Child cases of anorexia nervosa has doubled

The number of child cases of anorexia nervosa treated in Irish hospitals has doubled in the past five years.

The latest figures from the HSE show there were 58 discharges of children aged under 15 in 2014, but that number rose to 119 in 2018.

In 2017, there was an even higher number of 125 discharges of children from hospital with a principal diagnosis of anorexia nervosa.

The figures emerge in the wake of a recent study which estimated that around 95 children aged between eight to 17-years-old are diagnosed with anorexia in the Republic each year, of whom 11 are aged between eight and 12 years old.

The HIPE figures reveal there were 461 or nearly 500 hospital discharges of kids from birth to 15 years of age treated for a principal diagnosis of anorexia nervosa between 2014 and 2018.

Professor Sarah Byford, the author of a recent study published in The BMJ journal estimating anorexia in Ireland, said the discharges account for the most severely ill cases who cannot be supported in the community.

She also said newly released hospital in-patient figures are picking up all cases in that age group at any one time, not just new cases.

“My data (suggested) there’s around 100 new cases of young people being diagnosed every year, but there will be many more than that in the population of cases.

“These discharges may include some of the new cases, but may also include young people who have had anorexia for some time.” She said the increase could be due to a number of factors.

“It (could be) an increase in anorexia nervosa and thus a general increase in the most severe cases,” she said.

Prof Byford said the sharp rise in discharges in 2017 and 2018 could also be due to a better identification of cases as a result of policy pushes to better support young people with eating disorders.

She noted there could also be service level changes to admit young people earlier or alternatively there may be a policy of trying to reduce lengths of stay which would increase the number of young people who can be admitted and discharged each year.

Prof Byford said the Scandinavians are leading the way in terms of holding central records of conditions like anorexia nervosa.

“They have amazing research from thousands and thousands of patients,” she said.

She said her study estimated that overall that numbers of people with anorexia nervosa are not rising but they are increasing in the younger age groups.

“If we apply our incidence figures to the current population of (Ireland) you’re talking about 95 new cases a year for the full age range of eight to 17 year olds. For the younger group of eight to 12 years old, you’re talking about 11 new cases a year.

We are talking about relatively small numbers, but anorexia is quite a rare disorder.

It gets in the media a lot because it’s the most deadly of all the mental health problems but numbers are small.

Prof Byford, a leading anorexia expert, said they are seeing increases primarily in 11 to 12-year-olds.

“Although we do have some eight, nine and 10-year olds, those numbers are incredibly small but it’s the pre-teens around that 11 to 12. We’re all used to anorexia being a problem for 15, 16, 17 year olds — that’s where the numbers are highest — so it’s a little bit of a surprise that those numbers are starting to grow in 11 to 12 year olds as well.

“There are two possibilities. it may well be there is increased pressure on young people to lose weight and it is starting earlier but it may also be we are getting better at identifying anorexia.

“The sooner we can identify it, the sooner we can support them and try and stop the condition becoming long-term and chronic.

“Anorexia is quite complicated, it tends to be a combination of a genetic pre-disposition, development changes during puberty, and a number of risk factors.

“The (risk factors) might be simply the young person doesn’t like the way they look or they are being criticised for their eating habits, or weight or body shape.

“We know anorexia is related to trauma, abuse, bullying and also if young people have an anxious temperament or tendency towards perfectionism.”