Anorexia nervosa is an eating disorder in which the child engages in self–imposed starvation. Anorexia is an
illness in which the person has a relentless quest for thinness and refuses to maintain a normal or healthy
weight. Children with anorexia usually have a low body weight or at a minimum average weight for age and
height. Often children with anorexia see themselves as overweight, even when they look weak or are clearly
malnourished. A person with anorexia typically weighs themselves constantly, and portions food carefully
eating only very small quantities of certain foods.
Children with anorexia have an intense fear of weight gain and a distorted body image. Inadequate eating or
excessive exercising results in severe weight loss. Anorexia nervosa is a serious, life-threatening disorder,
which usually originates from emotional origins. Although children with anorexia nervosa are obsessed with
food, they persistently deny their hunger. Children suffering from anorexia nervosa often limit or restrict
other parts of their lives in addition to food, including relationships, social activities, or enjoyment.
The condition occurs most frequently in females; however, it can occur in males.
Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-
induced vomiting, or misusing laxatives, diuretics or enemas. According to some studies, people with
anorexia are up to ten times more likely to die as a result of their illness compared to those without the
disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid
imbalances. Suicide also can also be an ending result.
Some children suffering from anorexia recover with treatment after only one episode. Others get well but
have relapses. However, some people have a more chronic form of anorexia, in which their health
deteriorates over many years as they battle the illness. Many people with anorexia also have coexisting
psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse,
cardiovascular and neurological complications, and impaired physical development.
Causes of Anorexia
Knowledge about the causes of anorexia nervosa is inconclusive, and the causes may be diverse. In an
attempt to understand and uncover the origins of eating disorders, scientists have studied the personalities,
genetics, environments, and biochemistry of people with these illnesses. Certain personality traits common in
persons with anorexia nervosa are low self-esteem, social isolation (which usually occurs after the behavior
associated with anorexia nervosa begins), and perfectionism. These children tend to be good students and
Anorexia usually begins as innocent dieting behavior, but gradually progresses to extreme and unhealthy
weight loss. Social attitudes toward body appearance, family influences, and developmental conditions are
believed possible contributors to the cause of anorexia. Children who develop anorexia are more likely to
come from families with a history of weight problems, physical illness, and other mental health problems,
such as depression or substance abuse. Further, often children with anorexia come from families that may
be considered as being too strict, overly-critical, prying, and overprotective. Children with anorexia may be
immature in their emotional development, and are likely to isolate themselves from others.
Eating disorders also have a tendency to run in families, with female relatives most often affected. A girl
with a has a ten to twenty times higher chance of developing anorexia nervosa, for example, if she has a
sibling with the disorder. This finding suggests that genetic causes may predispose some children to eating
disorders. Behavioral and environmental influences may also play a role. Stressful events are likely to
increase the risk of eating disorders as well. Children with anorexia should be diagnosed and treated as soon
as possible because eating disorders are most successfully treated when diagnosed and managed early.
Symptoms of Anorexia
• Dry skin that when pinched and released, stays pinched
• Abdominal pain
• Lethargy (sluggishness, drowsy dullness)
• Intolerance to cold temperatures (hypothermia)
• Emaciation (abnormal thinness caused by lack of nutrition)
• Growth of lanugo (fine, soft woolly body hair)
• yellowing of the skin
• thinning of the bones (osteoporosis)
• Brittle hair and nails
• Muscle weakness and loss
• Low blood pressure, slowed breathing and pulse
Treating Anorexia in Children
Goals to during treatment
• Rebuild the child to a healthy weight.
• Treating the psychological concerns associated to the eating disorder.
• Decreasing or eliminating behaviors or thoughts that trigger the impulse, and preventing relapse.
Some research suggests that the use of medications, such as antidepressants, or mood stabilizers, may be
moderately effective in treating individuals with anorexia by helping to settle mood and anxiety symptoms
that often co-exist with anorexia. Recent studies, however, have suggested that antidepressants may not be
effective in preventing some children with anorexia from relapsing. In addition, no medication has shown to
be effective during the critical first phase of restoring the individual to healthy weight. Overall, it is uncertain
if and how medications can help children overcome anorexia, but research continues.
Different forms of psychotherapy, including individual, group and family-based, can help address the
psychological motives for the disorder. Some studies suggest that family-based therapies in which parents
assume responsibility for feeding their afflicted child are the most effective in helping children with anorexia
gain weight and improve eating habits and moods. Studies have noted that a combined approach of medical
intervention and supportive psychotherapy aimed specifically for anorexia patients is more effective than just
psychotherapy alone. But the effectiveness of a treatment depends on the individual and his or her
To help children with anorexia nervosa overcome their disorder, a variety of methods may be effective.
Some form of psychotherapy is necessary to treat underlying emotional issues. Cognitive behavioral therapy
is sometimes used to change unusual thoughts and behaviors. Family therapy is particularly beneficial for
children. A physician is needed to prescribe medications that may be useful in treating the disorder. A
nutritionist may be necessary to advise parents and child about proper diet and eating routines. Where
support groups are available, they can be helpful to both children and families. Family support is important
during the treatment of anorexia because their support helps the child overcome their harmful eating habits.
This is done through education in family therapy parents learn to take control of their child’s eating. The
child suffering from anorexia will also learn to function more independently.
Individual therapy is a treatment that focuses on increasing the self-esteem, self-efficacy and self-worth of
the child, addressing the main issues of the eating disorder. The child will first learn to identify and
understand their emotions, and eventually learn to tolerate negative and positive emotions instead of numbing
themselves with starvation. The child learns to accept responsibility for food related problems as opposed to
giving up authority to the parent. The goal of this treatment is to help the child gain independence from his
or her family as a developing adolescent.