Incidence Of Eating Disorders Research Articles

Weight gain in anorexia nervosa across age groups in higher levels of care.

Eating disorders (EDs) have historically been thought of as afflictions of younger women, but EDs do occur in midlife/older adults, and the incidence of EDs among older women may be increasing. The present study sought to examine outcomes for patients with anorexia nervosa needing to weight restore across four age groups: under 18, 18-25, 26-39, and 40+. Based on prior research, it was hypothesized that there would be no differences between the age groups in percent of expected body weight (%EBW) gained during treatment. Participants were 2,491 patients receiving treatment for an ED at a large multisite treatment facility offering higher levels of care. At this treatment facility, EBW is individualized for each patient, considering a patient's premorbid body weight and historical weight trends. Adult patients ages 26-39 (t = -3.58, p < .001) and ages 40+ (t = -4.70, p < .001) had significantly lower improvements in %EBW compared to adult patients ages 18-25. Child and adolescent patients (under 18) had significantly greater improvements in %EBW than adult patients (t = 14.30, p < .001). Findings from the present study suggest that targeted treatments may need to be developed to increase weight gain in midlife/older adults. In addition, efforts may need to be strengthened to keep adults in treatment longer than they may initially want to, particularly when treatment and weight gain become difficult. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

CO205 Impact of GLP-1A Treatment on Eating Disorder Incidence: A Comparative, Real World Data Study in Patients With and Without Pre-Existing Mental Health Conditions

CO205 Impact of GLP-1A Treatment on Eating Disorder Incidence: A Comparative, Real World Data Study in Patients With and Without Pre-Existing Mental Health Conditions

Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021.

The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military-dependent youth. This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021. Active duty and national guard military-dependent youth, aged 10-17 years, who received care in the MHS via TRICARE Prime insurance, were identified by one or more ICD-10 codes indicative of an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other-specified eating disorders). During the 6-year surveillance period, 2534 dependents received incident diagnoses of eating disorders, with a crude overall incidence rate of 1.75 cases per 10,000 person-years. The most common diagnosis was other-specified eating disorder, followed by anorexia nervosa, bulimia nervosa, and binge-eating disorder. The crude annual incidence rate of all eating disorder diagnoses increased by nearly 65% from 2016 to 2021. Rates for all diagnoses were highest in 2020 and 2021. Period prevalence estimateswere .08% for any eating disorder diagnosis, .01% for anorexia nervosa, .004% for bulimia nervosa, .004% for binge-eating disorder, and .06% for other-specified eating disorders. The observed increase in eating disorder diagnoses during the surveillance period appeared to be driven by female dependents. More military dependents experienced a new-onset diagnosis during the COVID-19 pandemic compared to previous years. These findings highlight the need for eating disorder screening, identification, and treatment for dependents within the MHS. Children of US military service members may be at increased risk for eating disorders. Results indicate new-onset eating disorder cases increased 65% from 2016 to 2021, primarily among girls compared to boys. The most diagnosed and fastest growing diagnosis was other-specified eating disorder. Rates of anorexia nervosa increased following the COVID-19 pandemic. Findings highlight the need for eating disorder screening, identification, and treatment within the military healthcare system.

The cost-effectiveness of a virtual intervention to prevent eating disorders in young women in Sweden.

To determine the cost-effectiveness of a virtual version of the Body Project (vBP), a cognitive dissonance-based program, to prevent eating disorders (ED) among young women with a subjective sense of body dissatisfaction in the Swedish context. A decision tree combined with a Markov model was developed to estimate the cost-effectiveness of the vBP in a clinical trial population of 149 young women (mean age 17 years) with body image concerns. Treatment effect was modeled using data from a trial investigating the effects of vBP compared to expressive writing (EW) and a do-nothing alternative. Population characteristics and intervention costs were sourced from the trial. Other parameters, including utilities, treatment costs for ED, and mortality were sourced from the literature. The model predicted the costs and quality-adjusted life years (QALYs) related to the prevention of incidence of ED in the modeled population until they reached 25 years of age. The study used both a cost-utility and return on investment (ROI) framework. In total, vBP yielded lower costs and larger QALYs than the alternatives. The ROI analysis denoted a return of US $152 for every USD invested in vBP over 8 years against the do-nothing alternative and US $105 against EW. vBP is likely to be cost-effective compared to both EW and a do-nothing alternative. The ROI from vBP is substantial and could be attractive information for decision makers for implementation of this intervention for young females at risk of developing ED. This study estimates that the vBP is cost-effective for the prevention of eating disorders among young women in the Swedish setting, and thus is a good investment of public resources.

