Untreated eating disorders can have lifelong (and expensive) medical consequences.

1. Society for Adolescent Medicine. Eating Disorders in Adolescents: Position Paper of the Society for Adolescent Medicine. J Adolescent Health. 1995; 16:476-480.
   • "...medical complications in adolescents that are potentially irreversible include growth retardation if the disorder occurs before closure of the epiphyses, pubertal or arrest, and impaired acquisition of peak bone mass during the second decade of life, increasing the risk of osteoporosis in adulthood. The features emphasize the importance of medical management and ongoing monitoring by physicians who understand normal adolescent growth and development."
     
     
2. Bachrack LK, Guido D, Katzman, D. et al. Decreased Bone Density in Adolescent Girlks with Anorexia Nervosa. Pediatrics. 1990; 86:440-447.
   
   
3. Kreipe RE, forbes GB. Osteoporosis: A "New Morbidity" for Dieting Female Adolescents. Pediatrics. 1990; 86:478-480.
   • Almost half of bone mass is laid down during the adolescent years. Osteopenia/osteoporosis develops as an early complication of anorexia nervosa in adolescents. Decreased weight is one of the strongest determinants of low bone mineral density. Reduction in bone mass may result in pathologic fractures acutely but may also have lifelong consequences.
     
     
4. Fisher M, Golden NH, Katzman DK, et al. Eating Disorders in Adolescents. J Adolescent Health. 1995; 16:420-437.
   
   • Growth retardation and short stature are known complications of AN and are most severe when the disorder develops before the pubertal growth spurt.
     
     
5. Katzman DK, Lambe EK, Mikulis DJ, et al. Cerebral Grey Matter and White Matter Volume Deficits in Adolescent Girls with Anorexia Nervosa. J. Pediatrics. 1996; 129:779-781.
   
   
6. Katzman DK and Zipursky RB. Adolescent with Anorexia Nervosa: Impact of the Disorder on Bones and Brain. Annals NY Academy of Sciences. 1997; 817:127-37.
   
   • Adolescent girls with anorexia nervosa being treated as inpatients had decreased brain volume affecting both grey matter and white matter. Subjects had only relatively brief illness duration. Brains changes have been shown to be somewhat reversible, but the extent to which these changes are fully reversible is unknown. Cognitive deficits are known to be present in malnourished patients with AN [anorexia nervosa]. The extent to which these changes are correlated to short-term and long-term cognitive impairments has not been adequately studied nor has the extent to which adequacy of re-feeding affects the reversibility of cognitive or structural brain changes. "Early and aggressive treatment is essential" to minimize the potential long term physical consequences of this disorder.
     
     
7. Rome ES, Ammerman S, Rosen DS, at al. Children and Adolescents with Eating Disorders: The State of the Art. Pediatrics. 2003; 111:e98-e108.
   
   • To avert potentially irreversible effects on physical growth and development, many children and adolescents require inpatient medical treatment even when weight loss, although rapid, has not been as severe as that suggesting a need for hospitalization in adult patients.