Eating disorders are characterized by a persistent disturbance of eating or eating related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning (DSM V).
There are various types of eating disorders such as
Anorexia is a serious condition characterized by significantly low weight for age and sex and an enormous fear of gaining weight or becoming fat. They see themselves as fat and may have severe body image issues. They may restrict their food intake, exercise excessively, abuse laxatives or enemas and or purge to keep their weight as low as possible.
Common presentation of Anorexia in Adolescents
Bulimia Nervosa commonly known as Bulimia involves eating large quantities of food (bingeing) with inappropriate compensatory behaviours such as self-induced vomiting, misuse of laxatives, diuretics or enemas, excessive exercise or fasting. Binge eating and compensatory behaviours both are recurrent.
Common presentation of Bulimia in Adolescents
ARFID is a type of eating disorder in which the young people restrict their eating based on sensory characteristics of food such as smell, colour, appearance, texture etc or perhaps lack of interest in food which results in weight loss or secondary to a traumatic event such as choking during eating. Weight loss is not the main reason for dietary restriction. Although the presentation may mimic Anorexia, but it is not the same as Anorexia. However, if untreated it may develop into Anorexia.
Common presentation of ARFID
Eating disorders are very complex and may have a combination of biological, psychological and social causes. Often genetic and environmental factors in combination have been associated with increased vulnerability to the development of eating disorders.
If you think your child may have features suggestive of eating disorder, you should contact your GP first. Your GP would be able to identify the issues and point you in the right direction. You could see a child and adolescent psychiatrist for further assessment and diagnosis. The diagnosis is based on the information from the child/adolescent in a psychiatric interview, using relevant questionnaires (when needed), getting collateral information from family/carers, and carrying out a complete mental state examination.
Early intervention and right treatment would be the key to a successful treatment of eating disorder. There is a lot of evidence based on research that accessing the treatment early not only improves the mental health of the child but also reduces the chances of recurrence in adulthood. The treatment of eating disorders is multimodal and includes the use of pharmacology, psychological interventions, and social interventions.
The treatment depends upon the type of disorder and comorbid conditions.
Outpatient Treatment – it is appropriate for children and adolescents with good BMI, less physical issues and mild to moderate comorbid mental health issues. This would include psychotherapy including family therapy, dietary advice, and possible medication if there are other comorbid conditions such as depression, anxiety, OCD etc.
Inpatient Care- If your child has low BMI, serious physical health issues, poor motivation to change and severe comorbid mental health issues, the child may need inpatient care. In that case it would be most appropriate to be referred to CAMHS via your GP.
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