A comparison of clinical characteristics between adolescent males and females with eating disorders

Abstract

BackgroundEating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders.MethodsWe compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children’s Hospital in Uppsala, Sweden during the years 1999–2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN.ResultsThere was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females.ConclusionsA better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives.

Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review

“…Approximately one third of children with EDs report having abdominal complaints, including constipation, bloating, abdominal pain, and dyspepsia (Basso et al, ) (see Table ). Basso et al () reported the rate of celiac disease in a sample of children (81% female) with AN (0.6%) (Basso et al, ) to be similar to the general population (Green & Cellier, ), but Welch, Ghaderi, and Swenne () examined a larger sample of children with different types of EDs and found a rate of AN or atypical AN that was four times greater in girls (2.4%) and absent in boys (Welch et al, ). Similarly, Karwautz et al () examined a sample of children with celiac disease and found that the rates of EDs for females (4.8% with a history of ED; 3.9% with a current ED; [Karwautz et al, ]) were substantially higher than the general population (AN 0.3%; BN 1%; BED 1%) (Hoek & van Hoeken, ).…”

“…Celiac disease typically preceded the onset of disordered eating and a diagnosable ED in the majority of cases (85.7%), with an average of 9.87 years between the onset of celiac disease and the onset of eating pathology (Karwautz et al, ). Karwautz et al () and Wagner et al () found evidence that celiac disease started prior to the onset of disordered eating, but Basso et al (), Quick et al (), and Welch et al () did not provide data on the order of onset. Overall, children with celiac disease have a greater risk for developing EDs and disordered eating than the general population and the risk is predominant in females.…”

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders

“…Because research on eating disorders has historically focused on women, the nosology of eating disorders has evolved based on female symptom profiles (Anderson & Bulik, ) and normative data on men are lacking (see Figure S1 for lifetime prevalence of eating disorders by sex). Evidence indicates that, when diagnosed with eating disorders, men and women often differ in clinical characteristics (Núñez‐Navarro et al, ; Welch, Ghaderi, & Swenne, ), although psychiatric comorbidities appear common across gender (Ulfvebrand, Birgegård, Norring, Högdahl, & von Hausswolff‐Juhlin, ). Available evidence also suggests that men may be less likely to seek treatment (Striegel, Bedrosian, Wang, & Schwartz, ), less likely to be diagnosed with an eating disorder even when presenting with identical symptoms as women (Currin, Schmidt, & Waller, ), and less likely to access treatment even with similar clinical severity (Austin et al, ).…”

Male clinical norms and sex differences on the Eating Disorder Inventory (EDI) and Eating Disorder Examination Questionnaire (EDE‐Q)

“…Of note, few studies have distinguished between ED diagnostic groups when assessing sex differences. While evidence suggests that females with AN, BN, and BED report greater severity than males across several cognitive and behavioral ED domains (Dahlgren et al, 2017; Darcy et al, ; Shingleton, Thompson‐Brenner, Thompson, Pratt, & Franko, ), findings in AN have not been entirely consistent (Welch, Ghaderi, & Swenne, ).…”