| Bright Futures in Practice: Physical Activity |
EATING DISORDERS
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 SignificanceEating 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
Bulimia nervosa can damage teeth. Purging exposes the teeth to acidic vomitus, which demineralizes tooth enamel and slowly dissolves the teeth. Health professionals should refer children and adolescents to a dentist if tooth damage is apparent. With bulimia nervosa, enlargement of the parotid glands may also be present. |
