School-based screening for eating disorders could improve detection and outcomes
BOSTON, July 18, 2014 /PRNewswire-USNewswire/ -- A brief screening survey to identify teens at risk for an eating disorder could lead to earlier diagnosis and help find hard-to-detect cases, which could lower overall treatment costs and improve outcomes, Boston Children's Hospital researchers report today in American Journal of Public Health.
"Many cases of eating disorders go undetected for years. This may be because the stereotype that the typical teen with an eating disorder is a thin, affluent, white female. In reality, eating disorders come in all shapes and sizes and both genders, and they affect people from all racial/ethnic and socioeconomic backgrounds," says Kendrin R. Sonneville, ScD, RD, senior study author from Boston Children's Division of Adolescent Medicine.
Eating disorders—anorexia nervosa, bulimia nervosa and binge-eating disorder—are underdiagnosed and undertreated, particularly among low-income, minority, overweight and male teens. Only 3 to 28 percent of teens with eating disorders receive treatment for their condition. Moreover, interventions for eating disorders, such as residential treatment and lengthy therapy, tend to be very expensive. Teens with untreated eating disorders face medical complications, hospitalization and higher risk of early death.
The combination of under diagnosis, under treatment and high treatment costs has generated support for school-based screening, which could help identify teens with eating disorders. "However, the cost-effectiveness of school-based screening for eating disorders had not been demonstrated previously," says Sonneville.
In order to evaluate the cost-effectiveness of a school-based screening program, Sonneville and colleagues devised a computer simulation comparing annual screening of 10- to 17-year-olds to a no-screening scenario.
The researchers found that the 5-question survey boosted detection and treatment for eating disorders. Implementing a school-based screening program is a bargain in terms of time and money; screening costs $0.35 per student, and the survey can be scored in a few minutes.
"School-based screening for eating disorders is very likely a cost-effective approach to improving the health of teens. Early diagnosis leads to early treatment, which means these youth will get better faster and oftentimes avoid the long-term damage to their health and lives that the eating disorders can cause," says Sonneville. "A simple screening for eating disorders in schools could give millions of kids a new chance for a healthy life."
Boston Children's Hospital is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including seven members of the National Academy of Sciences, 13 members of the Institute of Medicine and 14 members of the Howard Hughes Medical Institute comprise Boston Children's research community. Founded as a 20-bed hospital for children, Boston Children's today is a 395-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Boston Children's is also the primary pediatric teaching affiliate of Harvard Medical School. For more information about research and clinical innovation at Boston Children's, visit: http://vectorblog.org.
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