Anorexia nervosa with an early onset : Selection, gender, outcome, and results of a long-term follow-up study

Teen-age onset has been a characteristic trait of anorexia nervosa from the early descriptions and onward. Early onset may be defined by using an age limit or by using menarche as a biological age limit. A review of the literature indicates that there are relatively more boys among patients with an extremely early onset. When patients are recruited exclusively from clinics for children or from clinics for adults, various selection biases will result, having great importance for the interpretation of the findings. Results from a Swedish long-term study are presented showing outcome in patients with different age at onset. The general trend is that early onset is predicting a better outcome, but the long-term course is far from favorable in many early onset cases. There is a risk of intractable sequelae, e.g., short stature, if anorexia patients with an early onset are allowed to run a long or chronic course of illness.