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Changing symptomatology in eating disorders

J B Ash1, E Piazza

  • 1Department of Psychiatry, Children's Hospital Medical Center, Boston, MA 02115, USA.

The International Journal of Eating Disorders
|July 1, 1995
PubMed
Summary

Eating disorders in children and adolescents have shifted over three decades. While physical symptoms decreased, psychological symptoms increased, indicating more diverse eating disorder presentations.

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Area of Science:

  • Child and Adolescent Psychiatry
  • Eating Disorder Research
  • Psychosomatic Medicine

Background:

  • Eating disorders represent a significant public health concern in pediatric populations.
  • Understanding temporal trends in eating disorder demographics and symptomatology is crucial for effective clinical practice and public health initiatives.
  • Previous research has indicated shifts in eating disorder prevalence and presentation, necessitating updated analyses.

Purpose of the Study:

  • To investigate demographic and symptomatological changes in eating-disordered children and adolescents over three decades (1970s, 1980s, 1990s).
  • To identify trends in the types and severity of eating disorder symptoms and associated psychiatric diagnoses.
  • To analyze changes in the overall incidence of eating disorder admissions over time.

Main Methods:

  • Retrospective review of medical records for 33 consecutive eating disorder admissions per decade.
  • Statistical analyses including Analyses of Variance (ANOVAs) and chi square analyses to compare demographic and clinical variables across decades.
  • Regression analyses to assess changes in total eating disorder admissions from 1970 to 1990.

Main Results:

  • Significant changes in eating disorder symptomatology were observed over the three decades.
  • Somatically based signs of eating disorders showed a decrease, while psychologically based symptoms remained stable or increased.
  • Eating disorders are becoming more widespread and heterogeneous, with newer variants like bulimia nervosa and atypical eating disorder coexisting with anorexia nervosa.

Conclusions:

  • The landscape of pediatric eating disorders has evolved, characterized by a shift towards more psychologically driven symptoms.
  • Eating disorders are not being replaced by newer forms but are diversifying and increasing in overall prevalence.
  • These findings underscore the need for evolving diagnostic and treatment approaches to address the heterogeneity of modern eating disorders in youth.

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