Identification of Risk Factors and Clinical Measures for Pediatric Eating Disorder Patients

Abstract

Eating disorders (EDs) commonly develop in childhood and adolescence. There is limited data on factors that assess levels of malnutrition in pediatric ED patients. The purpose of this study was; 1st, relationships were examined between resting energy expenditure (REE) and body mass index (BMI) and REE and body fat percentages in ED patients. 2nd; differences in BMI, REE, and body fat percentages were assessed based on hospitalization status, malnutrition category, age and presence of amenorrhea. Data were collected from medical files of 732 pediatric patients with an ED followed in a multidisciplinary outpatient clinic at Arkansas Children's Hospital from 1997 to 2013. We measured the following: 1) BMI, 2) degree of malnutrition (mild, moderate, severe), 3) REE scores, 4) presence of amenorrhea, and 5) body fat percentages. There was a statistically significant increase in BMI z‐scores from initial clinic visit (M= ‐0.54, SD=1.30) to final clinic visit (M= ‐0.15, SD=1.05), t(189)= ‐5.40, p<0.001. For all three malnourished groups, a statistically significant difference in mean body fat percentages was found: F (2, 74)= 4.28, p=.017. There was a small, positive correlation between REE and BMI, r=.27, n=577, p<.0001 and REE and body fat percentages, r=.15 n=231, p<.05. Lastly, there was a significant difference in REE in participants with amenorrhea (M=85.41, SD= 14.37) compared to participants without amenorrhea, M=93.70, SD=14.82; t(544) = ‐6.23, p<.001 and a significant difference in REE for hospitalized participants (M=85.16, SD= 14.10) compared to those that were not hospitalized, M=93.46, SD=14.85; t(588) = 6.50, p<.01. Our findings support the need for monitoring REE, BMI, body fat percentages, menstruation status, and BMI z‐scores in pediatric ED patients to increase quality of care.