Liver Involvement in Pediatric and Adult Patients with Anorexia Nervosa

Background: Feeding and eating disorders, including anorexia nervosa, are among the leading causes of malnutrition in industrialized countries. Hepatic involvement is an increasingly recognized complication in these patients.The aim of this study was to investigate the prevalence and severity of liver dysfunction in pediatric and adult patients with anorexia nervosa and to evaluate the effect of nutritional rehabilitation over a 12-month follow-up period. Methods: A retrospective single-center study was conducted, including pediatric and adult patients. Liver involvement was assessed via biochemical markers and abdominal ultrasonography. These parameters were analyzed in relation to nutritional status and duration of illness. Findings were compared between pediatric and adult patients. Results: 100 consecutive patients were enrolled (59 children and 41 adults). Hypertransaminasemia was identified in 30.5% of pediatric and 36.6% of adult patients. Liver steatosis was detected in 61% and 56% of children and adults, respectively. Other main causes of liver diseases were excluded in all cases. Severity of liver impairment significantly correlated with malnutrition status. Following nutritional rehabilitation, 86.7% of patients normalized liver enzyme levels, and improvement grade was significantly correlated with weight gain (r = 0.61, p < 0.001). Conclusions: Liver involvement is common in both pediatric and adult patients with feeding and eating disorders, with severity closely linked to nutritional status and improvement following nutritional rehabilitation. It remains important to exclude other causes of liver disease. Overall, our findings support the importance of routine liver function monitoring in patients with eating disorders and emphasize the need for timely multidisciplinary interventions that address both somatic and psychiatric aspects of care.