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J Adolesc Health. 2016 Apr;58(4):410-416. doi: 10.1016/j.jadohealth.2015.11.005. Epub 2016 Jan 28.

Does Sex Matter in the Clinical Presentation of Eating Disorders in Youth?

Author information

1
Pritzker School of Medicine, University of Chicago, Chicago, Illinois. Electronic address: kkinasz@uchicago.edu.
2
Department of Psychiatry, University of California, San Francisco, San Francisco, California.
3
Department of Medicine, University of Chicago, Chicago, Illinois.
4
Department of Psychiatry, University of California, San Francisco, San Francisco, California; Department of Pediatrics, University of California, San Francisco, San Francisco, California.

Abstract

PURPOSE:

Eating disorders (EDs) impact both males and females, but little is known about sex differences in ED psychopathology and overall clinical presentation. This study compared demographic and clinical characteristics of child and adolescent males and females who presented for ED treatment.

METHODS:

Participants included 619 youth (59 males and 560 females) ages 6-18 years who presented for treatment between 1999 and 2011.

RESULTS:

Males presented for ED treatment at a significantly younger age (p < .001), earlier age of onset (p = .004), and were more likely to be nonwhite (p = .023). Females showed more severe ED pathology across the Eating Disorder Examination subscales (weight concern: p < .001; eating concern: p < .001; restraint: p = .001; and shape concern: p = .019) and global score (p < .001). Males were more likely to present with an ED other than anorexia nervosa or bulimia nervosa (p = .002). Females presented with significantly higher rates of mood disorders (p = .027) and had a lower average percent of expected body weight (p = .020). Males and females did not differ in duration of illness, prior hospitalization or treatment, binging and purging episodes, anxiety disorders, behavioral disorders, or self-esteem. All analyses were controlled for age.

CONCLUSIONS:

Results indicate that further exploration into why the sexes present differently may be warranted. Developing ED psychopathology assessments that better capture nuances particular to males and reevaluating criteria to better categorize male ED diagnoses may allow for more targeted treatment.

KEYWORDS:

Anorexia nervosa; Bulimia nervosa; Comorbidity; Eating disorders; Sex distribution; Youth

PMID:
26830976
PMCID:
PMC4808325
DOI:
10.1016/j.jadohealth.2015.11.005
[Indexed for MEDLINE]
Free PMC Article

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