The prevalence and correlates of eating disorders in adult emergency department patients

Abstract

Objective This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. Method Emergency department patients aged 21–65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. Results Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. Discussion Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.

Prevalence of eating disorders among Saudi female university students during the COVID-19 outbreak

“… 26 This is consistent with Dooley-Hash et al., who found an association between eating disorders and depression in females. 27 Moreover, our study is consistent with Alwosaifer et al., 14 who found no significant association between monthly family income and BMI.…”

Emergency medicine physicians’ knowledge and perceptions of training, education, and resources in eating disorders

“…Comprehensive treatment and prospective management of patients with eating disorders does not occur in the Emergency Department, however, EM clinicians can draw from guidelines to develop hospital admission criteria and/or provide follow-up referrals. Knowledge of guidelines and follow-up treatment options are critical as recent studies suggest 15.9% of adult participants screened positive for an eating disorder in the Emergency Department [ 13 ] and 16% of adolescent and young adults screened positive for an eating disorder in an Emergency Department [ 14 ]. One study of Australian EM, general, pediatric, and psychiatric clinicians reported previous knowledge of the 2014 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders was related to increased confidence in treating eating disorders [ 15 ].…”

Screening, assessment and diagnosis in the eating disorders: findings from a rapid review

“…Detected prevalence of EDs among patients seeking emergency department services in the US was 16% and did not differ by reason for seeking treatment or any socio-demographic factors. Dooley-Hash et al [ 60 ] indicated this was much higher than the estimated prevalence in the general population (5%) and suggested that emergency department presentation could represent an important step in the identification of patients with ED for referral to services [ 60 ].…”