Most teens with eating disorders don't get appropriate help

Eating disorders affect a small proportion of U.S. adolescents but can be devastating for those who are afflicted, a study shows.

Adolescents with eating disorders are prone to at least one other psychiatric disorder, seriously contemplate or attempt suicide and have a social impairment as a result of their condition, according to the study published online March 7 in Archives of General Psychiatry.

Although most teens seek mental health treatment, few actually get help for their eating problems, said Kathleen Merikangas, PhD, study co-author and senior investigator and chief of genetic epidemiology at the National Institute of Mental Health's Division of Intramural Research Programs.

"The message for professionals is that when someone comes to your attention and you notice that they are very underweight or overweight, to screen for eating disorders," she said.

Researchers analyzed data on 10,123 adolescents ages 13 to 18. Of those, 0.3% had anorexia nervosa, 0.9% had bulimia nervosa and 1.6% had a binge-eating disorder.

Researchers found that 77.6% of teens with anorexia and 88.2% with bulimia had received mental health help, but only 26.5% and 21.5%, respectively, received help for their weight or eating problems. Teens with subthreshold eating disorders such as subthreshold anorexia nervosa and subthreshold binge-eating disorder, which show troubling behaviors but don't qualify as a disorder, were even less likely to discuss their eating troubles with a health professional, Merikangas said.

Adolescents may avoid the subject because they are in denial about their eating disorder, they feel shame or stigma, or the health professional fails to recognize their condition, she said.

Most teens with an eating disorder also met criteria for at least one other psychiatric disorder. For example, teens with anorexia were associated with oppositional defiant disorder, and those with bulimia were associated with mood and anxiety disorders. Eating disorders tended to begin between ages 10 and 14, the study said.

By helping to catch such disorders early, physicians can help save patients' lives, Merikangas said. "Eating disorders are associated with increased mortality. The medical complications of these disorders are very high."

The study is online (link).