Somatic and mental aspects of anorexia nervosa: Basic knowledge of the diagnostics and treatment for pediatricians

ABSTRACT

Anorexia nervosa is the mental disorder with the highest mortality and is often associated with a chronic course. During the corona pandemic the number of patients in need of treatment significantly increased, especially for affected patients in childhood. In addition, there is an increasing prevalence of atypical anorexia nervosa characterized by normal or overweight but with similar somatic or psychiatric symptoms. The prevalence of anorexia nervosa in males is probably underestimated because clinicians are not well informed about its characteristics in the male sex. Somatic consequences of anorexia nervosa are mostly starvation-induced and can affect many organs. Depressive symptoms, anxiety and obsessive-compulsive disorders are the most frequent psychiatric comorbid disorders or sequelae. Besides an important genetic disposition, further biological risk factors are discussed for the etiology of anorexia nervosa. Treatment consists of somatic stabilization, achievement of a healthy body weight and psychotherapy. The parents should always be integrated into the treatment of children and adolescents with anorexia nervosa. Weight stabilization and its adjustment to growth are essential for a positive long-term outcome. The new concept of anorexia nervosa as a metabo-psychiatric disorder is associated with the hope of new research and treatment strategies.