Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

A systematic review on understanding the prevalence of disordered eating/eating disorders in adults with overweight/obesity presenting for obesity treatment  (#253)

Hannah Melville 1 , Natalie B Lister 1 , Sol Libesman 2 , Anna L Seidler 2 , Clare Cheng 3 , Judy Kwan 3 , Sarah P Garnett 1 , Louise A Baur 1 , Hiba Jebeile 1
  1. Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  2. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
  3. Nutrition and Dietetics Group, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia

Current data on prevalence of disordered eating/eating disorders in adults presenting for obesity treatment is inconsistent. This systematic review aimed to understand the prevalence of disordered eating/eating disorders in adults presenting for obesity treatment.

Three databases were searched to March 2024. Eligible studies measured disordered eating/eating disorders in adults with overweight/obesity at baseline, including ≥ 325 participants to ensure a representative sample.

Eighty-one studies (k) were included (n=90,900, 75.9%F, median age 44 years (IQR=5), median BMI 46kg/m2 (IQR=10). Adults presented for bariatric surgery (k=49), behavioural weight management (k=10) or low/very low energy diets (k=3). Clinical interviews assessed diagnosed eating disorders in 31 studies. Prevalence of any eating disorder was reported in seven studies, ranging from 1.3% to 8.6% (k=4), and 19.7% to 31.9% (k=3).  Prevalence of binge eating disorder was 1.3% to 41.1% (k=19) using DSM-4 criteria and varied in studies using DSM-5 criteria reporting prevalence of 3.4% to 6.4% (k=6) and 26% to 28% (k=3). Prevalence of bulimia nervosa ranged from 0.1% to 3.6% (k=8), night eating syndrome 0.8% to 10.1% (k=4) and anorexia nervosa 0% to 0.2% (k=3). One study reported prevalence of unspecified eating or feeding disorders at 9.5%. No studies reported on avoidant/restrictive food intake disorder or pica. Fifty-four studies used self-report questionnaires. Binge eating disorder assessed by Questionnaire on Eating and Weight Patterns ranged from 2.6% to 25.3% (k=17). Binge eating, night eating and loss of control behaviours (interview or self-report) reported prevalence of 2.2% to 65.2% (k=36), 0.8% to 28.0% (k=11) and 6.3% to 61.2% (k=3) respectively.

Overall, there was high variability in prevalence of eating disorders in adults presenting for obesity treatment, with most studies reporting prevalence of less than 20%. It is important to consider possible co-morbidity in adults presenting for obesity treatment and resolve what population factors drive this heterogeneity.