Anorexia Nervosa | Diagnosis & Treatment

How is anorexia nervosa diagnosed?

It can be hard to diagnose anorexia nervosa, since many children and adolescents with the disorder try to keep their illness very private and hidden. Parents, teachers, coaches or instructors may be able to identify a child with anorexia, but the diagnosis is usually made by a qualified mental health professional or medical provider.

Since early treatment can often prevent future problems, if you note symptoms of anorexia in your child, it’s a good idea to seek evaluation and treatment sooner rather than later.

If an eating disorder is suspected, some components of the evaluation may include:

  • a careful patient and family history
  • physical examination
  • laboratory tests, including a complete blood count and a urinalysis
  • mental health and nutritional assessments

To help diagnose anorexia, your child’s doctor will:

  • assess weight changes
  • inquire about self-perceptions of weight and desired weight
  • ask your child about binging and out of control eating and purging
  • ask your child about use of laxatives and diet pills

The doctor also may inquire about:

  • abdominal pain
  • bloating
  • constipation
  • hair loss or change in hair texture
  • cold intolerance
  • fatigue
  • weakness
  • fainting
  • substance use
  • sexuality
  • depression
  • amount of physical exercise
  • stress fractures

Your child’s doctor also will likely conduct the following studies:

  • Social history: A review of risk factors focusing on the home, education and activities.
  • Family history: Information about conditions and disorders within the family, including eating disorders, obesity, alcoholism, depression or other mental illness.
  • Physical exam: A clinician will assess and examine your child’s blood pressure, pulse, temperature, weight and height, skin and hair changes, heart function and abdomen.

What are the treatment options for anorexia nervosa?

Anorexia is usually treated with a combination of:

  • individual therapy (usually including both cognitive and behavioral techniques)
  • family therapy
  • nutritional rehabilitation
  • behavior modification

Medication (usually antidepressants) may be helpful if your child also is feeling depressed. It's important to remember that family members play a vital supportive role in any treatment process.

If your child becomes really sick — the condition gets worse, causing unstable vital signs, for example — they will be admitted to the hospital. Inpatients are placed on the "Restrictive Eating" clinical practice guideline. This means they meet with the same types of caregivers as an outpatient would, while participating in a special meal plan with customized weight gain goals.

What is the long-term outlook for a child with anorexia nervosa?

Treatment for anorexia nervosa is a slow process that may last years. The vast majority of adolescents suffering from anorexia will enter a recovery phase, but there may be a lifelong struggle with food and consequent weight loss or gain.The mortality rate for adolescents with anorexia is between three to five percent, and is usually caused by a cardiovascular problem such as heart failure. Suicide is also a significant risk in older adolescents.