Anorexia Nervosa (Child)

Some teens have an extreme fear of being at a higher weight or having obesity. This leads them to stay away from food, eat very little, or eat very small amounts of only certain foods. They may even appear to starve themselves. They are often at a very low weight. But they see themselves as being at a very high weight. They also may weigh themselves repeatedly. Or exercise to the extreme. This condition is called anorexia nervosa.

Anorexia nervosa is a serious, complex problem involving social, behavioral, cultural, physical, and mental components. It's not a lifestyle choice. Though it is more often associated with females, it can affect males, too. Symptoms include severe weight loss, vomiting and diarrhea, and lack of energy. Also, hair thinning, amenorrhea (loss of menstruation), and other serious physical problems. If not treated, severe anorexia nervosa can be fatal.

It's hard to assess and care for children with anorexia. A complete physical and medical history is needed for a diagnosis. It's especially important to be alert when male teens have weight loss or other anorexia-related symptoms. Often the anorexia symptoms can be overlooked and males don't get appropriate care in a timely manner.

Severe malnutrition may need a hospital stay and I.V. (intravenous) or tube feedings. Doctors, nurses, dietitians, and psychologists will be part of your child's health care team. A dietitian will work with the family to make sure that a child gets healthy food and fluid intake and gains weight. A counselor and other mental health providers will help the family with conflicts and provide individual therapy to the child and family therapy. Full recovery often takes years.

• Keep all follow-up appointments with both your mental health team and your medical health care providers.
• Work with the health care team to make a consistent treatment plan.
• Work with mental health providers to help your child and family break out of harmful thought and behavior patterns.
• Let your child have some control over their situation and support their healthy choices.
• Offer your child healthy foods and plenty of liquids to drink. Healthy weight gain should be slow and steady. Ask the nutritionist for help and support.
• Provide time for regular, fun physical activity. Match these to your child's interests, endurance, calorie intake, and weight. Activities should promote self-esteem.
• Offer support and reassurance to your child. Encourage your child to express their feelings. Ask your therapist how to listen and respond to your child in a way that is nonjudgmental.
• If you have any concerns, contact your child's health care team.

Follow up with your child's doctor as advised. Recovery will take time, but many of the physical complications of anorexia nervosa resolve with enough weight gain. This is one of the many reasons why staying in touch with providers, using the ideas suggested by the health care team, keeping follow-up appointments, and asking for help are so critical to your child's recovery. And to your family's ability to manage this illness.

Call or text 988 if your child:

• Is suicidal, has a clear suicide plan, and has the means to carry the plan out. Don't leave your child alone. When you call or text 988, you will be connected to trained crisis counselors at the Suicide Prevention Lifeline. An online chat choice is also available. Lifeline is free and available 24/7. 988 counselors will work closely with 911 to get you the mental health care you need.
• Has trouble breathing or skin or lips that look blue, purple, or gray.
• Is very confused, agitated, or irritable.
• Is very drowsy or has trouble awakening.
• Faints or has loss of consciousness.
• Has a rapid heart rate, very low heart rate, or a new irregular heart rate.
• Has chest pain.
• Has a seizure (rhythmic jerking of arms and legs).
• Has a severe stiff neck, headache, and fever.
• Vomits blood.
• Has severe dehydration symptoms: very tired, sunken eyes, not urinating, not making tears.
• Has large volume of blood in the stools.
• Has sudden spreading red or purple rash.

Contact your child's doctor right away if any of these occur:

• Continued refusal to eat or drink
• Return of peculiar eating habits or rituals
• Any signs of purging (vomiting, taking laxatives)
• Continued weight loss or poor weight gain
• Excessive exercise
• Withdrawal from social interaction
• Talking about suicide or self-harm but the threat is not immediate. This means your child has no definite plan and no access to a self-harm method (such as guns or pills).