17 - Eating disorders

Summary

Introduction

Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular, or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, but their occurrence in younger children has received little attention. Recently, a number of reports have described series of young patients, ages 8 years and above, with eating disorders (Fosson et al., 1987; Higgs et al., 1989; Gowers et al., 1991; Bryant-Waugh and Lask, 1995). The range of these disorders in children include selective eating, food avoidance emotional disorder, functional dysphagia, and pervasive refusal syndrome (discussed later in this chapter), as well as the more common conditions of anorexia nervosa and bulimia nervosa. In the medical literature, there have been an increasing number of studies published involving functional brain imaging in adults with eating disorders, and some of these studies have also included older adolescent subjects. There have been relatively few reports of functional imaging studies in children with eating disorders.

In this chapter, we will first provide background information, including theories of etiology concerning early-onset anorexia nervosa and bulimia nervosa. We will then review some of the structural and functional neuroimaging studies of eating disorders in the adult population. Finally, we will describe in detail the recent neuroimaging studies in children with anorexia nervosa.