ABSTRACT
Objectives of review. To review papers published in 2003 and 2004 specifically relating to the clinical management of children and adolescents with eating disorders (EDs), and to identify main current areas of interest and research activity.
Summary of recent findings. Although there have been many publications relating to EDs in young patients during 2003-2004, there were no controlled treatment trials. Recent findings include evidence that adolescence remains a period of high risk for both AN and BN, and that outcome in AN remains relatively poor with up to half experiencing persisting psychiatric problems up to 10 years later. Rate of weight gain whilst in hospital is emerging as a factor predictive of outcome for AN. Developments in individual psychological interventions have included motivational approaches and the use of monitored exercise in underweight patients during refeeding. Treatment of choice for pubertal delay and bone complications is still normalization of dietary intake and weight restoration, and the use of medication in general is not recommended as a first-line choice of treatment for the ED. Effective family interventions have been described and evaluated, both for AN and BN.
Future directions. It is recommended that attention is paid to diagnostic and classification issues, and that specific developmentally appropriate interventions for the full range of ED presentations seen in this age group are subjected to proper evaluation. Controlled treatment trials are very much needed, and might help reduce some of the variability in guidelines and recommendations currently available to clinicians working with this age group.
