Knowledge and Practice of Eating Disorders among a Group of Adolescent Dental Patients

Objectives: The objectives are to ascertain how much is known about the eating disorders of bulimia and anorexia nervosa in a group of female adolescents, to determine if they had practiced behaviors consistent with these eating disorders, and to determine if there was a disconnect with actual and perceived healthy weight status. Study Design: 126 research subjects completed a survey instrument. Embedded in the eighteen question survey were the five “SCOFF” questions, to determine if an eating disorder may exist. The BMI percentile was obtained for all participants. Results: 18.3% of the research sample may have an eating disorder as predicted by the SCOFF questions. Of those with a suspected eating disorder, only 38% could correctly identify the best description of bulimia nervosa and 50% for anorexia nervosa. The BMI percentiles were higher in the group suspected of having an eating disorder. Conclusions: Young adolescent females are at risk for eating disorders. Educational interventions should be directed at this young age group. If the at-risk individuals knew more about the consequences of these disorders, they may be less likely to practice the behaviors.

bulimia, anorexia, eating disorders, body mass index, adolescent

1. American Psychiatric Association Work Group on Eating Disorders. Prac-tice guideline for the treatment of patients with eating disorders (revision). Am J Psychiat 157:1-39, 2000.

2. North Dakota State University Counseling Center, Eating Disorders Statistics. Available at: http://www.ndsu.edu/fileadmin/counseling/Eating_ Disorder_Statistics.pdf. Accessed August 24, 2012.

3. National Association of Anorexia Nervosa and Associated Disorders. Eating disorders statistics. Available at: http://www.anad.org/get-informa-tion/about-eating-disorders-statistics/Accessed August 24, 2012.

4. Hoek HW, Bartelds AIM, Bosveld JJF, van der Graaf Y, Limpens VEL, Maiwald M, Spaaij CJK. Impact of urbanization on detection rates of eating disorders. Am J Psychiat 152:1272-1278, 1995.

5. Garfinkel PE, Lin E, Goering C, Spegg D, Goldbloom D, Kennedy S, Kaplan A, Woodside DB. Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups. Am J Psychiat 152:1052-1058, 1995.

6. Hoek HW, van Hoeken D. Review of the prevalence and incidence of eating disorders. Int J Eat Disorder 34:383-396, 2003.

7. Whitaker AH. An epidemiological study of anorectic and bulimic symp-toms in adolescent girls: Implications for pediatricians. Pediatr Ann 21:752-759, 1992.

8. Milos G, Spindler A, Hepp U, Schnyder U. Suicide attempts and suicidal ideation: links with psychiatric comorbidity in eating disorder subjects. Gen Hosp Psychiat 26:129-135, 2004.

9. Johnson JG, Spitzer RL, Williams JBW. Health problems, impairment and illness associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients. Psychol Med 31:1455-1466, 2001.

10. Kreipe RE, Mou, SM. Eating disorders in adolescents and young adults. Obstet Gyn Clin N Am 27:101-124, 2000.

11. Sullivan PF. Mortality in anorexia nervosa. Am J Psychiat 152:1073-1074, 1995.

12. Lo Russo L, Campisi G, Di Fede O, Di Liberto C, Panzarella V, Lo Muzio L. Oral manifestations of eating disorders: a critical review. Oral Dis 14:479-484, 2008.

13. Roberts MW, Li S-H. Oral findings in anorexia nervosa and bulimia nervosa: a study of 47 cases. JADA 115:407-410, 1987.

14. Little JW. Eating disorders: Dental implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:138-143, 2002.

15. DeBate RD, Tedesco LA, and Kerschbaum WE. Knowledge of oral and physical manifestations of anorexia and bulimia nervosa among dentists and dental hygienists. J Dent Educ 69:346-354, 2005.

16. American Psychiatric Association (APA), 1994. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., American Psychiatric Association, Washington, D.C.

17. Cavanaugh CJ, Lemberg R. What we know about eating disorders: facts and statistics. In Lemberg R, Cohn, L, eds., Eating Disorders: A Reference Sourcebook. Oryx Press, Phoenix, 1999.

18. Striegel-Moore R, Leslie D. One year use and cost of inpatient and outpa-tient services among female and male patients with an eating disorder: evidence from a national database of insurance claims. Int J Eat Disorder 27:381-389, 2000.

19. Campbell SM, Roland MO. Why do people consult the doctor? Fam Pract 13:75-83, 1996.

20. Hunt, J, Rothman AJ. College students’ mental models for recognizing anorexia and bulimia nervosa. Appetite 48:289-300, 2007.

21. D’Souza MC, Forman SF, Austin SB. Follow-up evaluation of a high school eating disorders screening program: knowledge, awareness and self-referral. J Adolescent Health 36:208-213, 2005.

22. Morgan JF, Reid F, Lacey JH. The SCOFF questionnaire: assessment of a new screening tool for eating disorders. Brit Med J 319:1467-1468, 1999.

23. Luck A, Morgan J, Luck JF, Reid F, O’Brien A, Brunton J, Price C, Perry L, Hubert Lacey J. The SCOFF questionnaire and clinical interview for eating disorders in general practice: comparative study. Brit Med J 325:755-756, 2002.

24. Mond JM, Myers TC, Crosby RD, Hay, PJ, Rodgers B, Morgan JF, Lacey JH, Mitchell JE. Screening for eating disorders in primary care: EDE-Q versus SCOFF. Behav Res Ther 46:612-622, 2008.

25. Perry L, Morgan J, Reid F, Brunton, J, Obrien A, Luck A, Lacey H. Screening for symptoms of eating disorders: Reliability of the SCOFF screening tool with written compared to oral delivery. Int J Eat Disorder 32: 466-472, 2002.

26. Parker SC, Lyons J, Bonner J. Eating disorders in graduate students: Exploring the SCOFF questionnaire as a simple screening tool. J Am Coll Health 2: 103-107, 2005.