High Prevalence of Eating Disorders in the ED

Almost there in recognizing that fatosity itself is an eating disorder of choice.

The prevalence of eating disorders among teens who present to the emergency department (ED) is much higher than previously thought, new research shows.

Suzanne Dooley-Hash, MD, and colleagues from the University of Michigan, in Ann Arbor, found that 16% of patients between 14 and 20 years of age screened positive for an eating disorder during an ED visit for any reason.

Males accounted for 26.6% of all eating disorders identified during the ED visit; no difference in eating disorder rates was observed across ethnic or income groups.

"One of the reasons I was interested in this subject is because I think eating disorders are underdiagnosed, so that was the initial reason for doing this study," Dr. Dooley-Hash told Medscape Medical News.

"Our prevalence figures may be slightly higher than elsewhere, as Ann Arbor is a college town and these are the people at risk for eating disorders.

"But a lot of the more recent studies have been finding similar numbers, and we also think it is more common in males than ever before as well."

The study is published in the November issue of the International Journal of Eating Disorders.

Binging Most Common

Patients aged 14 to 20 years who presented to the ED of the University of Michigan Medical Center in Ann Arbor from October 15, 2010, to March 1, 2011, were eligible for screening.

Patients were first instructed on the use of a touchscreen tablet computer, which they used to complete a 20-minute screening survey.

A modified version of a validated self-report questionnaire, the SCOFF, was used to screen for the presence of eating disorders.

The abbreviated Patient Health Questionnaire 2 (PHQ-2) was used to measure depressive symptoms as well.

The first 3 questions on the 10-item Alcohol Use Disorders Identification Test (AUDIT)-C were also used to assess for risk drinking behavior during the past 3 months.

A total of 942 ED patients (mean age, 17.7 years) completed the computerized questionnaires.

Analysis of baseline characteristics in those who screened positive for an eating disorder showed that they were 2.6 times more likely to be female ( P < .001). Average body mass index (BMI) was also higher in patients with eating disorders, at 26.0 vs 23.2 for those with no eating disorder. They were also over 3 times more likely to be obese than those with no eating disorder.

But not quite.

Just come out and say it - eating to the point of getting fat is a disorder of choice.