An update on prevalence rates of disordered eating behaviours in children and adolescents with overweight or obesity and the management of binge eating disorder

Author/s
Elizabeth Tyrrell Bunge, Dasha Nicholls, Darren Cutinha
Citation
Focus Issue 6: Eating disorders
CEPiP.2024.1.77-90
Abstract

Background: A number of studies have been published in recent years examining disordered eating behaviours (DEBs) in children and young people (CYP).

Objective: To provide an up-to-date review of prevalence rates across a range of DEBs, including food addiction, in CYP living with overweight and obesity, across both community and clinical populations.

Methods: In January 2022 three separate databases were searched (PubMed, MEDLINE and PsycINFO) for papers published after April 2016. The search was updated in February 2024 using identical search terms across (MEDLINE, Embase and OVID Journals). Data were extracted by the main author, and prevalence rates of DEBs calculated from available data, if not already provided. Included studies were categorised as examining: binge or loss of control eating (LOC) only, food addiction and a range of DEBs.

Results: 44 studies were included in this review. Of these 37 were cross sectional, three were cohort studies, two were prospective observational studies and 2 were case-control studies. The total number of participants across all included studies was 28,640. In studies focusing on binge or LOC eating alone, prevalence rates and methods of data collection varied widely. Amongst clinical samples, rates of binge eating pre-bariatric surgery were 37.7% dropping to 18.5% at 5 year post surgery. For young people living with obesity and concurrent Attention Deficit Hyperactivity Disorder (ADHD) and/or ASD, 65% reported binge eating symptoms. In community samples rates of binge/LOC eating ranged from 8.8% to 52.8%. Within studies looking at food addiction in clinical populations, rates ranged from 9.9% to 30.8%. In community samples this ranged from 16.2% to 23.8%. The Yale Food Addiction Scale (YFAS) and YFAS-Child version were used across all studies collecting data on food addiction, meaning greater consistency and generalisability of results when compared to studies assessing binge/loss of control (LOC) eating or a range of DEBs. Amongst studies assessing a range of DEBs, one study found that there was presence of at least one disordered eating behaviour in 82.2% of a clinical population of adolescents living with obesity. Studies looking at a range of DEBs in community samples found prevalence rates ranging from 8.4% to 59.8% using a range of assessment tools.

Discussion: Heterogeneity between studies in terms of assessment tools used, methods of data collection and types of DEBs assessed limits conclusions about the true prevalence of disordered eating among CYP, and how many might reach a diagnostic threshold for an eating disorder diagnosis. Further research is needed to help inform service delivery and effective referral and treatment pathways.

Cite as: Cutting Edge Psychiatry in Practice 2025, 6(1):77-90; https://doi.org/10.65031/dutc3589

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