ABSTRACT
Two psychiatric syndromes comprise the major eating disorders in adolescence: anorexia nervosa and bulimia nervosa. Both disorders feature disturbed eating patterns that reflect underlying fears of weight gain. Adolescence is the period of development most closely associated with the onset of both eating disorders, although they can develop in pre-pubescents (see Chapter 6) and adults. Anorexia nervosa typically develops in early (ages 13–14) or late (ages 17–18) adolescence, while bulimia nervosa commonly originates in the later teenage years or early adulthood. There has been an increase in interest in eating disorders that do not fulfill criteria for anorexia nervosa or bulimia and these are known either as ‘eating disorders not otherwise specified’ (EDNOS) or as ‘atypical eating disorders’. It appears that they may be more common than anorexia nervosa or bulimia (Fairburn and Harrison, 2003; Rodriguez et al., 2001) but they have not been well researched in this age-group and thus this chapter will concentrate exclusively on anorexia and bulimia. A host of biological, psychological, familial and sociological factors have been implicated in the etiology and maintenance of the disorders. In this chapter we will examine the epidemiology, clinical picture, and medical complications of anorexia nervosa and bulimia nervosa, and discuss risk profiles for the development of these eating disorders in adolescence.
