Early onset eating disorders in male adolescents: a series of 10 inpatients

Objective : This case series aims to describe the demographic and clinical features of male inpatients with early onset eating disorders. Method : Retrospective review was made of medical files of male patients treated for eating disorders at two children's hospitals over a 2 year period, with an onset of eating disorder before age 14 years, presenting for index admission. Demographic characteristics, DSM-IV diagnosis, clinical characteristics and treatment received were reviewed. Results : Ten male patients with a median age of 12.8 years (range 10.2 to 13.5) were identified; three met the full criteria for anorexia nervosa (AN) and four met all except the weight criterion. There was high psychiatric comorbidity: four with a major depressive episode, seven an anxiety disorder, three with obsessive-compulsive disorder (OCD) symptoms. Seven engaged in over-exercise. Seven were treated with an antidepressant, and five with an atypical antipsychotic; six required nasogastric tube (NGT) feeding. Conclusion : A minority of patients met full diagnostic criteria for AN, with many not meeting weight criteria despite medical instability. The main clinical features were food restriction, over-exercise and psychiatric comorbidity. Treatment with antidepressants, antipsychotics and NGT feeding was frequent. Future prospective studies could help identify gender-specific features as well as benefits and potential side effects of pharmacotherapy in this age group.