Unhealthy
eating behaviors and preoccupation with body
size can lead to life-threatening eating disorders
(e.g.,
anorexia nervosa, bulimia nervosa) described
in the Diagnostic and Statistical Manual of Mental
Disorders, fourth edition, text revision (DSM-IV-TR).1,2 (DSM-IV
criteria for anorexia nervosa, bulimia nervosa,
and eating disorders not otherwise specified follow
on pages 119 and 120.) Many children and adolescents
with eating disorders participate in excessive
physical activity to control their weight.3 Some
become anxious or depressed if they are unable
to participate in physical activity.4
Eating
disorders have been observed in both sexes and
across socioeconomic and racial/ethnic groups.
The prevalence of anorexia nervosa and bulimia
nervosa is thought to be 1 to 2 percent among female
adolescents. Estimates of mortality resulting from
anorexia nervosa vary considerably. The average
estimate is 5 to 8 percent, but some estimates
are as high as 20 percent.5,6 Death
may be due to cardiac arrhythmia (irregular heartbeat),
acute cardiovascular failure, gastric hemorrhaging,
or suicide. The major medical complications observed
in children and adolescents with anorexia nervosa
include the following:7