Emergency Department Visits and Hospitalizations for Eating Disorders During the COVID-19 Pandemic.

Recent studies have reported increasing eating disorder incidence and severity following the coronavirus disease 2019 (COVID-19) pandemic. In a diverse cohort of pediatric hospitals, we examined trends in the volume of emergency visits and inpatient admissions for eating disorders before and during the pandemic. We examined monthly trends in volume of patients with eating disorders (identified by principal International Classification of Diseases, 10th Revision, diagnosis codes) across 38 hospitals in the Pediatric Health Information System pre- (January 2018-March 2020) and post-COVID-19 onset (April 2020-June 2022). Using interrupted time series analysis, we examined the pre- and post monthly trends in eating disorder emergency and inpatient volume. Before the pandemic, eating disorder emergency visit volume was increasing by 1.50 visits per month (P = .006), whereas in the first year postonset, visits increased by 12.9 per month (P < .001), followed by a 6.3 per month decrease in the second year postonset (P < .001). Pre-COVID-19, eating disorder inpatient volume was increasing by 1.70 admissions per month (P = .01). In the first year postonset, inpatient volume increased by 11.9 per month (P < .001), followed by a 7.6 per month decrease in the second year postonset (P < .001). The volume of patients seeking emergency and inpatient eating disorder care at pediatric hospitals has increased dramatically since the pandemic onset and has not returned to prepandemic levels despite a decline in the second year postonset, with important implications for hospital capacity.

6 Incidence of Eating Disorders During COVID-19: A Retrospective Review

Abstract Background The COVID-19 pandemic has had marked effects on mental health, including in pediatric populations. Pediatric patients have faced mental health concerns at increased rates including anxiety and depression. Furthermore, patients with eating disorders represent a vulnerable group who have been negatively impacted as well, as a result of lack of support, loss of in-person follow-up and increased relapse. In our centre, and nationally, clinicians have noted a trend towards increased eating disorder referrals and increased hospitalizations during the pandemic. Objectives The objective of this study was to determine the incidence, severity and triggers for eating disorders in the adolescent population during the COVID-19 pandemic and how it compares to the year prior. As well, the subset of patients who were hospitalized for medical stabilization were further analyzed to determine severity of illness. Design/Methods A retrospective chart review compared the first year of the COVID-19 pandemic (March 2020-March 2021), to the previous 12 months. Inclusion criteria included referrals to an eating disorder clinic and inpatient admissions to pediatrics or mental health services during the specified time frame. Data collected included age of onset, triggers, comorbid mental health conditions, and weight measures. Among hospitalized patients, orthostatic vital changes, need for NG feeds, length of medical stabilization and length of mental health hospitalization were included. Results Overall, 76 patients were included in the study. 44 (57.9%) were referred after COVID, which was significantly increased from the prior year (p=0.05). On average, patients presented at a younger age (14.2 ± 2.3 vs. 14.9 ± 1.9; p=0.08). Pre-COVID, approximately 44% of referrals were from family physicians and 19% from pediatrics. During COVID, approximately 39% were from family doctors and 25% from pediatricians. There was an increase in the number of patients requiring hospitalization for treatment (16 vs. 3), with 50% of the post-COVID admissions being direct from the ED Clinic on initial assessment. The reason for hospitalization was unstable vitals/ bradycardia in 68.7% of admissions; self-harm comprised the majority of the other admissions. Conclusion Our results support national and international reports that eating disorder incidence has increased during COVID-19. Patients described loss of routine, anxiety, and isolation as triggers related to the pandemic. Disruptions to daily life including school, sports, recreation, and relationships had profound effects on the mental health of children. The effect of social media on body image has also contributed. It is important for clinicians to screen for mental health conditions, including eating disorders at all available opportunities. Furthermore, this study demonstrates the need for increased services at our centre. Limitations for this study include that it is a single-centre study with a relatively small patient population. As well, it does not capture patients who may have been referred only to psychiatry.

