CHICAGO (AAP) -- According to a new policy statement from the American Academy of Pediatrics (AAP) entitled, "Identifying and Treating Eating Disorders," primary care pediatricians are in a unique position to detect the onset of eating disorders and stop their progression at the earliest stages of the illness.

The statement points out that the numbers of children and adolescents with eating disorders has increased steadily from the 1950s. In addition, during the past decade, the prevalence of obesity in children and adolescents has increased significantly, accompanied by an unhealthy emphasis on dieting and weight loss among children and adolescents. There have also been increasing concerns with weight-related issues in children at progressively younger ages.

It is estimated that one half of one percent of adolescent females in the United States have anorexia nervosa, that one to five percent meet criteria for bulimia nervosa, and that up to five to ten percent of all cases of eating disorders occur in males. These numbers, however, do not represent all those who have "disordered eating" as many young people have abnormal attitudes and eating behaviors, but don't technically meet the criteria for anorexia or bulimia.

Pediatricians can help families and children learn to apply the principles of nutrition and physical activity and to avoid an unhealthy emphasis on weight and dieting. In addition, pediatricians can implement screening strategies to detect the early onset of an eating disorder and be careful to avoid seemingly innocuous statements (such as, "you're just a little above the average weight") that can sometimes serve as the impetus for the onset of an eating disorder.

Policy recommendations indicate that pediatricians should:

• be knowledgeable about the early signs and symptoms of disordered eating and other related behaviors.
• be aware of the careful balance that needs to be in place to decrease the growing prevalence of eating disorders in children and adolescents. When counseling children on risk of obesity and healthy eating, care needs to be taken not to foster overaggressive dieting and to help children and adolescents build self-esteem while still addressing weight concerns.
• be familiar with the screening and counseling guidelines for disordered eating and other related behaviors.
• play a role in primary prevention through office visits and community- or school- based interventions with a focus on screening, education and advocacy.