ABSTRACT
Eating disorders are more often diagnosed in females than in males and typically have their onset in mid- to late adolescence (Hudson et al. 2007; Lucas et al. 1991). However, it is not uncommon for children and early adolescents to present for treatment of an eating disorder (see Chapter 19, ‘Recognising and diagnosing early onset eating disorders’). Such cases can be challenging diagnostically, as some eating disorder aspects overlap with normal child development (Watkins and Lask 2009). For example, a clinician familiar with developmental stages would not expect an 11-year-old girl to necessarily be menstruating. However, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a diagnostic criterion for anorexia nervosa (AN) is the absence of menses (American Psychiatric Association 2000). The clinician must try to ascertain whether the 11-year-old patient has prevented onset of menses by maintaining a low, unhealthy weight or is simply not developmentally ready to menstruate.
