Low body weight in young children could increase anorexia nervosa later

Low body weight in young children could increase anorexia nervosa later
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Published in the Journal of the American Academy of Child and Adolescent Psychiatry, low body weight in young children and anorexia nervosa may be dangerously linked.

A new study has discovered that a persistent low body mass index (BMI) in children, starting as young as 2 years old for boys and 4 years old for girls, may be a risk factor for the progress of anorexia nervosa in adolescence. The study also found that persistent high body weight in young children could also be a risk factor for later development of other eating disorders such as bulimia nervosa, binge-eating disorder, and purging disorder.

This large population study is based on data from 1,502 individuals who participated in the Avon Longitudinal Study of Parents and Children in the UK.

Identifying the risk

Zeynep Yilmaz, PhD, explains: “Until now, we have had very little guidance on how to identify children who might be at increased risk for developing eating disorders later in adolescence.”

Yilmaz is an assistant professor of psychiatry and genetics at the UNC Center of Excellence for Eating Disorders in the University of North Carolina School of Medicine, USA.

Yilmaz adds: “By looking at growth records of thousands of children across time, we saw early warning profiles that could signal children at risk.”

Co-author Cynthia Bulik, PhD, Distinguished Professor of Eating Disorders also from UNC adds: “Clinically, this means that paediatricians should be alert for children who fall off and stay below the growth curve throughout childhood. This could be an early warning sign of risk for anorexia nervosa.

“The same holds for children who exceed and remain above the growth curve–only their risk is increased for the other eating disorders such as bulimia nervosa and binge-eating disorder.”

We need to consider surrounding factors

Although eating disorders are psychiatric in nature and are considered to be a mental health disorder, the study highlights the need to also consider metabolic risk factors alongside psychological, sociocultural, and environmental components.

Yilmaz adds: “The differences in childhood body weight of adolescents who later developed eating disorders started to emerge at a very early age, way too early to be caused by social pressures to be thin or dieting.

“A more likely explanation is that underlying metabolic factors that are driven by genetics, could predispose these individuals to weight dysregulation. This aligns with our other genetic work that has highlighted a metabolic component to anorexia nervosa.”

Corresponding author of the study is Nadia Micali, concludes: “Our results also highlight the multi-factorial composition of eating disorders, as well as the need to develop early detection tools that could be used as part of routine checks by all paediatricians. Indeed, the earlier the problem is identified, the better it can be managed, especially if support is provided to the family as a whole, rather than just the individual.”

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