Higher admission and rapid readmission rates among medically hospitalized youth with anorexia nervosa/atypical anorexia nervosa during COVID-19

The COVID-19 pandemic has had sweeping and deleterious effects on the well-being of individuals worldwide. Eating disorders (EDs) are no exception, with incidence and prevalence of EDs rising since COVID-19 onset. The current study examined inpatient census and readmission rates among youth (aged 8–18) hospitalized for medical complications of anorexia nervosa (AN) or atypical anorexia nervosa (AAN) throughout distinct periods of the COVID-19 pandemic, including pre-COVID-19 (n = 136), COVID-19 lockdown (n = 3), and post COVID-19 lockdown (n = 24). Data from the COVID-19 lockdown period was excluded from analyses due to low sample size. Youth hospitalized during post COVID-19 lockdown were over 8-times more likely to be readmitted within 30-days of discharge compared to patients hospitalized before the pandemic (p = .002). Further, the inpatient census of youth with AN/AAN was significantly higher during post COVID-19 lockdown compared to pre-COVID-19 (p = .04). One-third of patients hospitalized since the pandemic identified COVID-19 consequences as a primary correlate of their ED. Our findings, although not causal, suggest an association between COVID-19 and AN/AAN development and exacerbation in youth, thus prompting more medical admissions and rapid readmissions among this demographic. This study has important implications for understanding how AN/AAN onset and exacerbation in youth has been affected by the COVID-19 pandemic and can inform new efforts to support individuals navigating treatment during a global crisis.

Cost-Effectiveness Comparison of Delivery Modalities for a Dissonance-Based Eating Disorder Prevention Program over 4-Year Follow-Up

The cost-effectiveness of delivery methods for an eating disorder prevention program is reported. In an effectiveness trial (enrollment 2013-2015) comparing three formats (clinician-led, peer-led, and Internet-delivered) for delivering the Body Project eating disorder prevention program to college women versus an educational video control, the peer-led method was more effective than the three alternatives at preventing onset of eating disorders over 4-year follow-up. Eating disorder incidence was 19.3% for clinician-led groups, 8.1% for peer-led groups, 15.5% for Internet-based eBody Project participants, and 17.6% for educational video controls. Delivery costs per person are reported for the Body Project, including participant time, and the cost-effectiveness is calculated for peer-led groups versus the video control. Data analyses were conducted in 2019-2021. Delivery costs per person for the Body Project, including participant time, were approximately $96 for clinician-led groups, $80 for peer-led groups, and $22 for the eBody Project, compared with $9 for the educational video control. For each additional case of eating disorder onset that was prevented by the peer-led groups, compared with the video control, the cost was about $740. There were no differences in health care utilization across condition. Eating disorder prevention costs via the Body Project compare very favorably with the costs for treating an eating disorder, which previously have been estimated to range from approximately $20,300 for cognitive-behavioral therapy for bulimia nervosa to approximately $119,200 for adequate care treatment of anorexia nervosa. These analyses demonstrate the economic value of the Body Project for preventing eating disorders among college-age women when delivered in peer-facilitated groups. ClinicalTrials.gov Identifier: NCT01949649.

