Wednesday, August 19, 2009

Is Your Child One of the 12 Percent?

One of the things you hear a lot these days--at least if you spend any time talking to doctors about eating disorders--is that they affect a relatively small number of kids. Prevalence rates for anorexia are usually quoted as .5 to 1 percent, and 3 to 6 percent for bulimia. (Binge eating disorder is a newer diagnosis; I've heard 3 percent for BED but don't know if it's accurate.) Which somehow makes them less worthy of attention, concern, and research money than, say, childhood obesity, which as we all know is public healthy enemy #1. (That's sarcasm, y'all.)

But a new study out of University of Texas at Austin shows that fully 12 percent of all adolescents experience some form of eating disorder. That's 12 out of 100. Which may not sound like much.

But consider that 1 out of 15,000 kids gets cancer of some kind, and think about the attention and research and money devoted to understanding and treating childhood cancers. Then think again about the number: 12 percent.

It sounds a lot bigger now.

One of the pervasive problems in treating eating disorders is a lack of effective treatments. We need more research, which needs we need more research dollars. One reason we don't get those dollars is that families are often reluctant to acknowledge that their child has an eating disorder because of the stigma associated with these illnesses.

Cancer used to carry a lot of stigma, too. As a culture we've mostly gotten over that. How about we start challenging the stereotypes around eating disorders? Parents could be amazing advocates, if only we were willing to stand up and say, "Yes, my child is one of the 12 percent--now what are we going to do about it?"

How about it?


Monica said...

It's interesting and gratifying to note that they include "subthreshold" EDs in that study. I don't have access to the full-text now, but I'm figuring that I would have fallen into the "subthreshold" anorexia category when my eating was very disordered.

I was lucky in the sense that I had depression as a comorbidity and getting me on anti-depressants essentially stopped the ED, but my eating is still not entirely ordered.

Anyway, that 12%, unfortunately, seems much truer to what I've encountered than the numbers that I've previously seen. That's more than 1 in 10. That's kind of a shocking incidence-- I go to a small liberal arts school where class size is usually around 10-20. That's 1-2 people per class I have. The more I think about it, the more amazed I am, even knowing that person is normally me.

Siobhan said...

I am also imagining that many families, those who yell "don't eat so much, you'll get fat!" and then reward the child for being thin, even when (s)he's anorexic by that point,won't acknowledge the eating disorder.

Rachel said...

It's also worth pointing out that these statistics are compiled based on reported cases of eating disorders, usually by families who have sufficient health insurance coverage to get treatment for them. For example: A recent study showed that rates of bulimia may actually be higher amongst black girls but because minorities disproportionately have less health care coverage than whites, they're just not reported as much. And studies by Dianne Neumark Sztainer indicate that a lot of kids, especially fat kids, engage in dangerous disordered behaviors even if they fall short of a clinical eating disorder diagnosis.

Harriet said...

I'm sure you're right, Rachel. And who's reporting sub-threshhold cases, in any case? Self-reporting is notoriously inaccurate when it comes to eating disorders.

Rachel said...

I found this chart below on NEDA's website and think it interesting to note here. The reported funds are for anorexia research only and do not include bulimia or ED-NOS research dollars. But, since anorexia seems to get the lion's share of research dollars, I think it's especially illuminating. The two numbers represent the prevalence and the research funds.

Eating disorders: 10 million $12,000,000

Alzheimer’s disease: 4.5 million $647,000,000

Schizophrenia: 2.2 million $350,000,000

Anonymous said...


I don't think anorexia nervosa gets the lion's share of research dollars. There's a perception that AN gets a lot of attention and bulimia nervosa is neglected. That might be true in terms of sensational popular media stories, but it is NOT true in terms of treatment studies. There are MORE for BN than AN.

Similarly, there is a perception that adolescent eating disorders get lots of attention, but there are FEWER studies of adolescents than adults. Here's a video review of the available adolescent studies.

Management of Eating Disorders from the
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services gives an overview of the available research.

The entire field is woefully understudied, but AN does NOT receive an underdue amount of research attention. In my opinion the popular media attention given to AN is often useless rather than helpful, and can't be considered any kind of advantage.