Number of children hospitalised for eating disorders doubles, new figures show

Between 2018 and 2022, there were 6,472 child and adolescent inpatient admissions due to mental or behavioural disorders to psychiatric and medical hospitals — about one quarter (24%) were for an eating disorder. File picture

Hospital admissions for eating disorders among children in Ireland have more than doubled in just five years, according to new research.

A new study has found a 121% rise in hospitalisations for under-18s between 2018 and 2022 — from 170 admissions in 2018 to 375 in 2022 — with a sharp spike during the pandemic.

Clinical experts who analysed records from psychiatric units, acute medical hospitals, and community mental health services said their findings highlight the “magnitude of eating disorders amongst children and adolescents in Ireland”.

In total, there were more than 1,573 eating disorder admissions in the five years — three-quarters were to acute medical hospitals and the remainder to inpatient psychiatric hospitals.

The study team said it was not surprising that the majority of admissions were to acute hospitals, as the HSE’s eating disorder care plan recommends hospital admission when patients are at substantial risk of “physical harm due to the physical complications of malnutrition”, or need urgent, medically monitored refeeding.

“This includes patients of very low weight, severe dietary restriction and/or at high risk of refeeding syndrome. Nasogastric feeding can be used to supplement insufficient nutritional intake where necessary”, said the study.

Hospitalisations peaked in 2021 — during the height of covid lockdown restrictions — with 538 admissions, nearly three times the pre-pandemic figure.

Anorexia nervosa or atypical anorexia nervosa was the most common eating disorder diagnosis in the children in psychiatric hospitals, accounting for 91% of admissions of the 370 psychiatric admissions over the five years.

The study by the Health Research Board (HRB), in collaboration with clinical experts, found the remainder were for bulimia nervosa (4%), while ‘other’, or unspecified, accounted for 5%. Specific eating disorder diagnosis for acute medical hospital admissions was not available.

“The findings show a significant demand for enhanced community and inpatient services that ensure timely and effective treatment for children and adolescents affected by eating disorders”, said lead author Harriet Lovett.

Nine out of 10 admissions (89%) to acute medical hospitals were female, and the average age was about 13 years. In psychiatric hospitals, 95% were girls, and the average age was older, at just over 15.

Overall, between 2018 and 2022, there were 6,472 child and adolescent inpatient admissions due to mental or behavioural disorders to psychiatric and medical hospitals — about one quarter (24%) were for an eating disorder.

Stays in psychiatric units for eating disorders averaged 72 days, compared to 17 days in acute medical wards. Over the five years, the average hospital stay for the conditions fell from 80 days in 2018 to 69 days in 2022.

During that time, there were 902 referrals to two specialist community eating disorder outpatient teams, with numbers peaking in 2021 when there were 360 referrals — 18% required hospital admission.

The research team highlighted the crucial role of outpatient care in the study published in the Journal of Eating Disorders.

The authors called for continued development of Camhs eating disorder teams, a national eating disorder register, and better data systems to monitor patients’ care, service demand, and capacity.

“This will assist in improving services, outcomes and patient safety”, they added.