Prevalence of Eating Disorders and Their Association with a Previously Suffered Concussion Among Student-Athletes at a Power Five Conference University

Abstract Objectives Estimate the prevalence of eating disorders (ED) and their association with a previously suffered concussion among student-athletes at a Power Five conference university. Methods An observational, cross-sectional, and survey-based study was conducted among student-athletes of a Power Five conference university in Lubbock, Texas. Assessments of eating disorders were carried out using the Questionnaire for Eating Disorder Diagnoses (QEDD), which operationalizes ED criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Questionnaires were administered via the web-based survey platform Qualtrics. A total of 413 student-athletes were eligible for the study. Results Final analysis included data from 158 student-athletes across 11 different sports disciplines. A total of 7 respondents (4.4%, 95% CI: 1.9%, 9.2%) met diagnostic criteria for ED: 6 cases of Eating Disorder Not Otherwise Specified (EDNOS) and 1 case of non-purging bulimia. A majority of cases of EDNOS were observed among student athletes participating in Track &amp; Field (n = 4). Thirty-four respondents (21.5%, 95% CI: 15.5%, 28.9%) reported symptoms of ED but did not meet diagnostic criteria. Binging was the most prevalently reported symptom (n = 22, 65%). Statistical analysis of the incidence of ED and disordered eating among those with (n = 54), and without, a previous concussion demonstrated no significant difference (P = 1 and P = 0.7, respectively; Fisher's exact test). Conclusions An important prevalence of disordered eating behaviors seems to exist among this student-athlete population. However, no significant association with a previous concussion was found. Nonetheless, such results warrant for the implementation of effective screening measures and interventions for ED and associated symptoms considering their potential adverse effects on student-athletes’ long-term physical and mental health. Funding Sources Texas Tech University.

Estimation of Eating Disorders Prevalence by Age and Associations With Mortality in a Simulated Nationally Representative US Cohort

Eating disorders (EDs) are common psychiatric disorders associated with high mortality. However, data on ED disease dynamics and treatment coverage are sparse. To model the individual-level disease dynamics of ED from birth to age 40 years and to estimate the association of increased treatment coverage with ED-related mortality. In this decision analytical model study, an individual-level Markov state transition model was empirically calibrated in April 2019 using a Bayesian approach to synthesize available clinical and epidemiologic ED data. The simulation model was calibrated to nationally representative US survey data from 2007 and 2011. A virtual cohort of 100 000 individuals (50 000 [50%] male) was modeled from birth to age 40 years for 4 ED diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders. Age-specific ED incidence and mortality rates and background (all-cause) mortality. The main outcomes were age-specific 12-month and lifetime ED prevalence and number of deaths per 100 000 general population individuals by age 40 years. The mean and 95% uncertainty intervals (UIs) of 1000 simulations, accounting for stochastic and parameter uncertainty, are reported. The highest estimated mean annual prevalence of ED occurred at approximately age 21 years for both male individuals (7.4%; 95% UI, 3.5%-11.5%) and female individuals (10.3%; 95% UI, 7.0%-14.2%), with lifetime mean prevalence estimates increasing to 14.3% (95% UI, 9.7%-19.0%) for male individuals and 19.7% (95% UI, 15.8%-23.9%) for female individuals by age 40 years. Ninety-five percent of first-time cases occurred by age 25 years. Current treatment coverage averts an estimated mean of 41.7 deaths per 100 000 people (95% UI, 13.0-82.0 deaths per 100 000 people) by age 40 years, whereas increasing treatment coverage for all patients with ED could avert an estimated mean of 70.5 deaths per 100 000 people by age 40 years (95% UI, 26.0-143.0 deaths per 100 000 people). In this simulation modeling study, the estimated lifetime prevalence of ED was high, with approximately 1 in 7 male and 1 in 5 female individuals having an ED by age 40 years. The initial onset of EDs was highly concentrated during adolescence and young adulthood, suggesting that this is a critical period for prevention efforts. However, the high estimated prevalence of recurring ED later in life highlights the importance of identification and treatment of ED at older ages as well. These findings suggest that increasing treatment coverage could substantially reduce ED-related mortality.

The Role of Puberty and Ovarian Hormones in the Genetic Diathesis of Eating Disorders in Females.

Puberty is a critical risk period for eating disorders (EDs). ED incidence increases across the pubertal period and becomes female predominant, and genetic influences on disordered eating significantly increase. Surges of ovarian hormones, particularly estrogen, may drive this increasing genetic effect for EDs in pubertal girls and contribute to differential phenotypic presentations beyond puberty. In this article, we explain phenotypic associations between puberty and disordered eating and present evidence showing underlying genetic and hormonal influence. Potential benefits of communicating roles of genetic influence to people with or at risk for EDs are also discussed.

