Children barely into their teens are developing a potentially fatal eating disorder, with new research showing the average age for developing anorexia nervosa is now 13 years.
The authors express concern about the potential effects of orthodontic treatment on eating patterns — that dental work resulting in oral pain may have a bearing on the development of an eating disorder. They say this needed further study.
The researchers at Temple Street Children’s Hospital in Dublin note that a number of children had commenced orthodontic treatment prior to the onset of anorexia.
“When braces are fitted and frequently adjusted, the teeth loosen and move causing pain. Oral pain must be considered in cases of unintentional weight loss which could later precipitate disordered eating,” the report states.
It says dental professionals may sometimes discourage certain foods if they interfere with treatment, “which the ‘perfectionist’ child may over-interpret”.
“Future research should explore the relationship of orthodontics to weight loss.”
The young age at which children with the mental illness are being admitted to hospital has dropped six months in the last decade, from age 14 in 2002 to 13-and-a-half.
With an estimated six-month delay between onset of symptoms and seeking treatment for the illness, the researchers warn that “without prompt intervention”, the prognosis can get worse. It can also make weight restoration “more challenging as energy requirements can be greater at low weight”.
The Study of Anorexia Nervosa in Inpatients at a Children’s Hospital (2005-11) found that girls admitted to Temple Street were more underweight than boys, even though they showed up sooner for treatment following onset of symptoms.
Aside from low weight, over-exercising and food restricting were the most common presenting features.
On admission, it was noted that 25% of patients were known to have been vomiting and 65% over-exercising. All patients were restricting food intake. All the girls who had reached menarche (had their first period) had stopped menstruating.
Between 2005 and 2011, 20 children were admitted to Temple Street with anorexia nervosa, which the researchers said represented a 130% increase.
Of those hospitalised, the average length of stay was 38 days. While girls accounted for the majority of inpatients, 30% were boys, which the authors say indicates increasing prevalence of anorexia nervosa in males.
The study says while anorexia nervosa is best treated in the community, it is most successful when treated in the early stage. In this respect, the study says awareness at a community level of signs and symptoms may facilitate earlier treatment and negate the need for hospitalisation.
The authors or the report warn that anorexia nervosa “may look different nowadays and we must be ahead of the curve given its’ high mortality rate”.
They conclude that provisions will need to be made in the planning of the new paediatric hospital for dedicated beds and specialist medical, nursing, and dietetic posts.
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