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Teens’ eating disorders can be assessed in ED

Saturday November 24, 2012
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The ED may be a good place to spot undiagnosed eating disorders among teens and steer them to treatment, according to a study.

University of Michigan researchers screened more than 940 teens and young adults ages 14 to 20 for eating disorders as part of their visit to the U-M ED for any non-psychiatric reason.

They found that 16% of patients had indications of an eating disorder. Those that had such indications also were much more likely to show signs of depression and substance abuse, conditions that often go hand-in-hand with eating disorders.

The researchers noted that more than a quarter of the patients with signs of eating disorders were male, which they said was a higher percentage than might be expected.

Contrary to common perceptions of eating disorders, the patients who screened positive for eating disorders in the ED were more than three times as likely to be obese as those without eating issues. While anorexia nervosa is the most commonly known eating disorder, bulimia and binge eating are known to be associated with overweight and obesity.

Suzanne Dooley-Hash, MD, the study’s lead author and an emergency physician at U-M, sought to investigate whether eating disorders were more common among ED patients than care teams might think. For many teens and young adults, ED visits are more common than visits to doctor’s offices, and may even be the only form of medical care they receive. In the study population, teens who received public assistance of some sort were more likely to have signs of eating disorders.

Screening for eating disorders in the ED and helping at-risk teens get treatment after they leave could be effective in stemming problems before they become more serious, the researchers noted. Similar approaches have been taken for drug and alcohol abuse and other risky behaviors.

"They come in for other things, and it’s up to healthcare providers to know what to look for," Dooley-Hash said in a news release. "ER teams can be equipped to refer patients for care, just as we do for substance abuse. It could be a wakeup call, a teachable moment, a chance to tell them they need to seek help and to direct them to resources."

Although treatment for eating disorders is not guaranteed to work, and can take years, a patient’s chances of overcoming the disorder are better the sooner he or she is diagnosed, Dooley-Hash said.

The researchers acknowledged the study represents patients from only one hospital, located in a university town, and said further research would be needed to confirm the findings’ applicability before any interventions are designed.

The study appears in the November issue of the International Journal of Eating Disorders. The study abstract is available at http://onlinelibrary.wiley.com/doi/10.1002/eat.22026/abstract.


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