How Do Children with Eating Disorders Differ from Adolescents with Eating Disorders at Initial Evaluation?

PurposeTo compare the clinical presentation of children with eating disorders (ED) to that of adolescents with ED.MethodsDemographic, medical, and psychiatric data of all 959 in- and outpatients (85 males, 874 females) 8–19 years of age diagnosed with ED that presented to an academic center between 1997 and 2005 were examined via retrospective record review. Young patients (n = 109) were defined as aged < 13 years at presentation, and older patients (n = 850) ≥ 13 years and < 20 years.ResultsCompared with older adolescents (mean 15.6 years, SD 1.4), younger patients (mean 11.6 years, SD 1.2) were more likely to be male (χ2 = 9.25, p < .005) or diagnosed with eating disorder not otherwise specified (EDNOS) (χ2 = 5.09, p ≤ .05), and less likely to be diagnosed with bulimia nervosa (BN) (χ2 = 13.45, p ≤ .001). There were no significant differences in anorexia nervosa (AN) diagnoses between groups. Young patients were less likely to report purging (χ2 = 26.21, p < .001), binge eating (χ2 = 26.53, p < .001), diet pill (χ2 = 13.31, p < .001) or laxative use (χ2 = 6.82, p < .001) when compared with older teens. Young patients weighed less in percentage ideal body weight (p < .05), had a shorter duration of disease (p < .001), and had lost weight more rapidly than older adolescent patients (p ≤ .001).ConclusionsThere are important diagnostic and gender differences in younger patients. Young ED patients presented at a lower percentage of ideal body weight and had lost weight more rapidly, which may put them at higher risk for future growth sequelae than their older counterparts.