1 in 5 young people up to 18 years old has an eating disorder – 02/20/2023 – Health

One in five young people aged 6 to 18 has an eating disorder. If not treated, the condition can lead to disorders such as bulimia, anorexia nervosa and binge eating disorder.

In girls, the proportion is even higher, reaching almost a third (30%) compared to boys (17%) of the same age.

The data are from a global study, which evaluated more than 63,000 children, published this Monday (20) in the scientific journal Jama Pediatrics. The work was led by José Francisco López-Gil, from the Center for Social and Medical Research at the University of Castilla-La Mancha (Spain), and Héctor Gutiérrez-Espinoza, from the University of the Americas (Ecuador).

The research consists of a meta-analysis (analysis of data from research already published, without making new empirical studies) of 32 studies with an audience in the range of 6 to 18 years in 16 countries, including Brazil.

Eating disorders are psychiatric disorders characterized by abnormal eating or behavior that affects weight control and can result in serious health problems. As there are several possible causes that can lead to the condition and because it has a psychic origin, its diagnosis is difficult.

Although they are more frequent in young adults and adolescents, eating disorders in children can progress to disorders in adulthood.

The incidence varies from country to country and is more common in middle- and high-income countries, while in low-income countries other factors, such as malnutrition and food insecurity, are more frequent in children and adolescents.

To assess the prevalence of eating disorders in childhood, the researchers only included studies with children aged 6 to 11 years or adolescents aged 12 to 18 and whose primary outcome was an eating disorder. Of the total number of participants, 51.8% were girls.

An effective methodology for finding signs of disordered eating is the SCOFF questionnaire (“sick”, “control”, “one”, “fat”, “food”. It consists of five questions with yes and no answers that count points to know if there is any disorder. If the child or adolescent scores two points or more, they may be referred for psychiatric evaluation for an eating disorder.

The research, then, only included studies that had this methodology in their initial analysis.

Around 14,000 (23.5%) of the total 63,181 children and adolescents considered in the study had shown some sign of an eating disorder, and this proportion was significantly higher in girls than in boys.

Another point observed is that the proportion of children and adolescents with eating disorders increased with age (three percentage points every two years) and body mass index (3 pp every 5 kg/m2).

The authors conclude that, using the SCOFF tool, about one-fifth of children in 16 countries have an eating disorder condition. This proportion is worrying for public health policies and highlights the need for prevention strategies.

According to the Global Study of the Burden of Psychiatric Diseases in the World, from 1990 to 2019, eating disorders are among the mental health conditions that most cause years of life lost, with an average of 318 deaths in 2019 from this cause.

The same study estimated that 3 million children may have an eating disorder worldwide.

According to a recent survey by the University of Oxford, the number of healthy weight children trying to lose weight grew between 1997 and 2016.

Many of the compulsions or eating disorders can be treated, although each case must be evaluated with psychiatrists and doctors for specific treatments.

Pay attention to the signs

Signs of anorexia may be:

• has exaggerated and rapid weight loss;
• refuses to participate in family meals;
• takes the plate to the room, but does not eat;
• is exaggeratedly concerned with the caloric value of food;
• maintains intense, rigid and exaggerated physical activity;
• have very dry skin covered with lanugo (newborn-like hair).

These may be signs of bulimia:

• frequently visits the bathroom right after meals;
• have stained or yellowed teeth;
• frequently uses laxatives and diuretics;
• maintains intense, rigid and exaggerated physical activity;
• has rituals related to food or eating (eating only one food or a specific group of foods, chewing food excessively, or avoiding food touching the lips when being placed in the mouth);
• eats very small portions of food;
• skips meals frequently;
• Wear loose clothing to hide body contours

^{Sources: Fátima Vasconcelos, director of the Brazilian Association of Psychiatry; Sophie Deram, nutritionist at Ambulim; Veruska Lastória Amigo, psychiatrist at the Attention to Eating Disorders Program (Proata/Unifesp); Camila Junqueira, therapist at the Anorexia and Bulimia Project at Instituto Sedes Sapientiae; Alexandre Pinto de Azevedo, coordinator of the Assistance group for Men with Eating Disorders at Ambulim}