Eating Disorder Rates Similar in Young Girls and Boys
Eating Disorder Rates Similar in Young Girls and Boys: Researchers suggest sex differences may not emerge until adolescence
Among young children, the prevalence of eating disorders was similar between girls and boys, according to researchers.
In a large, nationally representative sample of American children, ages 9 to 10 years, about 1.4% (95% CI 1.0%-1.8%) had a diagnosed eating disorder according to DSM-5 criteria, reported Aaron Blashill, PhD, of San Diego State University, and colleagues in a research letter in JAMA Pediatrics.
Diagnoses were numerically more common in boys, but the difference did not reach statistical significance (P=0.28):
- Boys: 1.6% (95% CI 1.1%-2.3%)
- Girls: 1.1% (95% CI 0.7%-1.8%)
Across the clinical subtypes of eating disorders, other specified feeding and eating disorders (OSFED) was the most prevalent type, followed by binge eating disorder:
- Anorexia nervosa: 0.1% (95% CI 0.0%-0.3%)
- Bulimia nervosa: no cases identified
- Binge eating disorder: 0.6% (95% CI 0.4%-0.9%)
- OSFED: 0.7% (95% CI 0.5%-1.0%)
"The prevalence of early-onset EDs [eating disorders] has increased in the past several decades, with younger children more likely than adolescents to experience psychiatric comorbidity," the authors explained.
The analysis included data on over 4,500 children (majority were boys and white) who participated in the Adolescent Brain Cognitive Development (ABCD) study. One parent or guardian for each of these children completed the online Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), which was used to determine diagnoses based upon DSM-5 criteria for eating disorders.
The researchers also looked at prevalence rates for OSFED of the bulimia nervosa type and the OSFED binge eating disorder type separately. The diagnostic criteria for these subtypes included all the same criteria as bulimia nervosa and binge eating disorder, but seen at a lower frequency or shorter duration of behaviors. Following similar patterns for prevalence, OSFED of the binge eating type (0.6%, 95% CI 0.4%-0.9%) was more common compared with the OSFED bulimia type (0.1%, 95% CI 0.0%-0.3%).
Overall, there weren't any statistically significant differences in prevalences rates for any of these five clinical subtypes of eating disorders.
Prior research, however, has suggested significantly more females, ages 13 to 18 years, have been diagnosed with bulimia and binge eating disorders. "Taken together, sex differences in [eating disorders] may not emerge until adolescence. This is consistent with previous research demonstrating a lack of prepubertal sex differences in EDs, with elevated prevalence of EDs in girls during and after puberty," the researchers noted.
Blashill and colleagues also noted that this ABCD cohort will be followed up for an additional 10 years, and they recommended other researchers "harness this nationally representative, prospective data set to explore developmental risk factors for EDs."
Study limitations included a low overall prevalence of eating disorders among the sample, which the group suggested may have reduced the statistical power needed to identify significant prevalence differences between girls and boys. The exclusion of OSFED anorexia was another limitation.