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Anorexia Nervosa in Children

Medically reviewed by Last updated on Oct 3, 2022.

What is anorexia nervosa?

Anorexia nervosa is an eating disorder that can lead to severe weight loss. Anorexia may cause your child to stop eating or to eat fewer calories than her or his body needs. The weight loss is not related to another medical condition.

What increases my child's risk for anorexia nervosa?

Anorexia happens most often during teenage years, but younger children can also have anorexia. The following may increase your child's risk:

  • Early puberty that causes normal but unwanted weight gain
  • A desire to be perfect in everything your child does and how she or he looks
  • Participation in sports or activities that require a low weight
  • Constant dieting to lose weight
  • Being female
  • A family history of an eating disorder
  • Obsessive-compulsive disorder (OCD)
  • Trouble accepting how her or his body looks
  • Pressure from others to be thin
  • A recent loss or separation

What are the signs and symptoms of anorexia nervosa?

  • Body weight that is much lower than is healthy for your child's height and age
  • Fear of gaining weight, even if your child is very thin
  • Spending a lot of time thinking about food and how to lose more weight
  • Restricting food, measuring or weighing everything she or he eats, or not eating at all
  • Eating large amounts quickly and then purging (vomiting or using laxative) to prevent weight gain
  • Exercising too much to prevent weight gain
  • Feeling tired, dizzy, weak, or cold much of the time
  • Cracked or dry skin, thinning hair, or fine hair covering your child's body
  • Nails that break easily
  • Mood control problems, such as easily becoming angry, or depression

How is anorexia nervosa diagnosed?

Your child's healthcare provider will examine your child and check his or her height and weight. You and your child may be asked to fill out forms about your child's eating habits. The provider may ask how your child controls his or her weight. Your child may have a hard time talking about his or her weight or about not eating. He or she may also have trouble asking for help. The provider may recommend your child talk to an eating disorder expert who specializes in helping children or adolescents. The following tests can help your child's healthcare provider understand how anorexia may be affecting his or her body:

  • Blood tests will show if your child is getting enough iron, calcium, and other nutrients.
  • Urine tests may be used to check for signs of dehydration.
  • Bone density pictures may show bone loss that anorexia can cause. Your child's risk for bone loss is higher if she is female and no longer has a monthly period.

  • An EKG may be used to check the electrical activity of your child's heart. Anorexia can lead to heart rhythm problems.

How is anorexia nervosa treated?

Your child may feel like it will be hard to get better. She or he may have a lot of feelings about eating and reaching a healthy body weight. Treatment is meant to help your child develop a healthy relationship with food. Treatment may also be needed for health problems caused by anorexia. Treatment may need to take place in a hospital or clinic.

  • Counseling is an important part of treatment. Your child may work with healthcare providers alone or in a group. Group counseling is a way for your child to talk with others who have anorexia. Counseling may center on helping your child replace negative thoughts with positive thoughts. Family sessions can help everyone in the family understand anorexia and what to do to help your child.
  • Nutrition therapy means you and your child will meet with a dietitian to plan healthy meals. Others in your family may also meet with the dietitian. Healthcare providers and dietitians will work with your child to make small changes over time.
  • Medicines are sometimes used to help treat anorexia or the health problems it causes. Depending on your child's age, she or he may get medicine to help improve mood, control mood swings, or decrease obsessive thoughts. Vitamin or mineral supplements may also be needed if your child's nutrient levels are low because of anorexia.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

What can I do to care for my child?

  • Be patient. Recovery from anorexia is a process that takes time. Do not punish your child for not eating. Do not try to force your child to eat. Your child may have times when she or he goes back to not eating, or eating few calories. This is common. Work with healthcare providers to help your child get back on track with healthy eating and healthy exercise. Try not to be angry with your child for the episode. Encourage your child to talk about her or his feelings with you or someone else she or he trusts.
  • Help your child focus on a healthy self-esteem. Ask your child what she or he likes about herself or himself. It may also help to tell your child everything you like about her or him. Focus on other things than appearance. For example, your child may be a talented artist, or she or he may write well. Ask others not to comment on your child's weight or shape. Your healthcare provider can tell you healthy weight ranges for your child's age and height. It may take time before your child is comfortable knowing her or his weight or seeing weight as healthy. Help your child build a healthy self-esteem and to be patient as she or he changes her or his thinking.

Where can I get support and more information?

  • National Eating Disorders Association
    165 West 46th Street
    New York , NY 10036
    Phone: 1- 212 - 575-6200
    Phone: 1- 800 - 931-2237
    Web Address:
  • National Institute of Mental Health (NIMH), Office of Science Policy, Planning, and Communications
    6001 Executive Boulevard, Room 6200, MSC 9663
    Bethesda , MD 20892-9663
    Phone: 1- 301 - 443-4513
    Phone: 1- 866 - 615-6464
    Web Address:

Call your local emergency number (911 in the US) for any of the following:

  • Your child says she or he wants to harm or kill herself or himself.
  • Your child has pain when she or he swallows, or severe chest or abdominal pain.
  • Your child's heart is beating fast or fluttering, or she or he feels dizzy or faint.

When should I seek immediate care?

  • Your child's muscles are weak, and she or he has pain and stiffness.

When should I call my child's doctor?

  • Your child has tingling in her or his hands or feet.
  • Your female child's monthly period is light or has stopped completely.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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