B3832 - The link between questionnaire-reported disordered eating and eating disorder medical diagnosis - 26/07/2021

B number: 
B3832
Principal applicant name: 
Naomi Warne | University of Bristol (United Kingdom)
Co-applicants: 
Dr Helen Bould, Dr Tim Cadman, Dr Amanda Hughes, Professor Laura Howe
Title of project: 
The link between questionnaire-reported disordered eating and eating disorder medical diagnosis
Proposal summary: 

Eating disorders (including Anorexia Nervosa (AN) Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Other Specified Feeding and Eating Disorders (OSFED)) are severely impairing and have the highest mortality of any psychiatric condition. Prevalence of eating disorders in the general population is around 5% but up to a third of young women and one fifth of young men report disordered eating behaviours (e.g. fasting, purging, binge-eating, excessive exercise) that are impacting their lives. However, very little research has been conducted into the association between disordered eating behaviours (often reported on questionnaires) and eating disorder diagnoses (confirmed by medical records), or on factors that lead to a lack of eating disorder diagnosis in individuals who report disordered eating behaviours consistent with diagnostic criteria.
Furthermore, associations with potential risk factors such as socioeconomic position (SEP) are inconsistent for self-reported eating disorder symptoms and eating disorder diagnoses. Whilst some studies have found that lower SEP is associated with higher self-reported eating disorder traits, these findings are not universal. For example, a large national study in USA found no association between SEP and eating disorders. In addition, studies which have looked at rates of diagnosis and hospitalisation (rather than self-reported symptoms) have found that higher family SEP is associated with increased risk of eating disorders. However, it is not clear that higher SEP is a cause of eating disorders. An alternative explanation is that children from higher SEP backgrounds find it easier to access services, and this may be why there are higher rates of diagnosis in this group.
This project will look broadly at the association between disordered eating captured by questionnaire reports and eating disorder diagnoses from linked medical records. Firstly, we will assess whether individuals with disordered eating reported on questionnaires also have an eating disorder medical diagnosis. Secondly, we will explore what factors are associated with obtaining an eating disorder diagnosis in the whole sample and in those reporting diagnostic level disordered eating behaviours via questionnaire. We will also examine associations for socioeconomic position with disordered eating symptoms and eating disorder diagnosis in the ALSPAC cohort and with other population-based cohorts. Finally, we will examine similarities in outcomes for individuals who report disordered eating on questionnaires and those with a diagnosis of eating disorders.

Impact of research: 
This research will be able to provide a greater understanding of the link between population-level disordered eating and clinical eating disorer diagnoses. This may help us work out why some people with disordered eating do not receive a diagnosis or medical help which can inform future clinical practice.
Date proposal received: 
Wednesday, 7 July, 2021
Date proposal approved: 
Monday, 12 July, 2021
Keywords: 
Epidemiology, Eating disorders - anorexia, bulimia