Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 8;121(5):164-174.
doi: 10.3238/arztebl.m2023.0248.

The Diagnosis and Treatment of Anorexia Nervosa in Childhood and Adolescence

Johannes Hebebrand  1 , Gertraud Gradl-Dietsch, Triinu Peters, Christoph U Correll, Verena Haas
Affiliations
Review

The Diagnosis and Treatment of Anorexia Nervosa in Childhood and Adolescence

Johannes Hebebrand et al. Dtsch Arztebl Int. .

Abstract

Background: Anorexia nervosa (AN) is a serious disease with a lifetime prevalence of up to 3.6% in women and 0.3% in men. Abnormally low weight and the associated starvation partly account for its somatic and mental manifestations.

Methods: This review is based on publications retrieved by a selective search concerning AN in childhood and adolescence.

Results: The peak age of onset of AN is 15.5 years. The frequency of inpatient treatment for AN rose by 40% during the COVID pandemic, indicating the importance of environmental factors; the heritability of AN is estimated at 0.5. The ICD-11 sets the threshold for AN-associated underweight at the fifth percentile for age of the body mass index, as long as the remaining diagnostic criteria are met. The main goal of the multiprofessional treatment of AN is the return to normal body weight, which is a central prerequisite for regaining somatic and mental health. The mean duration of AN is 3.4 years, and approximately twothirds of patients recover from the disease over the long term.

Conclusion: Marked weight loss in childhood and adolescence can trigger AN in the presence of a predisposition to this disease. Patients and their families should receive psychoeducation regarding the symptoms of starvation and their overlap with those of AN. Important objectives are to shorten the duration of the illness, minimize mortality and the risk of chronic illness, and to identify pharmacological approaches to treatment.

PubMed Disclaimer

References

    1. American Psychiatric Association. 5th edition ed. Washington, DC: American Psychiatric Publishing, Inc; 2013. Diagnostic and Statistical Manual of Mental Disorders: DSM-5™.
    1. Galmiche M, Dechelotte P, Lambert G, et al. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019;109:1402–1413. - PubMed
    1. Solmi M, Radua J, Olivola M, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27:281–295. - PMC - PubMed
    1. Davidson KW, Barry MJ, et al. Force USPST. Screening for eating disorders in adolescents and adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327:1061–1067. - PubMed
    1. Hebebrand J, Hildebrandt T, Schlögl H, et al. The role of hypoleptinemia in the psychological and behavioral adaptation to starvation: implications for anorexia nervosa. Neurosci Biobehav Rev. 2022;141 104807. - PubMed

LinkOut - more resources