Eating Disorders in Males: An 8-Year Population-Based Observational Study.

The objective of the study was the realistic evaluation of the prevalence of eating disorders (ED) among Polish men who sought treatment through the National Health Fund (NFZ) in the years 2010–2017. According to ICD-10, four types of ED were analyzed: anorexia nervosa—AN (F50.0), atypical anorexia nervosa (F50.1), bulimia nervosa—BN (F50.2), and atypical bulimia nervosa (F50.3).The NFZ database was used. The ED groups were defined according to ICD-10 codes. Demographic data were collected from the web page of Statistics Poland (GUS). The annual prevalence of EDs was estimated, and the age groups were categorized into nine groups. For the incidence of EDs in male patients in the years 2010–2017, relative risk (RR) with 95% confidence interval (95% CI) was calculated.The frequency trend of AN in males remains relatively stable. AN occurred mainly in young men (between 11 and 30 years). It was noted that AN affected approximately 100 men in each year of observation, while atypical anorexia nervosa affected about 40 men. In 2017, the RR for EDs in young males was 0.041 (95% CI [0.033, 0.051]). Bulimia was relatively rare (about 35 males each year).The incidence of EDs in males is a relatively constant phenomenon. The real number of male patients with EDs may be higher. The current conceptualizations of ED pathology should be modified and better adapted to men. Clinical guidelines for specialists working with males with EDs should be developed.

\u201cOur daily life was mainly comprised of eating and sitting:\u201d a qualitative analysis of adolescents\u2019 experiences of inpatient eating disorder treatment in China

BackgroundSome individuals with Eating Disorders (EDs) require hospitalization to stabilize and improve life-threatening physical complications. The experiences of those receiving inpatient treatment for EDs are well-documented in western samples, but less is known about the experiences of those in China, the world’s most populous country in which the incidence of EDs may be increasing.MethodsThis qualitative study aimed to use Interpretative Phenomenological Analysis to understand the experiences of four adolescents receiving inpatient treatment for EDs in China. Individual, semi-structured interviews were conducted.ResultsFour themes emerged from the data: perceptions of the treatment received, peer influences during admission, the impact of treatment on wellbeing and participants’ sense of self.ConclusionsThis is the first published study on the experience of Chinese participants with EDs. Their experiences share commonalities with those reported by participants in Western studies and also illuminate differences in how EDs are understood and managed in inpatient settings in China. Cross-cultural collaborations will be important to share knowledge and practice.

Disaggregating the predictive effects of impaired psychosocial functioning on future DSM-5 eating disorder onset in high-risk female adolescents.

Impaired psychosocial functioning previously emerged as the only risk factor to predict future onset of each of the four Diagnostic and Statistical Manual of Mental Disorder (5th ed.) (DSM-5) eating disorders. The goal of this follow-up report was to refine understanding of this newly identified risk factor. Combining data from women at risk for eating disorders because of body image concerns (N = 1,153, mean age = 18.5 years, SD = 4.2), we investigated which subdomain(s) and individual item(s) of psychosocial functioning (friends, family, school, and work) at baseline predicted onset of any eating disorder, using Cox regression (CRA) and classification tree analysis (CTA). Psychosocial impairment with friends, family, and at school, but not at work, significantly increased risk for disorder onset over 3-year follow-up in univariate models. A one-unit increase in each domain raw score was associated with a 107, 22, and 43% increased hazard of eating disorder onset, respectively. Multivariate CRA found friends functioning, with a 92% increased hazard of disorder onset, contributed the strongest unique effect. CTA suggested that loneliness was the most potent risk factor with a threefold increased onset risk (eating disorder incidence for high vs. low scorers was 27 and 8%). Three friends functioning items and one school functioning item produced additional CTA branches. Results refine understanding of the relation of psychosocial impairment to future onset of eating disorders, suggesting that peer functioning is the most critical. Data imply it would be useful to target young women with impaired psychosocial functioning in prevention programs.

