Eating Disorder Prevalence in Children Age 9 to 10 Shows No Sex-Based Differences

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The overall prevalence of any eating disorders diagnosis was 1.4%.
The overall prevalence of any eating disorders diagnosis was 1.4%.

Significant sex differences were not found in the prevalence of eating disorders (EDs) in children age 9 to 10, according to study results published in JAMA Pediatrics

Early-onset EDs have increased in prevalence over the past few decades, raising public health concerns because of the significant morbidity and mortality associated with EDs. Only a single nationally representative study has reported the 12-month prevalence of ED in children. The study found a prevalence of 0.3% for girls and 0.1% for boys between the age of 8 and 15, but did not report the prevalence of specific ED diagnoses.

Kaitlin Rozzell, BS, of the department of psychology, San Diego State University in California, and colleagues, used baseline data collected in 2016 and 2017 from the Adolescent Brain Cognitive Development study of 4524 children age 9 to 10. They categorized EDs into 5 clinical subtypes: anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED).

The investigators determined that there were no significant sex differences across all ED diagnoses. The overall prevalence of any ED diagnosis was 1.4% and the prevalence of any OSFED diagnosis was 0.7%. They found that the prevalence of AN was 0.1%, but no cases of BN were reported in this sample. The prevalence of BED was 0.6%.

Past research in individuals age 13 to 18 did not find a difference in the prevalence of AN in boys and girls, but differences in BN, BED, and subthreshold AN prevalence was noted, with a higher prevalence in girls.

The investigators suggested that sex differences in ED prevalence may not manifest until adolescence, which is consistent with past research that found no differences in prepubertal children. 

The investigators noted several study limitations, including reliance on caregivers' reports of emaciation for the diagnosis of OSFED AN, which led to its exclusion from the study, and the failure to assess avoidance or restriction of food, as well as the low prevalence of ED, which may have reduced the statistical power to detect sex differences.

As the Adolescent Brain Cognitive Development study is a 10-year longitudinal study, the investigators suggested utilizing this data set to explore developmental risk factors for EDs.

Reference

Rozzell K, Moon DY, Klimek P, Brown T. Prevalence of eating disorders among US children aged 9 to 10 years: data from the Adolescent Brain Cognitive Development (ABCD) Study [published online November 26, 2018]. JAMA Pediatr.doi:10.1001/jamapediatrics.2018.3678

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