Abstract
Feeding and Eating Disorders (FED) are mostly described in infants and adolescents but are less well-known in children. Information on the prevalence of FED in the general pediatric population is still limited. The aim of this study was to estimate the prevalence and the care pathway of FED in a population aged 0–18 years old, using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 classification. Two physicians interviewed 401 families using a questionnaire including demographics, BMI, dietary behavior data, and age-appropriate screening tools. Qualitative and quantitative variables were compared using the Chi2 test and Student’s t-test, respectively. After a headcount adjustment based on the French population by age group, the estimated prevalence rate was 3% [95%CI (1.7–5.1)] for Avoidant and Restrictive Food Intake Disorder (ARFID), and 9.7% [95%CI (7.2–13.0)] for Unspecified FED (UFED), which included other restrictive and compulsive FED. The median age for ARFID was 4.8 years (0.8–9 years), and 7.5 years (0.6–17 years) for UFED. The interviews did not identify cases of anorexia, bulimia, binge eating disorder, other specified FED, pica or rumination. Only 15.2% of children with an FED were receiving medical care. The development of validated pediatric screening tools, as well as the training of health professionals in children FED is necessary.
Highlights
The knowledge of Feeding and Eating Disorders (FED) in children and adolescents has evolved significantly since the 2000s
We identified 2.7% of patients with ARFID, median age 4.8 years (0.8–9 years) and 8.7% of patients with Unspecified FED (UFED), median age 7.5 years (0.6–17 years), p = 0.09
ARFID should not be confused with a normal and transient neophobia at the age of 6–9 months, or with a marked selective eating behavior that would not include the associate clinical features described in the ARFID DSM-5 definition and could be classified as UFED
Summary
The knowledge of Feeding and Eating Disorders (FED) in children and adolescents has evolved significantly since the 2000s. Descriptions of pediatric eating disorders (ED) were limited in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) to pica or rumination, while anorexia nervosa (AN) and bulimia nervosa (BN) were described in adolescents in the same way as in adults [1]. The classification of GOSH (Great Ormond Street Hospital, London, UK) was proposed for children aged from 6 to 13 years old, which included early AN, restrictive eating, selectivity/neophobia, emotional food avoidance, functional dysphagia and food refusal [4,5]. The first cases of binge eating disorders (BED) in children were described in the
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