Essstörungen im Kindes- und Jugendalter

ZUSAMMENFASSUNG

Essstörungen sind ein häufiger Vorstellungsanlass in der pädiatrischen Praxis. Die Störung mit Vermeidung oder Einschränkung der Nahrungsaufnahme wurde neu in die ICD-11 aufgenommen. Sie betrifft in vielen Fällen das Klein- oder Schulkind und tritt vor allem bei Patienten mit zugrunde liegenden gastrointestinalen, neurologischen oder entwicklungsneurologischen Erkrankungen auf. Die wichtigste Differenzialdiagnose ist die kindliche Anorexia nervosa. Die jugendliche Anorexia nervosa ist eine der häufigsten chronischen Erkrankungen der Adoleszenz. Der Artikel stellt die Einteilung nach ICD-11 sowie neue Erkenntnisse zu deren Ätiologie, Diagnostik und Therapie dar. Dabei gelten neue Empfehlungen für die Realimentation. Eltern sind intensiv in die Behandlung einzubeziehen und übernehmen zu Beginn der Behandlung die Kontrolle über Essensmenge und Bewegungsverhalten. Lange vollstationäre Aufenthalte sind zu vermeiden. Die Bulimia nervosa und die Binge-Eating-Störung sind durch Heißhungerattacken gekennzeichnet. Dabei ist Binge Eating vielfach mit einer ausgeprägten Adipositas und psychischen Störungen wie Depressionen und Angststörungen assoziiert.

ABSTRACT

Eating disorders represent serious mental and physical disorders often primarily seen by pediatricians. Avoidant restrictive food intake disorder often diagnosed in early childhood is still quite a new diagnosis now included in ICD-11. This eating disorder often occurs in the context of gastrointestinal, neurological, or neuro-developmental conditions. The most important differential diagnosis is childhood anorexia nervosa. Adolescent anorexia nervosa often takes a chronic course. This article reviews new findings in etiology, diagnosis and treatment. New data suggest higher calorie refeeding to improve weight gain and shorten hospital stay. Parents are the most influential re-source in treatment of their child´s illness and must be mobilized to control their offspring´s eating behavior and physical hyperactivity. Bulimia nervosa and Binge Eating Disorder are characterized by binge eating episodes. Binge eating disorder is likely to co-occur with morbid obesity and mental disorders such as depression and anxiety disorders.

Schlüsselwörter

Essstörungen - Kindesalter - Jugendalter - Anorexia nervosa

Keywords

Eating disorders - childhood - adolescence - anorexia nervosa

Publication History

Article published online:
26 April 2021

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