Understanding Who Suffers From Eating Disorders

Illustration for article titled Understanding Who Suffers From Eating Disorders

A new study of adolescent eating disorders in the U.S. finds that they are far more prevalent than previously believed, and that the gender gap between male and female adolescents was far smaller than previously found. The study has the largest sample size of any previous study of its kind, and is the first population-based study to include the full adolescent age range — over 10,000 teens aged 13 to 18.

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The majority of adolescents in the study who had eating disorders were treated by mental health facilities for emotional or behavioral problems, though not necessarily for their eating disorder.

According to the study, which was kindly sent over to us in full,

"The sex ratio for most eating spectrum disorders in this study was generally smaller than that in prior treatment-seeking samples, and considerably smaller than the 9:1 ratio stated in the DSM-IV. The lack of a female preponderance of eating disorders could be attributable to either the methods of the present study or a true lack of a sex difference in eating disorders in adolescence. One indication that the difference may be genuine is provided by the large female to male ratio for [sub-threshold anorexia nervosa]."

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We're all heard the unfortunate term "manorexia" and how the female-focused imagery of eating disorders may inhibit male eating disorder sufferers from seeking care; here's some definitive, unfortunate proof that this spectrum doesn't solely affect women.

There was also cultural variance: Hispanic adolescents, for example, had the highest rates of bulimia, although the study's authors caution that they have not broken down the data for "immigration status, country of birth, and length of residence in the United States," which may have an impact. Also, "there was a trend toward ethnic minorities reporting more binge eating disorder, while non-Hispanic white adolescents tended to report more anorexia nervosa."

The study doesn't discuss religion, but another study released this week, which looked at about 500 students age 12-20 in Ceuta, a religiously diverse city that is in North Africa but part of Spain.

The incidence of eating disorders was found to be 2.3-fold higher among Muslim adolescents than among their Christian classmates. Similarly, body dissatisfaction was 1.8-fold higher in the former group. Finally, as a general conclusion, an average of one in four adolescents suffers some type of eating disorder, and 15% suffers body dissatisfaction.

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We're noted before that the vast majority of psych research is based on a very narrow sample — "an American college student is 4,000 times more likely than a non-American to be the subject of a psych study." The American study's authors note that comparison has previously been difficult to make between gender, race, and ethnicity because study methodology and samples have varied so widely. We may not know yet what accounts for it, but it's a step in the right direction.

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Prevalence And Correlates Of Eating Disorders In Adolescents [Archives Of General Psychiatry]
Eating Disorders and Body Dissatisfaction Is Double in Muslim Teenagers Than in Christian, Spanish Study Finds [Science Daily]
Over Half A Million US Teens Have Eating Disorder, But Few Have Sought Treatment [NYDN]

Earlier: Another Reason To Take Psych Research With Many Grains Of Salt

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DISCUSSION

So anybody want to help me to better understand my white 8 y.o. nephew who pretty much won't eat more than a few bites of the very, very limited items he likes (pretty much just french toast, cheese pizza, fries, chicken fingers and brown sugar poptarts)? We're way beyond picky eating. For instance, he and his brother stayed with me and my husband one weekend. My BIL specifically said that the nephew would eat at Bob Evans (there's only a few restaurants he will even go into, which is not helped by the fact that both parents let him control this decision) and had previously enjoyed the kid's french toast plate (which is two pieces of toast cut into quarters). Nephew ate two quarters of a slice and when I said he needed to eat one more before he could be done, he began dry heaving and essentially forced himself to throw up. At the table. In the middle of a restaurant. No, he did not have a stomach ache. His older brother didn't even bat a lash, just took his hand and went to the bathroom to clean him up because it is now normal for little brother to do this. My husband and I had heard from my BIL that Nephew had done this but we were still absolutely shocked. I don't know a single person with a healthy mental attitude about food who would sooner vomit than eat another quarter of a piece of bread. I have seen this kid eat 4 slices of pizza in one sitting, so I know he was not full. His parents are divorced and I guarantee that if the words "Your son has an eating disorder" came out of my mouth, my BIL would be extremely insulted (b/c everything is a criticism of him versus just family having a legitimate concern). Oh, and to further illustrate, the kid eats fries practically three meals a day but when I once served him tater tots, yeah he started to sob and dry-heave (I guess this was before he learned to take it to the level of actually vomiting). My husband and I have simply decided that from now on, we will not see or take the boys unless they have eaten beforehand. Lastly, he's 8 but looks about 5 or 6.