Incidence and Age-Specific Presentation of Restrictive Eating Disorders in Children A Canadian Paediatric Surveillance Program Study

Objectives: To document and describe the incidence and age-specific presentation of early-onset restrictive eating disorders in children across Canada. Design: Surveillance study. Cases were ascertained through the Canadian Paediatric Surveillance Program by surveying approximately 2453 Canadian pediatricians (a 95% participation rate) monthly during a 2-year period. Setting: Canadian pediatric practices. Participants: Pediatricians and pediatric subspecialists. Main Outcome Measures: A description of clinical presentations and characteristics of eating disorders in this population and the incidence of restrictive eating disorders in children. Results: The incidence of early-onset restrictive eating disorders in children aged 5 to 12 years seen by pediatricians was 2.6 cases per 100 000 person-years. The ratio of girls to boys was 6: 1, and 47.1% of girls and 54.5% of boys showed signs of growth delay. Forty-six percent of children were below the 10th percentile for body mass index, 34.2% were initially seen with unstable vital signs, and 47.2% required hospital admission. Only 62.1% of children met criteria for anorexia nervosa. Although children with anorexia nervosa were more likely to be medically compromised, some children who did not meet criteria for anorexia nervosa were equally medically unstable. Conclusions: Young children are seen with clinically significant restrictive eating disorders, with the incidence exceeding that of type 2 diabetes mellitus. These eating disturbances can result in serious medical consequences, ranging from growth delay to unstable vital signs, which can occur in the absence of weight loss or other restrictive eating disorder symptoms.