Bohon Cara, Le Grange Daniel, Attia Evelyn, Golden Neville H, Steinberg Dori
Equip Health, Carlsbad, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
J Eat Disord. 2025 Apr 11;13(1):66. doi: 10.1186/s40337-025-01254-6.
Several practice guidelines exist from professional organizations in the United States to support the assessment and management of eating disorders in children and adolescents. This manuscript synthesizes the key areas of overlap from these guidelines and provides directions for future research and alignment to improve care.
Consistent screening for eating disorders in primary care is recommended to ensure early identification and referral to treatment. Outpatient treatment supported by families, including family based treatment, is the first line of care recommended by guidelines. Multidisciplinary treatment teams benefit patients in covering the variety of aspects of health that eating disorders impact, including mental health, nutritional health, and physical health. Patients may require hospitalization under certain medical criteria such as bradycardia or specific lab abnormalities.
Guidelines show consensus on the importance of early identification and treatment access, involvement of family in treatment, and the use of a multidisciplinary treatment team. However, future work is needed to guide care of Avoidant/Restrictive Food Intake Disorder (ARFID), as well as the impact of weight inclusive care and the development of validated screening tools for children and adolescents for all eating disorders.
美国的专业组织制定了多项实践指南,以支持对儿童和青少年饮食失调的评估与管理。本手稿综合了这些指南中的关键重叠领域,并为未来的研究和改进护理的一致性提供了方向。
建议在初级保健中对饮食失调进行持续筛查,以确保早期识别并转诊接受治疗。由家庭支持的门诊治疗,包括基于家庭的治疗,是指南推荐的一线治疗方法。多学科治疗团队在涵盖饮食失调所影响的各种健康方面(包括心理健康、营养健康和身体健康)对患者有益。在某些医学标准下,如心动过缓或特定实验室异常,患者可能需要住院治疗。
指南在早期识别和获得治疗的重要性、家庭参与治疗以及使用多学科治疗团队方面达成了共识。然而,未来需要开展工作来指导回避/限制性食物摄入障碍(ARFID)的护理,以及体重包容性护理的影响,以及为所有饮食失调的儿童和青少年开发经过验证的筛查工具。