Anorexia nervosa is an eating disorder affecting 1 in 10 young people, which peaks in girls aged 15 – 19 years with 1 in 10 young people with AN being biologically male. This eating disorder may develop as early as 9 years of age, with early intervention with a skilled group of practitioners recommended. It is a serious mental health condition with ing rates of morbidity and mortality. In anorexia nervosa, food is restricted, and a person may present with a low body weight, weight loss, distorted self-body image and an intense fear of weight gain. Other characteristics may include
- failure to recognise the seriousness of low body weight
- loss or delay of menstruation
- avoiding specific foods/whole food groups
- preoccupation with food but unable to eat
- exercise strict food rules which other people are not expected to follow
- vomiting stomach contents after eating to avoid gaining weight
- excessive use of laxatives, diuretics
- cycles of binge-eating and severe restriction
- rigorous or “unhealthy” levels of exercise
If anorexia nervosa becomes a problem before puberty, and remains untreated, it can cause stunting (poor height growth) and negatively affect bone health (by reducing calcium mineralisation). This stunting may not be corrected later on, after the sensitive window of growth between age 13-16, with peak bone grow around age 14-15. In teenage girls, if periods are delayed beyond 16 this is a cause for concern with long-term risks to health. Disturbances in oestrogen production, the primary female sex hormone, which regulates fertility and sex characteristics like breast development, as well as bone mineralisation, if uncorrected, may cause infertility. For boys there is a similar drop in the sex hormone testosterone, which limits bone and muscular growth growth, causing similar stunting in height and bone mineralisation.
I offer ED dietary assessment as a first step to consider working with a young person and their family.