TY - JOUR T1 - Medical instability and growth of children and adolescents with early onset eating disorders JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 779 LP - 784 DO - 10.1136/archdischild-2011-301055 VL - 97 IS - 9 AU - Lee D Hudson AU - Dasha E Nicholls AU - Richard M Lynn AU - Russell M Viner Y1 - 2012/09/01 UR - http://adc.bmj.com/content/97/9/779.abstract N2 - Objective Little is known about the physical burden of early onset eating disorders (EOEDs). Most published data on physical instability and growth in malnutrition come from specialist centres, or from the developing world where aetiology differs. The authors present data on physical status at presentation from population-based surveillance systems in the UK and Ireland. Design Prospective surveillance study. Participants All suspected cases of EOED in children under 13 years of age reported by paediatricians and psychiatrists via the British Paediatric Surveillance System (BPSU) and Child and Adolescent Psychiatric Surveillance System (CAPSS) in the UK and Ireland from March 2005 to May 2006 (15 months). Results 208 cases were identified (24% reported by paediatricians). Median age was 11.8 years (IQR 1.74). 171 (82%) were female (78% premenarcheal and 60% prepubertal). 74% of males were prepubertal. 35% of cases had medical instability at presentation (60% bradycardia, 54% hypotension, 34% dehydration, 26% hypothermia). 52% of cases required admission at diagnosis (73% to a paediatric ward). 41% of cases with medical instability were not underweight, that is, they had body mass index (BMI) z-scores above −2.0 (2nd centile). Sensitivities for identifying medical instability with BMI z-score <−3 or 70% median BMI were 31% and 15%, respectively. Menarcheal status did not predict risk of medical instability. Conclusions EOEDs present with severe levels of physical instability and frequently to paediatricians. As anthropological indices alone are poor markers for medical instability, clinical assessment is essential. Doctors providing care for children have a central role in both the recognition and management of EOEDs. ER -