Teens and Eating Disorders
Eating disorders are a big and largely untreated challenge for adolescents. The Archives of General Psychiatry published an interesting article by Sonja Swanson (Arch Gen Psychiatry 2011; 68(7):714-723) containing the findings of a national survey in which adolescents were asked about eating disorders. Here are a few of my key takeaways:
In NYC, more than 25,000 young people suffer from eating disorders.
Prevalence rates for anorexia, bulimia, and binge eating among adolescents were .3%, .9%, and 1.6%, respectively.
The number more than doubles when subthreshold adolescents are included.
“Subthreshold” means that many—but not all—diagnostic criteria were met. Other studies have yielded even higher prevalences when subthreshold patients are included (14-22%).
Don’t think this is just an UES problem.
Measures of socioeconomic status (parental education, income, marital status) were not associated with higher prevalence. And ethnic differences were mixed; for example, Hispanic adolescents reported the highest prevalence for bulimia and non-Hispanic whites tended to report more anorexia.
Don’t overlook binge eating.
The prevalence of binge eating was more than anorexia and bulimia combined.
It’s not just about girls.
The prevalence of anorexia in boys and girls is equal. With bulimia and binge eating, about one boy is affected for every three girls.
Age of onset is young.
The median ages at onset of anorexia, bulimia, and binge eating were 12.3, 12.4, and 12.6, respectively.
These kids usually have other issues.
The majority of those with an eating disorder met criteria for at least one other behavioral diagnosis (e.g. major depression, anxiety disorder, substance abuse). Many of them (e.g. 89% of those with anorexia) reported social impairment. And more than a third of those with an eating disorder reported thoughts of suicide.
Too many of these adolescents go untreated.
The good news is that most of them received some sort of treatment for an emotional or behavioral problem. The bad news is that far fewer got treatment specifically for their eating disorder.
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