Eating disorders among children and adolescents.

Anorexia nervosa and bulimia nervosa represent extreme manifestations of weight control patterns in adolescents. When they occur in children, they often are associated with more severe psychiatric or family dysfunction. However, rather than framing these conditions as purely psychiatric problems, it is more useful to approach them in terms of development. Then, the pediatrician can be positioned to address the various biologic, psychological, and social issues presenting in the individual. Furthermore, the pediatrician already is familiar with the principles of managing chronic illnesses, and eating disorders frequently require months to years of treatment. Finally, for each patient in a pediatrician's practice who has an eating disorder, several other patients will develop unhealthy habits with respect to eating, food choices, and weight control. By being familiar with the larger issues associated with weight loss, rather than the more narrow topic of eating disorders, the pediatrician will be able to help all patients remain healthy in a culture of thinness, regardless of their diagnosis.