Life threatening complications ‘common’ in eating disorders

Potentially life threatening medical complications are ‘common’ in children affected by early onset eating disorders (EOEDs), a study reported in the Medical Journal of Australia has found.

The first prospective national study of EOEDs also revealed major limitations in current diagnostic criteria, possible missed diagnoses and a need for better education of health professionals.

The study examined data from 101 cases of EOEDs in children aged five to 13 years, and found that 78% were hospitalised with an average length of stay of almost 25 days.

Study co-author and leading child psychologist Dr Sloane Madden, from Westmead Children’s Hospital, said the results show younger children with EOEDs are presenting with severe disease.

"Only 37% of inpatients in the study met the current diagnostic criteria for anorexia nervosa, yet 61% had potentially life threatening complications of malnutrition and only 51% met the weight criteria," Dr Madden said.

"This suggests the current criteria for diagnosing anorexia nervosa in young children are limited.

"The high rates of potentially life threatening medical complications also suggest possible missed diagnoses and a need for better education of health professionals."

An editorial on the study in the same edition of the MJA highlighted that about a quarter of cases in the study were boys.

Editorial author, Foundation Chair of Mental Health at the University of Western Sydney’s School of Medicine, Professor Phillipa Hay, said, "The relatively high proportion of younger boys with EOEDs contrasts with men accounting for about one in ten adult cases of anorexia nervosa and bulimia nervosa," Professor Hay said.

"More research is needed, but the work by Madden and colleagues supports the hypothesis that EOEDs may differ in important ways, including sex distribution and course, from eating disorders with onset in adolescence and adulthood.

"It is imperative that research attention is now directed towards understanding why such young children are developing severe eating disorders and how effective identification and treatment can be targeted earlier."

(Source: Australian Medical Association: Medical Journal of Australia: April 2009)