Adolescent athletes are especially vulnerable to developing disordered eating behaviors. Risk factors include participation in sports where weight and lean body type are important, high-intensity training, pressure from coaches, and training and dieting beginning at an early age. Medical complications associated with these unhealthy dietary and weight-control practices and eating disorders can be potentially dangerous. Prevention strategies include minimizing the importance of weight, increased sensitivity on the part of those working with athletes for issues around weight and dieting, and appropriate education on proper weight-control methods and nutrition. The long-term prognosis is not known.

Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behaviour. Anorexia nervosa has been well documented in pre-pubertal children. Eating disorders are most prevalent in the Western cultures where food is in abundance and for females attractiveness is equated with thinness. Eating disorders are rare in countries like India. As Western sociocultural ideals become more widespread one may expect to see an increase in number of cases of eating disorders in non-Western societies. Etiological theories suggest a complex interaction among psychological, sociocultural, and biological factors. Patients with anorexia nervosa manifest weight loss, fear of becoming fat, and disturbances in how they experience their body weight and shape. Patients with bulimia nervosa present with recurrent episodes of binge eating and inappropriate methods of weight control such as self-induced vomiting, and abuse of diuretics and laxatives. Major complications of eating disorders include severe fluid and electrolyte disturbances and cardiac arrhythmias. The most common cause of death in anorexia nervosa is suicide. Management requires a team approach in which different professionals work together. Individual and family psychotherapy are effective in patients with anorexia nervosa and cognitive-behavioral therapy is effective in bulimia nervosa. Pharmacotherapy is not universally effective by itself. Patients with eating disorders suffer a chronic course of illness. The pediatrician plays important role in early diagnosis, management of medical complications, and psychological support to the patient and the family.

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The authors present core ideas or constructs that might be integral to a feminist and multicultural model of consultation. According to the model, the structure of consultation is (a) nonhierarchical and (b) an open triad (incorporating extrapersonal and outside factors). The process of consultation is (c) culturally responsive and (d) empowering. The role of the consultant is as (e) an agent for change and (f) an advocate for both the client and the system. Los autores y sus ideas centrales presente o construyentes quizás sea integral para una feminista y un modelo de la consulta multicultural. Según el modelo, la estructura de la consulta es (a) nonhierarchical y (b) una tríada abierta (incorporando extrapersonal y factores exteriores). El proceso de la consulta es (c) culturalmente receptiva y (d) autorizada. El papel del consultor es como (e) un agente para el cambio y (f) un defensor para el cliente y el sistema.

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