National population-based data on the incidence, prevalence, and psychiatric comorbidity of eating disorders in Taiwanese adolescents and young adults.

Nationwide data on eating disorders (EDs) among East Asian populations are scarce. This study aimed to estimate the prevalence, incidence, and psychiatric comorbidities of EDs in Taiwan. Drawing from the National Health Research Institute database, we identified the study subjects aged 11-34 years who received an ED diagnosis during ambulatory visits or hospitalization from 2001 to 2012. We analyzed the subjects by age and gender. Diagnoses for comorbid psychiatric disorders were entered in the analysis only if they occurred within 1 year before or after the ED diagnosis date. Rates were age- and sex-adjusted to the average population within the study period. The estimated mean annual incidence was approximately 11.11 (95% CI 10.51-11.72) per 100,000 residents, and the 1 year prevalence was 20.87 (95% CI 20.05-21.70) per 100,000 residents, with evidence of female predominance (female/male ratio = 10.95, 95% CI = 8.97-13.36). Incidence and prevalence peaked at ages 20-24 in females and at ages 25-29 in males. Both rates nearly doubled within a decade. Specifically, the anorexia nervosa trend recently stabilized in females and decreased in males, while that for bulimia nervosa increased in both females and males. The most common comorbid diagnoses were anxiety (53%) and major depressive disorders (22%). The incidence and prevalence of EDs were lower in Taiwan than in Western countries. However, these rates were rapidly rising, notably in males. The majority of Taiwanese ED patients also received a diagnosis for various psychiatric comorbidities, a finding worthy of clinical attention.

Time trends in healthcare-detected incidence of anorexia nervosa and bulimia nervosa in the Norwegian National Patient Register (2010-2016).

Few studies have investigated temporal trends in the incidence of eating disorders (EDs). This study investigated time trends in the age- and sex-specific incidence of healthcare-detected anorexia nervosa (AN) and bulimia nervosa (BN) from 2010 to 2016. Data were retrieved from the Norwegian National Patient Register as defined by the International Classification of Diseases (ICD-10): narrowly defined AN (F50.0), broadly defined AN (F50.0 + 50.1), narrowly defined BN (F50.2), and broadly defined BN (F50.2 + 50.3). The average annual percent changes (AAPCs) in incidence rates (IRs) were examined by Joinpoint regression analyses. The overall (i.e., both genders, ages 10-49) rates of AN were stable across the 7-year period, with IRs ranging from 18.8 to 20.4 per 100,000 for narrowly defined AN and 33.2 to 39.5 per 100,000 for broadly defined AN, whereas overall rates of BN declined. Age- and gender-stratification revealed a significant average annual increase in AN (narrow and broad) among 10- to 14-year-old girls. The incidence of broadly defined AN also increased significantly among females aged 15-19 years between 2010 and 2012, before leveling off. Nearly universal declines in the incidence of narrowly and broadly defined BN among females occurred. IRs among males were stable and comparatively low, with no significant trends toward increasing or decreasing rates of AN or BN over time. Although register-based studies provide an underestimate of the true incidence and may not accurately reflect population-level changes in true ED occurrence, this study extends our knowledge regarding trends in the detected incidence of EDs into the second decade of the 21st century.

An experimental therapeutics test of whether adding dissonance-induction activities improves the effectiveness of a selective obesity and eating disorder prevention program.

Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition. College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments. Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d=-0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively). The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity.

