How Do Children with Eating Disorders Differ from Adolescents with Eating Disorders at Initial Evaluation?

Purpose: To compare the clinical presentation of children with eating disorders (ED) to that of adolescents with ED. Methods: Demographic, medical, and psychiatric data of all 959 in- and outpatients (85 males, 874 females) 8-19 years of age diagnosed with ED that presented to an academic center between 1997 and 2005 were examined via retrospective record review. Young patients (n = 109) were defined as aged < 13 years at presentation, and older patients (n = 850) ≥ 13 years and < 20 years. Results: Compared with older adolescents (mean 15.6 years, SD 1.4), younger patients (mean 11.6 years, SD 1.2) were more likely to be male (χ² = 9.25, p < .005) or diagnosed with eating disorder not otherwise specified (EDNOS) (χ² = 5.09, p ≤ .05), and less likely to be diagnosed with bulimia nervosa (BN) (χ² = 13.45, p ≤ .001). There were no significant differences in anorexia nervosa (AN) diagnoses between groups. Young patients were less likely to report purging (χ² = 26.21, p < .001), binge eating (χ² = 26.53, p < .001), diet pill (χ² = 13.31, p < .001) or laxative use (χ² = 6.82, p < .001) when compared with older teens. Young patients weighed less in percentage ideal body weight (p < .05), had a shorter duration of disease (p < .001), and had lost weight more rapidly than older adolescent patients (p ≤ .001). Conclusions: There are important diagnostic and gender differences in younger patients. Young ED patients presented at a lower percentage of ideal body weight and had lost weight more rapidly, which may put them at higher risk for future growth sequelae than their older counterparts.