About eating disorders in adolescents Custom Search Eating disorders are commonly seen is adolescents. These disorders are more common in girls than in boys. The term includes anorexia nervosa characterized by extreme aversion to eating springing from abnormal fear of gaining weight which actually leads to loss of body weight, bulimia nervosa characterized by excessive eating and binge eating disorder characterized by recurrent episodes of excessive eating. Cause: The exact cause of these disorders is not known. Different factors may interact with each other resulting is these disorders. Genetic factors are supposed to play a role as there is higher incidence of anorexia and bulimia in first degree relatives of affected persons. Hormonal factors may also be involved. Fat cells produce a hormone called Leptin which signals satiety. Anorexia patients may respond with excessive amount of leptin as they start gaining weight. Abnormality in the leptin receptor is suspected in bulimia. The receptor may not respond as expected signaling satiety leading to excessive eating. Abnormal levels of neurotransmitters (chemicals responsible for transmitting signals along nerves) like serotonin have been demonstrated in some patients. Many patients with anorexia have elevated levels of a peptide in the intestine called Ghrelin. Psychological factors also play a significant role in eating disorders. Many teenagers are extremely conscious about their physical appearance. Any negative comment from a relative or friend about their “shape” may make them paranoid about losing weight and getting back to shape. Those suffering from depression may go on over eating leading to weight gain. Teenagers interested in activities which require higher degree of physical fitness like gymnastics, skating or ballet may be scared of putting on extra fat and suffer from anorexia nervosa. They are often influenced by suggestions and comments from their coaches. Clinical features, diagnosis and management of anorexia nervosa Early diagnosis of anorexia nervosa can be quite difficult. Occasionally the affected adolescent may express concern about gaining excessive weight. Parents may notice that the teenager is reducing dietary fat drastically. They may also mention that their daughter or son is trying some weight losing program. Loss of weight in teenager should strongly arouse suspicion of anorexia nervosa. Other symptoms and signs depend on the degree of malnutrition. The body tries to conserve energy is every way. Body temperature may come down. The heart slows down (bradycardia). Muscle mass is reduced. Skin becomes dry and nails become brittle. Function of the nervous system may also be affected. Impairment of concentration, irritability and depression may be noted. Reproductive system may also be affected due to negative feed back from the hypothalamus. Pubertal development may be slowed down. Girls may suffer from secondary amenorrhea. The combination of weight loss and secondary amenorrhea should indicate probability of anorexia nervosa. Both ideal body weight for height (IBW) and body mass index (BMI) are reduced. It is better to weigh the patient with only a gown as some clever teenagers may try to conceal weight loss by wearing bulky clothes. Laboratory findings: Depending on severity many organs can be affected leading to abnormalities in their functions. All the blood cells (red blood cells. white blood cells and platelets) may be decreased. The levels of many hormones may be decreased. Thyroid stimulating hormone, Thyroxine, Follicle stimulating hormones, Luteinizing hormone, estradiol and testosterone are usually reduced. There may be abnormalities in sodium and potassium levels in blood. Phosphorous may be decreased. Blood urea and creative levels may be increased due to Kidney dysfunction. ECG may also show abnormality and such parents are at risk of developing arrhythmia. If there is any doubt other causes of weight loss should be looked for and ruled out. Custom Search
Page last reviewed on 13th June 2010
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