Assessment of eating disorders in patients diagnosed with major depressive disorder

Introduction Evaluation of eating disorders in patients with major depression is an important part of the case management and a comprehensive approach to both psychopathological dimensions could lead to full remission of symptoms and a lower rate of relapse. Objectives To assess the incidence of eating disorders in patients diagnosed with major depressive disorder (MDD). Methods A group of 40 patients (female n =28, male n =12) diagnosed with MDD according to DSM 5 criteria, consecutively admitted in our department, were screened for eating disorders through a structured interview. Results A number of 12 patients (30%) reported a type of eating disorder: binge eating disorder ( n =6) of mild ( n =4), moderate ( n =1) or severe ( n =1) intensity; night eating syndrome ( n =2); purging disorder ( n =2); bulimia nervosa ( n =2) of mild ( n =1) and moderate ( n =1) severity. Obesity was recorded in a number of 10 patients (25%). Also, a number of 7 patients (17.5%) had several criteria for eating disorder (anorexia nervosa, bulimia nervosa or binge eating disorder), but insufficient to formulate a DSM 5 based diagnosis. A higher incidence of all the eating disorders and obesity was observed in women comparative to men (35.7% vs. 25%). Conclusions A structured assessment of eating disorders in patients diagnosed with major depressive disorder could bring to the clinician' attention underlying symptoms that may be neglected during a usual psychiatric interview, also these symptoms have a high impact over the case prognosis.

I’m really fat!

Introduction The eating disorders are changes in eating behaviour associated with distortions in the self-concept and self-image, pathological fear of getting fat, morbid motivation for thinness and changes in appetite and its control, with or without compensatory attitudes. In the DSM-5 and in the CID-10, the two fundamental diagnostics are anorexia nervosa and bulimia nervosa. Purpose Characterization of the Portuguese population concerning eating disorders incidence. Methods Bibliographic revision through Pubmed until 2013, using the keywords: anorexia nervosa, bulimia nervosa, eating disorders. Psychometric instruments like the Eating Disorder Examination 12th version (Cooper and Fairburn, 1987), Eating Attitudes Test/EAT-25 (Garner e Garfinkel, 1979) and the Eating Disorder Inventory (Garner et al., 1983; Machado et al., 2001) contributed for the characterization of the Eating Disorders in the Portuguese population. Results The Eating Disorders have a higher incidence in the young Caucasian woman, living in the urban area. The combination of the restrictive diet with intense physical exercise in the anorexia nervosa very often evolves with negative emotions. The emotional instability, namely the dysphoria, the anxiety and the sleep pattern changes are frequent. The bulimia nervosa initially manifests itself by restrictive diet, which evolves to excessive food intake episodes getting increasingly frequent and intense. Conclusions The Eating Disorders come from the gene-environment interaction and risk premorbid biological and psychological changes may result. These are inseparable from the interaction with the social context where the epigenetic mechanisms may play an important role. The reason for thinness, limitations at the level of interoception and obsessive-compulsive character traits are predisposing factors.

Sex- and age-specific incidence of healthcare-register-recorded eating disorders in the complete swedish 1979-2001 birth cohort.

To investigate the sex- and age-specific incidence of healthcare-register-recorded anorexia nervosa (AN) and other eating disorders (OED) in a complete birth cohort, and assess whether incidence varies by diagnostic period and (sub-) birth cohort. We used the actuarial method and Poisson models to examine the incidence of AN and OED from 1987 to 2009 (when individuals were 8-30 years old) for a cohort of 2.3 million individuals (48.7% female) born from 1979 to 2001 in Sweden, identified using Swedish registers. For both sexes, incidences of AN and OED increased considerably for diagnostic periods after 2000, but differed little by birth cohort. In 2009, AN incidence in the peak age category was 205.9 cases/100,000 persons (95% CI: 178.2, 233.5) for females (14-15 years), versus 12.8 cases/100,000 (95% CI: 5.6, 20.1) for males (12-13 years). OED incidence in the peak age category was 372.1 cases/100,000 (95% CI: 336.4, 407.9) for females (16-17 years), versus 22.2 cases/100,000 (95% CI: 13.3, 31.1) for males (14-15 years). Our finding of an increase in healthcare-register-recorded eating disorders for diagnostic periods after 2000 likely reflects improved detection and expanded register coverage in Sweden. The peak of eating disorder incidence in adolescence, which began unexpectedly early for AN in males, suggests the importance of vigilance for signs of AN in young boys and early primary prevention efforts. Waiting until later could miss critical windows for intervention that could prevent disorders from taking root.