20,000 CHILDREN IN DANGER: STARVING TO DEATH; Anorexia is killing our kids.. and they're getting younger.

Byline: JOANNE McELGUNN

BETWEEN 10 and 15 per cent of children who develop a serious eating disorder will die.

That's the stark reality, according to Professor Fiona McNicholas, a psychiatrist of child and adolescent medicine at Crumlin Children's Hospital in Dublin.

She said: "It's a staggering statistic. Very few people realise the high mortality associated with eating disorders."

Prof McNicholas explained that half of those who die suffer a fatal heart attack or liver damage brought on by starvation.

A quarter will commit suicide in later life as they become overwhelmed by their inability to cope.

And the remaining 25 per cent will die in adulthood from medical complications such as chest infections.

Prof McNicholas said: "The biggest thing about eating disorders is that they have the highest mortality rate of all psychiatric disorders, higher even than schizophrenia.

"While the peak age for anorexia and bulimia is the 15 to 19 age group, much younger children are now coming to our attention.

"We don't have a particular number of beds set aside for children with eating disorders but there is always a huge demand for places.

"And younger children get sicker much faster as they have less body fat and any weight loss makes an immediate difference to their health.

"We get children coming into us with very low heart rates of only 30 beats a minute when the normal for a two to 10-year-old is 75 to 110 beats.

"Their weight loss has been drastic and they are very cold. They are critically unwell and need immediate attention.

"First we need to medically stabilise them by re-feeding them. Their weight will have dropped to a critical level and we must stabilise it. The child's heart will also be monitored.

"Once they are at a safe weight we begin psychiatric treatment to try to find out what their faulty thinking is and to challenge it.

"These kids, especially the girls, desperately want to be thin. Boys often explain that they lose weight in order to be healthy.

"The best outcome for any child is to have their illness detected early and receive immediate treatment."

A third of anorexic children who are hospitalised make a full recovery.

A further third will suffer minor relapses, especially when under stress.

But the rest will never recover and will always equate their self-esteem with how much they weigh.

Prof McNicholas explained: "These children have chronic eating disorders and they will always be counting calories.

"They can tell you how many calories are in an apple versus a bag of crisps.

"Some children do recover but it can take a long time, between three and four years. Others will have occasional relapses and will lose a bit of weight.

"They might be able to come out of it themselves or with the help of a counsellor."

Most children with anorexia spend at least three months in hospital when initially diagnosed.

Professor McNicholas said: "Some are very underweight when admitted and we would aim for a kilo a week increase in their weight.

"Some kids just want to get home and will eat anything, but others will totally refuse.

"If you have a girl of 11 who is refusing to eat then we get the consent of the parents to feed her. This may involve putting a tube through her nose into her stomach. It has to be done, otherwise she could die from malnutrition or a heart attack."

Professor McNicholas believes parents play a vital role in the recovery.

She said: "Parents must monitor their child in a way that is not intrusive. They must try and trust the child to eat, but must supervise them very closely.

"Parents must be knowledgeable about eating disorders in order to spot early symptoms of a relapse."

Symptoms include skipping meals, making trips to the bathroom after eating and becoming depressed and withdrawn.

Professor Hilary Hoey at Trinity College Dublin and National Children's Hospital, Tallaght, said if parents are worried about a child they should see their GP.

Professor Hoey said: "If a child is losing weight parents should take their child to the family doctor.

"If it's a medical problem that needs to be excluded straight away.

"But if it's anorexia the child needs professional psychological help.

"It's not that they won't eat. For some reason which we don't fully understand yet, they don't want to eat and need specialised help."

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