Prevalence, predictors, and treatment of eating disorders in children: a national study

Psychol Med. 2023 May;53(7):2974-2981. doi: 10.1017/S0033291721004992. Epub 2021 Dec 15.

Abstract

Background: Although the prevalence rates of preadolescent eating disorders (EDs) are on the rise, considerably less is known about the correlates and treatment of EDs in this age group. Clarifying the epidemiology of EDs in preadolescent children is a necessary first step to understand the nature and scope of this problem in this age group.

Methods: Analysis of data collected in the ABCD Study release 2.0.1. The ABCD cohort was a population-based sample that consisted of 11 721 children ages 9-10 years. Measures included reports of a lifetime and current mental disorders determined using a diagnostic interview for DSM-5 disorders, sociodemographic factors, and psychiatric treatment utilization.

Results: The lifetime prevalence of EDs was 0.95%. Being Black, multiracial, having unmarried parents, and family economic insecurity were significant predictors for developing an ED. Among psychiatric conditions, the major depressive disorder was most robustly associated with EDs in both cross-sectional and temporal analyses. Only 47.40% of children who had a lifetime ED received some type of psychiatric treatment. EDs were not a significant predictor of psychiatric treatment utilization after accounting for sex, sexual orientation, parent marital status, economic insecurity, and all other psychiatric diagnoses.

Conclusions: Despite increasing prevalence rates of preadolescent EDs, the current findings suggest that the majority of children with these disorders remain untreated. Devoting increased attention and resources to reaching families of children with EDs with the least means for receiving care, and screening for EDs in children with depression, may be important steps for reducing this unmet need.

Keywords: ABCD study; Epidemiology; eating disorders; preadolescence.

MeSH terms

  • Child
  • Cross-Sectional Studies
  • Depressive Disorder, Major*
  • Feeding and Eating Disorders* / epidemiology
  • Feeding and Eating Disorders* / therapy
  • Female
  • Humans
  • Male
  • Prevalence
  • Psychotherapy