The Changing Face and Focus of the Adolescent with an Eating Disorder

Authors

  • Carly Chason University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, 1601 4th Ave S, Children’s Park Place I 310, Birmingham, AL, 35233, USA
  • Krista M. Davis University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, 1601 4th Ave S, Children’s Park Place I 310, Birmingham, AL, 35233, USA
  • Lynae J. Hanks University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, 1601 4th Ave S, Children’s Park Place I 310, Birmingham, AL, 35233, USA
  • Krista Casazza University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, 1601 4th Ave S, Children’s Park Place I 310, Birmingham, AL, 35233, USA

DOI:

https://doi.org/10.6000/1929-5634.2016.05.01.3

Keywords:

Adolescent, eating disorder, muscle function, handgrip strength, metabolic health

Abstract

The classic silhouette of the typical adolescent with an eating disorder (ED) is a white female with extremely low body weight; this has begun to take a new shape. The most apparent shift in the classic views are sex and weight. A trend toward a progressively decreasing age of onset in ED has also emerged. The objective of this paper is to describe the ED patients presenting to Children’s of Alabama’s Adolescent Eating Disorders Clinic, encompassing their age, sex, BMI percentile and muscle function. The data was examined from all first presentations to the clinic from 2013 to 2016. Between May 2013 and March 2016, 102 new patient appointments were scheduled. 88 patient’s charts were reviewed from the time of each initial appointment in the Adolescent Eating Disorders Clinic to obtain the sex, age, race, height, weight, reason for referral/active problems and ED diagnosis for each patient. BMI percentile was calculated according to reference ranges for sex and age. Handgrip strength was measured by dynamometer. As is consistent with previously published data, there were significantly more females than males seen in our population. There were more females than males across all categories of ED diagnoses. The highest number of diagnoses occurred between the ages of 13-16. A positive correlation between BMI percentile and measured handgrip strength was observed. Measured handgrip strength in females was lower in ages 13-18 than expected grip strength for age. When males were grouped by “Males 14 and under” and “Males 15 and over,” a lower measured grip strength compared to the expected grip strength for age was demonstrated. The impact of ED on morbidity and mortality has been well recognized; however the most often reported association was mainly based on changes in body weight. The adverse metabolic consequences perturb nutrient sensing and ultimately delivery and utilization. A shift in the focus of energy balanced towards systemic malnourishment may allow healthy and sustained metabolic improvements.

References

Herpertz-Dahlmann B. Adolescent Eating Disorders: Definitions, Symptomatology, Epidemiology and Comorbidity. Child and Adolescent Psychiatric Clinics of North America 2009; 18(1): 31-47. http://dx.doi.org/10.1016/j.chc.2008.07.005 DOI: https://doi.org/10.1016/j.chc.2008.07.005

Loth K, MacLehose R, Bucchianeri M, Crow S, Neumark-Stainer D. Personal and Socio-environmental predictors of dieting and disordered eating behaviors from adolescence to young adulthood: 10 year longitudinal findings 2014. DOI: https://doi.org/10.1016/j.jadohealth.2014.04.016

Madden S, Morris A, Zurynski YA, Kohn M, Elliot EJ. Burden of eating disorders in 5-13 year-old children in Australia. Med J Aust 2009; 190(8): 410-14. DOI: https://doi.org/10.5694/j.1326-5377.2009.tb02487.x

Ackard DM, Fulkerson JA, Neumark-Sztainer D. Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. Int J Eat Disord 2007; 40(5): 409-17. http://dx.doi.org/10.1002/eat.20389 DOI: https://doi.org/10.1002/eat.20389

Whitelaw M, Gilbertson H, Lee KJ, Sawyer SM. Restrictive eating disorders among adolescent inpatients. Pediatrics 2014; 134(3): e758. http://dx.doi.org/10.1542/peds.2014-0070 DOI: https://doi.org/10.1542/peds.2014-0070

Sawyer SA, Whitelaw M, Le Grange D, Yeo M, Hughes EK. Physical and Psychological Morbidity in Adolescents with Atypical Anorexia Nervosa. Pediatrics 2016; 137(4): e20154080. DOI: https://doi.org/10.1542/peds.2015-4080

Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 2011; 68(7): 714-23. http://dx.doi.org/10.1001/archgenpsychiatry.2011.22 DOI: https://doi.org/10.1001/archgenpsychiatry.2011.22

Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 2010; 49(10): 980-89. http://dx.doi.org/10.1016/j.jaac.2010.05.017 DOI: https://doi.org/10.1016/j.jaac.2010.05.017

Peebles R, Hardy KK, Wilson JL, Lock JD. Medical compromise in eating disorders not otherwise specified: Are diagnostic criteria for eating disorders markers of severity? Pediatrics 2010; 125(5): e1193-e1201. DOI: https://doi.org/10.1542/peds.2008-1777

Westmoreland P, Krantz MJ, Mehler PS. Medical complications of Anorexia Nervosa and Bulimia. The American Journal of Medicine 2016; 129(1): 30-37. http://dx.doi.org/10.1016/j.amjmed.2015.06.031 DOI: https://doi.org/10.1016/j.amjmed.2015.06.031

Cianferrotti L, Brandi ML. Muscle-bone interactions: basic and clinical aspects. Endocrine 2014; 45(2): 165-77. http://dx.doi.org/10.1007/s12020-013-0026-8 DOI: https://doi.org/10.1007/s12020-013-0026-8

Robinson L, Aldridge V, Clark EM, Mirsa M, Micali M. A systematic review and meta-analysis of the association between eating disorders and bone density. Osteoporosis International 2016; 27(6): 1953-66. http://dx.doi.org/10.1007/s00198-015-3468-4 DOI: https://doi.org/10.1007/s00198-015-3468-4

Downloads

Published

2016-06-03

How to Cite

Chason, C., M. Davis, K., J. Hanks, L., & Casazza, K. (2016). The Changing Face and Focus of the Adolescent with an Eating Disorder. Journal of Nutritional Therapeutics, 5(1), 21–26. https://doi.org/10.6000/1929-5634.2016.05.01.3

Issue

Section

Articles