Estimated Prevalence and Care Pathway of Feeding and Eating Disorders in a French Pediatric Population

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.

What do we know about the epidemiology of avoidant/restrictive food intake disorder in children and adolescents? A systematic review of the literature

“…Three studies were conducted in specialised tertiary care services for feeding problems and they showed the highest prevalence rates of ARFID, ranging from 32% to 64% (Farag et al, 2022;Krom et al, 2019;Williams et al, 2015). Two studies examined the prevalence of ARFID in general paediatric services, with a prevalence of 3% in an outpatient sample (Bertrand et al, 2021) and of 7.2% in an inpatient sample SANCHEZ-CEREZO ET AL. (Schöffel et al, 2021).…”

Worldwide prevalence of DSM-5 eating disorders among young people

“…Additionally, the range for point prevalence has been 0–2.5% for anorexia nervosa for the youth of all genders [11,18–21,26 ▪ ,27,28,29]. For young women, the estimated current prevalence of anorexia nervosa was 0–3.2% [16,18–22,26 ▪ ].…”

“…The point prevalence of OSFED for youth of all genders ranged from 0 to 11.2% [11,18–20,27,29]. For young women, the estimated current prevalence of OSFEDs was 0.3–14.5% [16,18,22].…”

The factor structure and validity of a diagnostic interview for avoidant/restrictive food intake disorder in a sample of children, adolescents, and young adults

“…While these feeding/eating concerns were previously classified under multiple diagnoses in earlier iterations of the Diagnostic and Statistical Manual of Mental Disorders (DSM), including feeding disorder of infancy and early childhood and eating disorder not otherwise specified, the DSM‐5 ARFID criteria acknowledges the presence of these symptoms across the lifespan. While the true prevalence of ARFID in the general population remains unknown, current estimates suggest that <5% of children and <1% of adults may be affected by ARFID, though data on developmental differences in symptom presentation is lacking (Bertrand et al, 2021 ; Chen, Chen, Lin, Shen, & Gau, Chen et al, 2019 ; Hay et al, 2017 ; Herle et al, 2020 ). Up to 14% of patients seeking treatment for eating disorders and 32% of patients seeking treatment for feeding problems may have ARFID (Fisher et al, 2014 ; Forman et al, 2014 ; Nakai, Nin, Noma, Teramukai, & Wonderlich, Nakai et al, 2016 ; Nicely, Lane‐Loney, Masciulli, Hollenbeak, & Ornstein, Nicely et al, 2014 ; Norris et al, 2014 ; Ornstein et al, 2013 ; Williams et al, 2015 ).…”