by EBSCO Medical Review Board
(Anorexia Nervosa in Children)


Anorexia is an eating disorder marked by very low food intake and/or excess physical activity. It is often driven by fears of weight gain and distorted body image. Anorexia can lead to severe symptoms, such as stunted growth, bone loss, damage to major organs such as the heart, and even death.


The cause of anorexia in children is not known. It appears that genetics and world around them play a role.

Risk Factors

Anorexia can occur in both girls and boys, but is much more common in girls. Things that increase your child’s risk of anorexia include:

  • Family history of eating disorders
  • Low self-esteem
  • Intense drive for perfection
  • Fear of becoming overweight
  • Feels pressure to be thin
  • Activity in which body image is major issue, such as gymnastics and fashion modeling
  • Mood disorders, such as anxiety, or obsessional traits
  • History of emotional or sexual child abuse


It may take some time for physical sins to appear. Behaviors that may show up first include:

  • Feels they are overweight even if it is not true
  • Obsession with food
  • Harsh limits on food or food groups even when thin
  • Fear of overweight even if they are losing weight
  • Excess exercise
  • Self-induced vomiting
  • Abuse of laxatives
  • Denies hunger

Physical symptoms may include:

  • Changes in weight, such as slow weight gain or weight loss
  • Loss of menstrual periods or delay in the start of periods
  • Feeling cold, especially in the hands and feet
  • Changes is body temperature
  • Hair loss and/or growth of fine hair on the body
  • Fainting or severe lightheadedness
  • Constipation
  • Fatigue and muscle weakness
Body Dysmorphia
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The doctor will ask about child’s symptoms and past health. A physical exam and a psychological test will be done. The diagnosis will be based on information from questions and the exam.

Tests may be done to see what problems may be present. Tests may include:

  • Blood tests—to look for changes in electrolytes, vitamins, and other important nutrients
  • Electrocardiogram (EKG)—to look for heart changes
  • Bone density test—to test the health of bones


Management of anorexia will include:

  • Making sure the child is getting good nutrition
  • Talking about feelings and thoughts linked to anorexia
  • Finding and treating any problems caused by poor food intake

The length and intensity of treatment will vary. It may take many years to fully manage anorexia. Treatment should include more than one approach but may include:

Nutritional Support

Some dietitians focus on eating disorders. They can help to set weight and calorie goals. They can also sort through distorted nutrition information that someone with anorexia may have picked up. It is also important to relearn hunger cues.

Nutrition may need to be given through a tube. It is often only needed for those with severe nutrition problems. It may be used at the start or for those with a long-term problems.


Therapy can address harmful thought patterns, anxiety, and poor self-esteem. The goal is to develop a more positive attitude about food and body image.

There are different types of therapy. Treatment may include more than one type of therapy. Some therapy options include:

  • Family therapy—Family members can play a big role in thought process and recovery. Proper support and understanding from family can be helpful.
  • Cognitive behavioral therapy—Focuses on thought pattern to create a healthier and more realistic self-image.
  • Interpersonal therapy—To help balance relationship concerns with others.


Antidepressant medicine may help some children.


Severe anorexia can cause more serious health problems. A hospital stay may be needed. They will give needed nutrition or track problems such as heart disorder.

An inpatient program may help children who have not been helped by other treatment.


The cause of anorexia is complex. Not all can be prevented. Family habits can play a positive role in children's self-image. Helpful habits include:

  • Compliment inner qualities instead of their outward appearance.
  • Send positive messages about eating. Avoid making negative comments about your own body in front of your child.
  • Do not diet at home. Instead, focus on eating a healthy diet. Include and talk about whole grains, fruits, and vegetables.
  • Try to eat meals as a family.
  • Discuss media images of bodies and other harmful messages with your children.


Healthy Children—American Academy of Pediatrics 

Kids Health—Nemours Foundation 


Caring for Kids—Canadian 

Health Canada 


Anorexia nervosa. Boston Children’s Hospital website. Available at: Accessed August 23, 2020.

Anorexia nervosa. Child Mind Institute website. Available at: Accessed August 23, 2020.

Anorexia nervosa. EBSCO DynaMed website. Available at: . Accessed August 23, 2020.

Campbell K, Peebles R. Eating disorders in children and adolescents: state of the art review. Pediatrics. 2014 Sep;134(3):582-592. Available at:

Kids and eating disorders. Kids Health—Nemours Foundation website. Available at: Accessed August 23, 2020.

Revision Information