The prevalence and correlates of eating disorders in adult emergency department patients

Objective: This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. Method: Emergency department patients aged 21–65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. Results: Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p <.001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p <.001) and to be female (OR = 2.37, CI = 1.76, 3.19, p <.001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. Discussion: Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.