MEDICAL COMPLICATIONS IN MALE-ADOLESCENTS WITH ANOREXIA-NERVOSA

Purpose: Medical information on male anorectics is scant. We present d ata on 10 males with anorexia nervosa, who were treated at our Eating Disorders Center during a twelve-year period. Methods: Retrospective c hart review. Results: All patients were malnourished weighing 80% or l ess of their ideal body weight with a mean B.M.I. of 13.5 +/- 2.0. Hei ght below the 50th percentile was evident in 80% of the patients, and was below the 10th percentile in 30% of the patients. Structural brain changes on brain computerized tomography scans were noted in seven ou t of nine patients and more than 50% had mild anemia relative to the T anner stage. Other findings included a mean presenting heart rate of 6 8.3 +/- 17: four out of ten patients had presenting heart rates of 80 or greater and of these, three had serious medical problems and were s everely malnourished. Two patients had cardiac complications and one h ad a life-threatening electrolyte disturbance. Conclusion: Despite the small number of patients, the proportion of male adolescent anorectic s with medical. abnormalities seems high, and may be due to difficulti es in establishing the diagnosis and delay in seeking medical attentio n. Patients who had heart rates of 80 or greater were perhaps sicker a nd further along in their development of congestive heart failure, thu s explaining their initial relative tachycardia. We suggest a higher i ndex of suspicion for congestive heart failure and closer medical moni toring when a malnourished adolescent with anorexia nervosa presents w ith relatively elevated heart rates.