Screening for Eating Disorders in Adolescents and Adults

Abstract

ImportanceEating disorders (eg, binge eating disorder, bulimia nervosa, and anorexia nervosa) are a group of psychiatric conditions defined as a disturbance in eating or eating-related behaviors that impair physical or psychosocial functioning. 1,2 The prevalence of eating disorders in the US has not been well studied; thus, current rates may underestimate the true burden of disease. According to large US cohort studies, estimated lifetime prevalences for anorexia nervosa, bulimia nervosa, and binge eating disorder in adult women are 1.42%, 0.46%, and 1.25%, respectively, and are lower in adult men (anorexia nervosa, 0.12%; bulimia nervosa, 0.08%; binge eating disorder, 0.42%). Eating disorder prevalence ranges from 0.3% to 2.3% in adolescent females and 0.3% to 1.3% in adolescent males. 1,3 Eating disorders are associated with short-term and long-term adverse health outcomes, including physical, psychological, and social problems. 1 IMPORTANCE Eating disorders (eg, binge eating disorder, bulimia nervosa, and anorexia nervosa) are a group of psychiatric conditions defined as a disturbance in eating or eating-related behaviors that impair physical or psychosocial functioning. According to large US cohort studies, estimated lifetime prevalences for anorexia nervosa, bulimia nervosa, and binge eating disorder in adult women are 1.42%, 0.46%, and 1.25%, respectively, and are lower in adult men (anorexia nervosa, 0.12%; bulimia nervosa, 0.08%; binge eating disorder, 0.42%). Eating disorder prevalence ranges from 0.3% to 2.3% in adolescent females and 0.3% to 1.3% in adolescent males. Eating disorders are associated with short-term and long-term adverse health outcomes, including physical, psychological, and social problems. OBJECTIVEThe US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for eating disorders in adolescents and adults with a normal or high body mass index. Evidence limited to populations who are underweight or have other physical signs or symptoms of eating disorders was not considered. The USPSTF has not previously made a recommendation on this topic.POPULATION Adolescents and adults (10 years or older) who have no signs or symptoms of eating disorders (eg, rapid weight loss, weight gain, or pronounced deviation from growth trajectory; pubertal delay; bradycardia; oligomenorrhea; and amenorrhea). EVIDENCE ASSESSMENTThe USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for eating disorders in adolescents and adults. The evidence is limited and the balance of benefits and harms cannot be determined.RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for eating disorders in adolescents and adults. (I statement)

Recent advances in the identification of related factors and preventive strategies of hip fracture

“…A recent study found that anorexia nervosa (AN) is closely related to low BMD and an increased risk of hip fracture ( 24 ). Studies have shown that the bone loss rate of the hip joint of amenorrhea women with anorexia nervosa is 2.4% per year ( 25 , 26 ). AN is a mental illness, long-term malnutrition is accompanied by severe bone loss, followed by hypogonadism and growth hormone resistance, which becomes an important intermediary factor for bone loss in patients with AN ( 27 , 28 ).…”

Parents of children with high weight and disordered eating: Commentary on Wilksch (2023)

“…Yet, data are unavailable to support or reject this notion. Indeed, the US Preventive Services Task Force made no recommendation on universal ED screening due to a lack of research on the benefits versus harms (Davidson et al, 2022). By failing to screen all children for EDs, we miss a critical window for early intervention among those who are susceptible.…”