The identification of children and adolescents with bulimia nervosa (BN) or syndromes including binge-eating has been an area of development in recent years. This chapter reviews this increasingly important area, providing an overview of the nature of these phenomena, risk factors for their development and the medical complications of these disorders. Few clinical research studies have specifically focused on the medical complications of binge eating disorder (BED) and BN in children and adolescents. Abnormalities of fluids and electrolytes, most commonly hypokalaemia, are found in children and adolescents with BN. Cardiovascular abnormalities occur in adolescents with BN and cause significant morbidity and mortality. Gastrointestinal complications occur frequently and are a major source of morbidity for patients with BN. Binge eating can result in gastric dilatation, necrosis and perforation. The chapter has attempted to provide a comprehensive review of the nature of BN and binge-eating symptoms in children and adolescents.

Ovarian hyperstimulation syndrome (OHSS) is characterized by ovarian enlargement and a shift of fluid from the intravascular to the extravascular space. OHSS is classified into mild OHSS, moderate OHSS, and severe OHSS. Vascular endothelial growth factor is a powerful mediator of vessel permeability. Angiogenin may play a role in neovascularization leading to the development of OHSS. The different complications of OHSS are vascular complications, liver dysfunction, renal complications, respiratory complications, and gastrointestinal complications. Current management of OHSS relies on the prediction and active prevention. Any patient undergoing ovarian stimulation is at risk of OHSS but it appears to be more frequent in younger women (aged less than 35 years) and women with polycystic ovarian syndrome (PCOS). This chapter discusses oestradiol monitoring of ovulation, ultrasonographic monitoring of OHSS, and prevention and treatment of OHS that includes basic treatment and surgical treatment.