Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.

ABSTRACT. Background. Eating disorders in children and adolescents remain a serious cause of morbidity and mortality in children, adolescents, and young adults. The working knowledge of pathophysiology, recognition, and management of eating disorders continues to evolve as research in this field continues.Objectives. This article builds on previous background and position papers outlining issues relevant to the care of the adolescent patient with an eating disorder.Methods. The eating disorder special interest group from the Society for Adolescent Medicine recognized the need to update the state of the art published guidelines for the care of the adolescent patient with an eating disorder. This article was a multidisciplinary, group effort to summarize the current knowledge of best practice in the field.Results. This article summarizes newer findings on pathogenesis and etiology, prevention and screening, risk factors, nutritional issues, care from the primary care clinician's perspective, appropriate use of a multidisciplinary team, and issues of managed care and reimbursement.Conclusions. Primary prevention combined with early recognition and treatment helps decrease morbidity and mortality in adolescents with eating disorders. Pediatrics 2003;111:e98 -e108. URL: http://www. pediatrics.org/cgi/content/full/111/1/e98; adolescent, child, eating disorder, anorexia nervosa, bulimia nervosa.ABBREVIATIONS. AN, anorexia nervosa; BN, bulimia nervosa; ED-NOS, Eating disorder-not otherwise specified; BMI, body mass index. E ating disorders in children and adolescents continue to be a serious problem and may result in premature death or life-long medical and psychosocial morbidity. In 1995, the Journal of Adolescent Health published background and position papers outlining relevant issues in the care of the adolescent with an eating disorder. 1 This article provides an update on the state of the art for the child and adolescent with an eating disorder. Topics covered are pathogenesis and etiology, prevention and screening, risk factors, nutritional issues, aspects of care from a primary care clinician's perspective and goals for a multidisciplinary team, care in the inpatient and outpatient settings, use of clinical pathways, and issues of managed care and proper reimbursement. PATHOGENESIS AND ETIOLOGY OF EATING DISORDERSDespite increasing awareness of the major eating disorders, a specific etiology for the pathogenesis of anorexia nervosa (AN) and bulimia nervosa (BN) remains unclear. Rather than single factor causal theories, eating disorders are now viewed as multifactorial disorders with the symptom pattern representing a final common pathway. 2 Interest has focused variously on the contribution of environmental and social factors, psychological predisposition, and biological vulnerability, with recent familial aggregation studies renewing interest in the contribution of genetic predisposition.Dieting continues to be a common entry point in both syndromes, with the greatest risk being the group of severe dieters. 3 ...

Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The primary objectives of this clinical report are to define the ingredients of sports and energy drinks, categorize the similarities and differences between the products, and discuss misuses and abuses. Secondary objectives are to encourage screening during annual physical examinations for sports and energy drink use, to understand the reasons why youth consumption is widespread, and to improve education aimed at decreasing or eliminating the inappropriate use of these beverages by children and adolescents. Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents. Furthermore, frequent or excessive intake of caloric sports drinks can substantially increase the risk for overweight or obesity in children and adolescents. Discussion regarding the appropriate use of sports drinks in the youth athlete who participates regularly in endurance or high-intensity sports and vigorous physical activity is beyond the scope of this report. Pediatrics 2011;127:1182-1189 Sports and energy drinks are a large and growing beverage industry now marketed to children and adolescents for a variety of uses. Marketing strategies for sports drinks suggest optimization of athletic performance and replacement of fluid and electrolytes lost in sweat during and after exercise, and marketing strategies for energy drinks purport a boost in energy, decreased fatigue, enhanced concentration, and mental alertness. Sports drinks are different products than energy drinks; therefore, the terms should not be used interchangeably. Sports drinks are flavored beverages that often contain carbohydrates, minerals, electrolytes (eg, sodium, potassium, calcium, magnesium), and sometimes vitamins or other nutrients. Although the term "energy" can be perceived to imply calories, energy drinks typically contain stimulants, such as caffeine and guarana, with varying amounts of carbohydrate, protein, amino acids, vitamins, sodium, and other minerals.With children and adolescents, careful consideration is necessary when selecting a beverage to hydrate before, during, or after exercise and outside of physical activity to prevent excessive sugar and caloric intake that may encourage dental erosion, overweight, and obesity. 1

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