Eating Disorders in Children: A Narrative Review

Abstract

This narrative review covers research from the years 2019-2024 on eating disorders in children. This research suggests that global prevalence rates have been highly variable, ranging from a low of .95% to 22% and the rates are increasing. The variability of rates may relate to different types of eating disorders or to age range differences of the samples, as the rates are higher for older children and those with less severe problems. Several different types are represented here including anorexia nervosa, bulimia nervosa, binge eating and avoidant/restrictive food intake disorder. Other feeding problems reviewed here are neophobia, picky eating, failure to thrive and obesity. A few comorbidities exacerbate feeding disorders including anxiety, depression, conduct disorder, obsessive-compulsive disorder and attention deficit/hyperactivity disorder. Predictors/risk factors have been the primary focus in this literature and have included perfectionism, appearance comparison and body image dissatisfaction. Both psychological and physical interventions have included family-based treatment and unguided internet cognitive behavioral therapy as well as manual therapies and herbal medicine. Surprisingly, only a couple papers were found on potential underlying mechanisms including a review of studies showing EEG waves suggestive of attention to visual food stimuli. Similarly, another group reported altered reward responses to food related stimuli on fMRIs as well as decreased gray matter volume and cortical thickness in areas of the brain associated with reward. The studies in this review highlight the prevalence and severity of eating disorders in children. However, they have been primarily based on parent-report surveys that have yielded mixed results across different types of eating disorders.