A new large-scale data study in the UK provides clarity on early warning signs associated with an eating disorder. Swansea University researchers believe their findings will help primary care physicians detect eating disorders earlier in the course of care.
Investigators discovered that people diagnosed with a disorder had higher rates of other conditions and of prescriptions in the years before their diagnosis. The study appears in the British Journal of Psychiatry.
In the UK eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder affect an estimated 1.6 million people. In the U.S., more than 10 million people are affected although the true figures may be higher, as many people do not seek help.
Experts explain that eating disorders predominantly affect women but men are not without risk. Most people are diagnosed during adolescence and early adulthood. Eating disorders have the highest mortality of all mental illnesses, both from physical causes and from suicide.
Yet despite the scale of the problem, resources to treat eating disorders are scarce. There are very few specialized treatment centers. People affected are often young and vulnerable, and may avoid detection. However, the earlier a disorder can be diagnosed, the better the likely outcome for the patient.
Investigators believe this is an area where the new findings can make a big difference. The new knowledge can help primary care physicians understand what could be early warning signs of a possible eating disorder.
The research team, from Swansea University Medical School, examined anonymized electronic health records from primary care practices and hospital admissions in Wales. 15,558 people in Wales were diagnosed as having eating disorders between 1990 and 2017.
In the two years before their diagnosis, data shows that these 15,558 people had:
- higher levels of other mental disorders such as personality or alcohol disorders and depression;
- higher levels of accidents, injuries and self-harm;
- higher rates of prescription for central nervous system drugs such as antipsychotics and antidepressants, and;
- higher rates of prescriptions for gastrointestinal drugs (e.g. for constipation and upset stomach) and for dietetic supplements (e.g. multivitamins, iron).
Therefore, looking out for one or a combination of these factors can help physicians identify eating disorders early.
Dr. Jacinta Tan, an associate professor of psychiatry at Swansea University led the research. Tan is also a consultant child and adolescent psychiatrist. She comments:
“I cannot emphasize enough the importance of detection and early intervention for eating disorders. Delays in receiving diagnosis and treatment are sadly common and also associated with poorer outcomes and great suffering,” she said.
“This research contributes to the evidence about prevalence of eating disorders and begins to quantify the scale of the problem in the entire country of Wales. The majority of these patients we identified are not known to specialist eating disorder services.
“The increased prescriptions by GPs both before and after diagnosis indicates that these patients, even if not known to specialist services, have significantly more difficulties or are struggling. This underlines the clinical need for earlier intervention for these patients and the need to support GPs in their important role in this.”
Dr. Joanne Demmler, senior data analyst in the National Centre for Population Health and Wellbeing Research, based at Swansea University, noted, “This has been an absolutely fascinating project to work on. We used anonymized clinical data on the whole population of Wales and unraveled it, with codes and statistics, to tell a story about eating disorders.
This ‘storytelling’ has really been an intricate part of our understanding of this extremely complex data and was only possible through a very close collaboration between data analysts and an extremely dedicated and enthusiastic clinician.”
Source: Swansea University/EurekAlert