The American Academy of Pediatrics (AAP) has officially released a new clinical report on guidance in identifying and managing eating disorders in both childrens and adolescents. Published in Pediatrics, these guidelines are a positive step in helping frontline providers in identifying and referring younger patients with the disorder early on.

This is a first for AAP.

The main authors, Dr. Hornberger and Dr Lane, review common diagnoses, outline the appropriate medical evaluation and present options for treatment. The earlier a child can receive appropriate treatment, the better (1).

The Academy is a reputable, highly regarded organization that has a deep reach, so this is beneficial for many families and physicians.

One key takeaway is that the average pediatrician should be well versed in risk factors, early signs and symptoms. The article also emphasized keeping an eye on both females and males; males being a group that can be overlooked. Hornbergers made a powerful statement, “For too long, eating disorders were considered a disease that afflicted mostly affluent White teenage girls. We know today that girls and boys of all ages, income levels and racial and ethnic groups struggle with eating disorders. Our hope is to help counter the stigma they may experience and provide an environment for open non-judgemental conversations.”

Here are some highlights of the newly released document:

Notable changes in DSM-5
- Binge-eating disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) were added.
Those with a “healthy, overweight or obese” with atypical AN might be overlooked by providers (2).
Screening all genders and sexual orientations for disordered eating behaviors.
Adolescents with chronic diseases that involve nutrition may be at risk (diabetes, cystic fibrosis, inflammatory bowel disease (IBD), and celiac disease) (2).
Orthorexia, the behavior of limiting foods in the diet based on how healthy they are, can be intertwined with disordered eating and should be considered .
Younger athletes should be screened often as weight and health are often part of training and programs.

The document itself promotes and brings awareness to the fact that pediatricians are in a special position to be able to screen and refer appropriately. They offer tools such as screens and suggest being mindful of growth and weight trends over time. As a practice, we are especially grateful for those pediatric and adolescent medical providers that are well versed in screening and treating eating disorders. THANK YOU!

1. https://www.stanfordchildrens.org/en/topic/default?id=anorexia-nervosa-in-children-90-P 02554

2. https://pediatrics.aappublications.org/content/147/1/e2020040279