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Optimal practice review: recommendation reminders detail

Recommendation reminder 1: Recommendation reminder 1: Oestrogen administration should not be used to treat bone density problems in children and adolescents as this may lead to premature fusion of the epiphyses

Guidance:Eating disorders
Date issued:January 2004

Eating disorders comprise a range of syndromes encompassing physical, psychological and social features. The impact of a person's eating disorder on home and family life is often considerable and may place a heavy burden on family members over a long period of time. Approximately 1 in 250 females and 1 in 2000 males will experience anorexia nervosa, generally in adolescence or young adulthood. About five times that number will experience bulimia nervosa. Other atypical eating disorders are more common still, though many of those affected will not receive treatment. Because eating disorders commonly develop during adolescence they can blight physical and social development, causing many of those affected to fail to reach their academic potential. Depressed mood is a common feature, while the adverse physical consequences of dieting and weight loss are notable and sometimes prove fatal. Indeed, anorexia nervosa has the highest mortality rate of any psychiatric disorder of adolescence.
The treatment experience of those with eating disorders is extremely variable. In part, this relates to the inherent ambivalence to treatment commonly shown by those with these conditions. It is also due to the uneven provision of effective psychiatric treatments that range from high quality age-appropriate specialist eating disorder services, to basic generic treatment provision in areas of the country where skills and experience are scarce.
Bone loss is a significant problem in anorexia nervosa and has serious long-term consequences. Weight restoration in adolescents is associated with important gains in bone density. However, oestrogen administration does not appear to have a positive impact on bone density in children and adolescents, and hormone replacement therapy is not recommended in these patient groups as it may cause premature fusion of the bones.

This page was last updated: 08 October 2007

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.