Nutritional Disorders of Children

Eating disorders are becoming increasingly common with young children these days. These are: Anorexia, Bulimia, and Binge eating. Anorexia is when a child refuses to eat and his/her nutrition and growth suffers greatly. Bulimia occurs when a child overeats and then flushes out the food by either vomiting or by using laxatives to avert weight gain. Binge eating, we’re all familiar with, is an eating disorder in which a child might overeat hastily, but without purging.

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It is usually observed, that in children and teens eating disorders might overlap. For instance, children may interchange between anorexia and bulimia.

The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings, to evaluate patients suspected of having these disorders, and to manage (or refer) patients in whom eating disorders are diagnosed. This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. Medical complications of eating disorders may affect any organ system, and careful monitoring for these complications is required. The range of treatment options, including pharmacotherapy, is described in this report. Pediatricians are encouraged to advocate for legislation and policies that ensure appropriate services for patients with eating disorders, including medical care, nutritional intervention, mental health treatment, and care coordination.

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It has long been recognized that the intestinal flora of the very young varies, and that the character of the ingested food is one factor in the production of this variation. The description of acidophilic, gram-positive organisms in the stools of breast fed infants by Escherich1 and Moro1 are classic, and the same authors, as well as Bahart,1 Giarre,1 Concetti1 and Schikora,1 with equal clearness have described bacteria to be found in the stools of artificially fed infants. Thus it has been common knowledge for many years that infants fed a diet rich in bovine milk acquire a characteristic stool flora which in contrast to that of the nursling is putrefactive in its activities and which produces chemical substances (indol, phenol, skatol, etc.) which are known to arise from the splitting of protein.

The eating disorders clinical guideline covers physical and psychological treatments, treatment with medicines, and what kinds of services best help people with eating disorders.

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The guideline looks at eating disorders for children aged 8 years through to adults. It covers anorexia nervosa, bulimia nervosa, and related eating disorders, in particular, binge eating disorder. It does not look at obesity, or how to diagnose or treat an eating problem that has been caused by another physical or mental disorder.

Eating disorders in children and teens cause serious changes in eating habits that can lead to major, even life threatening health problems. The three main types of eating disorders are:

Anorexia, a condition in which a child refuses to eat adequate calories out of an intense and irrational fear of becoming fat
Bulimia, a condition in which a child grossly overeats (binging) and then purges the food by vomiting or using laxatives to prevent weight gain
Binge eating, a condition in which a child may gorge rapidly on food, but without purging

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In children and teens, eating disorders can overlap. For example, some children alternate between periods of anorexia and bulimia.

Eating disorders typically develop during adolescence or early adulthood. However, they can start in childhood, too. Females are much more vulnerable. Only an estimated 5% to 15% of people with anorexia or bulimia are male. With binge eating, the number rises to 35% male.

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Anorexia in children as young as 4. In “The Eating Disorders: Medical and Psychological Bases of Diagnosis and Treatment” (the textbook Dr. Blinder edited), it says that childhood anorexia generally has the same diagnostic criteria as adolescent and/or adult-onset anorexia — except that, in children, a 15 percent reduction in body weight is sufficient for diagnosis, instead of the 25 percent required for older age groups. (Prepubertal children — especially girls — have less body fat than their adolescent counterparts.)

The etiology of eating disorders is multifactorial, and there is increasing evidence from both family and twin studies for a strong genetic component that is shared between AN and BN The mechanism(s) by which genetic factors influence risk have not been elucidated, but various hypotheses have been proposed. Genetic predisposition to various trait disturbances such as behavioral rigidity, perfectionism, or harm avoidance may be more salient than genetic influences on eating, hunger, or satiety. Genetic effects seem to be “activated” by puberty and there is strong evidence for genetic-environment interactions.

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Dieting has also been implicated as a potent proximal risk factor in the development of disordered eating and eating disorders.In 1 community-based study, dieters at 5-year follow-up were at significantly higher risk of disordered eating behaviors (eg, vomiting or using diet pills or laxatives) than nondieters and were also at increased risk of obesity. In another large community cohort, dieters were 5 times more likely to develop an eating disorder and severe dieters were 18 times more likely to develop an eating disorder than nondieters.

Primary care providers are in a unique position to detect the onset of eating disorders at the earliest stages and to stop their progression.32,33 Pediatricians should screen for eating disorders as part of annual health supervision or during preparticipation sports examinations by monitoring weight and height longitudinally and paying careful attention to potential signs and symptoms of disordered eating.

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In children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status. These data also indicate that decreased morbidity (reflected by a lower acute care hospitalization rate) may be related, at least in part, to successful management of feeding problems. Our results emphasize the importance of a structured approach to these problems, and we propose a diagnostic and treatment algorithm for children with developmental disabilities and suspected feeding disorders.children, developmental disabilities, fundoplication, gastroesophageal reflux, gastrostomy, hospitalization, nutrition.

Many children and teens with eating disorders struggle with one or more of the following problems:

  • distress
  • fear of becoming overweight
  • feelings of helplessness
  • low self-esteem

To cope with these issues, children and teens may adopt harmful eating habits. In fact, eating disorders often go hand-in-hand with other psychiatric problems such as the following:

  • anxiety disorders
  • depression
  • substance abuse

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Eating disorders in children and teens can lead to a host of serious physical problems and even death. If you spot any of the signs of the eating disorders listed below, call your child’s doctor right away. Eating disorders are not overcome through sheer willpower. Your child will need treatment to help restore normal weight and eating habits. Treatment also addresses underlying psychological issues. Remember that the best results occur when eating disorders are treated at the earliest stages.

If you suspect your child has an eating disorder, trust your instincts. Parents often know when something is wrong. Educate yourself through research, talk to medical and mental health professionals and identify your support system. Don’t let your child’s eating disorder isolate you, don’t dwell on the past, and don’t lose hope. Identify what you want to work toward for your family, and take committed action toward that end.

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The long-term treatment of bulimia is to stop the binge-and-purge cycle. Treatments might involve nutritional counselling, antidepressants medication, behaviour modification, and group therapy.

Children are known to reject certain foods or food choices they want to eat, it is a common cause of child factors difficult to eat,

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Researchers said that there is a misconception that only rich, white girls have eating disorders. They said that there are more and more boys and minorities who are being diagnosed with eating disorders. Another disturbing trend is that sufferers of these conditions seem to be getting younger. The total prevalence of eating disorders is between 0.8 percent and 14 percent depending on criteria used. Athletes, particularly gymnasts and runners, seem to be most susceptible to developing eating disorders.

Interestingly, the pressure to get thinner to curb obesity in America may be a contributing factor in the rise of eating disorders in children.
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