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Eating Disorders Often Go Undiagnosed in Patients Who Have a History of Obesity

​Children and adolescents who were once overweight or obese represent a substantial portion of patients being treated for eating disorders, including binge-eating, bulimia and anorexia nervosa. Studies have found it often takes significantly longer for these children to be identified as having an eating disorder, and for treatment to begin.

A case report in the October 2013 Pediatrics, “Eating Disorders in Adolescents With a History of Obesity,” published online Sept. 9, describes the specific challenges in the identification and treatment of eating disorders in young patients with a history of obesity.
  • In the first case described, a 14-year-old boy lost 87 pounds over two years; what began as attempts to eat healthy and exercise quickly developed into severe restriction. Despite the fact he had lost over half his body weight, medical notes indicated no concern about an eating disorder until his mother requested an evaluation.
  • In the second case, an 18-year-old girl lost 83 pounds in three years, going from the 97th percentile for body mass index to the 10th percentile. At several medical visits, her mother expressed concerns about her minimal dietary fat intake and restrictive eating, but these concerns were overlooked, and the teen’s amenorrhea and dizziness were attributed to dehydration or possibly polycystic ovary syndrome.
  • In both cases, despite regular medical check-ups and obvious signs of malnutrition, eating disorders were not identified and consequently worsened. According to the study authors, any weight loss, even if it takes a child from overweight, to the “average” range, should prompt eating disorder screening.

The study authors conclude that the symptoms of eating disorders should be on every clinician’s radar, regardless of the patient’s weight.

 

Published
9/9/2013 12:00 AM