Eating disorders in adolescents.

Eating disorders including anorexia nervosa and bulimia are commonly seen in adolescent patients. There are many medical complications including disturbances in cardiac, endocrine, bone, gastrointestinal, hematological, neurological, metabolic, and renal function. There are characteristic dermatological and dental findings. Attention to key elements of the history and characteristic findings on physical exam can help the primary care provider in timely diagnosis. Although there is a wide differential diagnosis for these patients, the presence of alteration in body image and fear of being overweight are key features that help distinguish eating disorders from other disease states. Management requires a multi-disciplinary team that can provide psychological, nutritional and medical services. Adequate nutritional rehabilitation is critical and should occur concurrently with the mental health interventions. With early detection and adequate treatment, prognosis for recovery can be quite good, although mortality rates in long-term studies are surprisingly high.