Using pediatric growth curves in secondary prevention of eating disorders: Closing the diagnostic gap between onset of growth stunting or BMI suppression and clinical presentation

Abstract

Eating disturbances among children (13 years old and younger) often present with both atypical clinical features and a distinct gender distribution and therefore may not fit the diagnostic criteria presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This study proposes the use of pediatric growth curves as a diagnostic tool to close the diagnostic gap between onset of growth stunting or BMI suppression and clinical presentation. The growth charts of female adolescents with Eating Disorders (EDs) have been shown to display significant height and weight stunting in comparison to the general population as well as downward trends in weight and height curves before the clinical onset of the eating disorder. What is not yet understood, however, is if these trends are present in the growth curves of both male and female patients across a wider variety of ages, or if these trends can be used as a diagnostic standard for patients with eating disorders. The present study had three major aims: first, to replicate findings from previous studies of premenarcheal and adolescent females’ growth curves; second, to investigate whether these trends or patterns are common to both males and females; and then third, to determine if they have some dependency on patient age. The finding that abnormal patterns in growth can be observed in pediatric BMI charts of males and females, adolescents and children, individuals with and without a prior history of overweight or obese, and subjects with restricting and non-restricting EDs, suggests that growth charts can be useful tools for ED diagnosis and may even allow for earlier detection. This study also underlines the importance of diagnostic criteria for EDs for primary care physicians (PCPs) that are not wholly dependent on behavioral or psychological symptoms.