St Vincent's Eating Disorders Prevalence Study

07 May 2024

St Vincent’s has embarked on a study to discover the prevalence of people presenting to Emergency for various conditions, but who also showed common signs and symptoms that occur with an eating disorder.

The study’s purpose was to discover the prevalence of people with possible eating disorders presenting to our hospital.

The multidisciplinary team including St Vincent’s emergency specialists, dietitians, exercise physiologists and gastroenterologists audited medical records of people 16 years or older, for common signs of an eating disorder - over a three year period.

As a result, the investigators identified 192 definite eating disorders from a total of 598 episodes of care from 2018 to 2020 presenting to Emergency. Of the 598 episodes, only 19% were diagnostically coded with an eating disorder, documenting their diagnoses and frequency of accessing health care.

This not only impacts patients who are not able access treatment for an eating disorder, it results in financial implications for the hospital and impedes future planning of services and health infrastructure, because documentation shows far less people seeking treatment for an eating disorder than the reality.

This research has highlighted the need for greater awareness of clinical signs and symptoms of an eating disorder, such as unexplained low body mass index and hypokalemia, amongst acute care clinicians. It also highlights that eating disorders present in many different ways not just as thin young women seeking care, highlighting the need for more robust screening and assessment of people who might have signs and symptoms of an eating disorder.

“Correctly identifying eating disorders in those seeking somatic care should be a public health priority”, said A/Prof Susan Hart, St Vincent’s Eating Disorders Coordinator. “This will facilitate timely and equitable access to diagnostic assessment and evidence based treatment”.

While this study was undertaken in a single emergency department that would benefit replication at other hospitals, the investigators’ hypothesise that this pattern of under-recognition and diagnoses of eating disorders might occur across the health care system in NSW.

It’s known that people with eating disorders often present to acute care settings with non-specific problems such as abdominal pain and often don’t disclose their eating disorder.

Susan believes this is because they are reticent to be admitted to hospital, have had their past experiences of seeking health care for an eating disorder dismissed, and often because they genuinely believe they’re not sick enough to warrant further intervention. The study reveals the need for an enhanced understanding of healthcare presentations of people with eating disorders, as being crucial for improving access to treatment.

Following from these results, St Vincent’s is planning to undertake more research on how to better recognise patients in the acute care setting, and are commencing research partnerships with eating disorder organisations such as the ‘Inside Out Institute for Eating Disorders’, to scale up the research in NSW.

Associate Professor Susan Hart