Eating disorders in children and adolescents: an update

Anorexia nervosa: a role for L-arginine supplementation in cardiovascular risk factors?

OBJECTIVE

The aim of the present study was to evaluate the effects of a short-term oral L-arginine treatment on platelet NO production, intracellular calcium concentration, iNOS and eNOS expression, in AN patients.

METHOD

Forty outpatients belonging to restricting subtype and 40 normal participants age and sex matched were enrolled in the study.

RESULTS

NO production was significantly elevated in the platelets from AN patients compared with controls while [Ca(2+)](i) was significantly decreased in patients with respect to controls. Western blot analysis demonstrated that iNOS isoform was more pronounced in the cell lysates from AN patients than controls. After supplementation with L-arginine, both NO production and [Ca(2+)](i) seem to return to control levels, suggesting a probable recovery of their metabolisms. The same was found after western blot analysis of NOS expression.

DISCUSSION

The results here proposed can be considered highly indicative of a positive effect of L-arginine supplementation on platelet NO production in AN patients.

Obesity and eating disturbances are common in 15-year-old adolescents. A two-step interview study

A two-step interview study of eating disorders (EDs) and sub-clinical EDs in 15-year-old adolescents was carried out in western Finland. The sample consisted of all ninth graders in a well-defined catchment area (n=606, 98.2% of eligible students). In the first step, a self-report questionnaire was administered at schools regarding mental health problems and life circumstances. The questions concerning anorectic and bulimic eating pathology were formulated according to the DSM-IV diagnostic criteria of EDs. The second step consisted of a semi-structured interview Rating of Anorexia and Bulimia-Teenager version (RAB-T) to which 128 subjects were invited, on the basis of their answers to questions about eating pathology in the questionnaire. The participation rate in the interview was 88.3%. The lifetime prevalence rate for anorexia nervosa (AN) in 15-year-old girls was 1.8% and the point prevalence rate 0.7%. No cases of AN were found among the boys. All criteria fulfilling cases of bulimia nervosa (BN) were not found in our sample. High rates of AN not otherwise specified (AN-NOS; 4.9%) and sub-clinical EDs (4.9%) were found among the girls; 6.7% of girls and 0.6% of boys were regarded as being "at risk" of developing EDs. Data on height and weight are based on current measurements taken at school healthcare; 22% of boys were overweight or obese compared with 16% of girls.

Cultural issues in eating pathology and body image among children and adolescents

Eating pathology and body image issues are now recognized as affecting all racial and ethnic groups. This article reviews eating pathology and body image concerns in four diverse groups in the U.S. (African Americans, Latino/as, Asians, and Native Americans). The major conclusion based on this review is that eating disturbances and body dissatisfaction occur to some degree in children and adolescents from all four major ethnic groups in the U.S; however, there is substantial variability across studies. Future directions include the need for studies of prevalence, prevention and treatment research, and investigations of neurobiological and genetic variables.

The prevalence, incidence and development of eating disorders in Finnish adolescents: a two-step 3-year follow-up study

OBJECTIVE

To investigate the prevalence, incidence and development of eating disorders and subclinical eating pathology.

METHOD

A two-step three-year follow-up study on eating disorders in adolescence (N = 595) was conducted in western Finland. A screening questionnaire followed by a semi-structured interview was used to determine the prevalence, incidence and development of eating disorders.

RESULTS

The lifetime prevalence rates for females age 18 were 2.6% for anorexia nervosa (AN), 0.4 for bulimia nervosa (BN), 7.7% for AN-NOS, 1.3% for BN-NOS and 8.5% for subclinical eating disorders. No prevalent case of DSM-IV eating disorders was found among the male participants. The incidence rate of any eating disorder in females age 15-18 was 1641 per 100 000 person-years.

CONCLUSION

Eating disorders are relatively common in female adolescents. As many as one in five adolescent females are or have been struggling with eating disorder related issues during their teenage years.

Recovery from lethal arrhythmia after weight gain in a patient with an eating disorder and epilepsy

We report a 13-year-old girl with epilepsy who experienced syncope after rapid weight loss due to an eating disorder. She developed a lethal (atrioventricular block) arrhythmia, which improved after weight gain. This case suggests that energy depletion might be involved in lethal arrhythmia.