations” field.
Objectives Remember that eating disorders are very common
among adolescent girls, and especially bulimic
disorders are encountered in boys as well.
One must remember to look for signs of an eating
disorder; patients seldom report it themselves.
The diagnosis and planning of treatment are the
responsibility of special personnel.
Basic Rules
An eating disorder refers to states in which food
and nourishment have an instrumental and
manipulative role: food has become a way to
regulate the appearance of the body.
The spectrum of eating disorders is vast. The most
common disorders are anorexia nervosa and
bulimia nervosa. In addition, incomplete clinical
pictures and simple binge eating have become
more general.
Recently the international trend has been to put
more emphasis on early reaction to the symptoms.
Even small children can have different kinds of
eating disorders that relate to difficulties in the
relationships between the child and his/her
caretaker. Aetiology
Currently, eating disorders are considered to be
multifarious. Genetic and sociocultural factors and
also individual dynamics all affect eating
disorders. The typical age of onset is adolescence, when the
body changes and grows.
Anorexia nervosa typically emerges between 14
and 16 years of age or around the age of 18 years.
Bulimia appears typically at the age of 19 to 20
years. Eating disorders are 10 to 15 times more common
among girls than boys.
Every 150th girl between the ages of 14 and 16
years suffers from anorexia nervosa.
There is no epidemiologic data on the occurrence
of bulimia, but it is considered to be more
common than anorexia nervosa.
Diagnostic Criteria for Anorexia Nervosa
The patient does not want to maintain his/her
normal body weight.
The patient’s weight is at least 15% below that
expected for age and height.
The patient’s body image is distorted.
The patient is afraid of gaining weight.
There is no other sickness that would explain the
loss of weight.
Diagnostic Criteria of Bulimia Nervosa
Desire to be thin, phobic fear of gaining weight.
Persistent preoccupation with eating and an
irresistible urge or compulsive need to eat.
Episodes of binge eating (at least twice a week);
control over eating is lost.
After the episode of binge eating, the person
attempts to eliminate the ingested food (e.g., by
self-induced vomiting and by abuse of purgatives
and diuretics).
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