Eating Disorders 

• A 2012 study of Irish adolescents (1,841 girls, 1,190 boys) found that disordered eating was more prevalent among girls than boys. Regarding pubertal status, greater maturity in girls was associated with increased eating concerns, a higher drive for thinness and higher levels of body dissatisfaction. For boys, greater maturity was associated with lower body dissatisfaction and lower scores in the drive for thinness. Early maturing girls and late maturing boys show elevated levels of disordered eating. McNicholas et al. (2012). Source
• According to a 2007 study of Irish children and adolescents, 1.2% of Irish girls may be at risk of developing anorexia nervosa, with 2% at risk of developing bulimia nervosa. Source: McNicholas, F. (2007) Eating Problems in Children and Adolescents.

Body Image

• According to the Irish Health Behaviour in School-aged Children (HBSC) Study 2014, for children aged 12-17 years, peers, the media and self-perception are the most frequently cited influencing factors on body image. Numerous other factors listed by children include clothes, sports players, parents, other people, and how one feels after eating and exercising. Gavin et al. (2015) The Irish Health Behaviour in School-aged Children (HBSC) Study 2014. Source
• 77% of Irish adolescents ranked body image as being important to them. 57% of the young people surveyed expressed some level of satisfaction with their body image, which means 43% were dissatisfied. Negative body image is considerably more prevalent among girls than boys. When asked about what influences their body image, comparison with others ranks as the most negative influence on girls’ body image and bullying as the most negative influence on boys’ body image. Department of Children and Youth Affairs (2012) How We See It: Report of a Survey on Young People’s Body Image. Source

Findings of Health Behaviour in School-aged Children in Ireland from 1998-2018, published March 2021

Research from NUI Galway

• Between 2002 and 2018, there was a statistically significant increase in the proportion of children who reported being on a diet or doing something else to lose weight (11.9% in 2002; 14.4% in 2018). A notable increase amongst boys aged 10-17 was part of the HBSC findings, whilst increases also occurred in girls aged 10-11.

Media

• 71.4% of Irish adolescents feel adversely affected by media portrayal of body weight and shape, with more than a quarter (25.6%) believing it to be far too thin. McNicholas et al. (2009). Source

Mental Health

• Self-image was identified as the number one factor that ‘hurts’ the mental health of Irish teens. Teenage Mental Health: What Helps and What Hurts. Department of Children and Youth Affairs (2009). Source
• According to a 2007 study of Irish children and adolescents, 1.2% of Irish girls may be at risk of developing anorexia nervosa, with 2% at risk of developing bulimia nervosa. Source: McNicholas, F. (2007) Eating Problems in Children and Adolescents.
• Based on the KIDSCREEN study of children in thirteen countries, Irish children aged 12-18 ranked twelfth out of the thirteen countries in terms of self-perception score. State of the Nation’s Children. Office of the Minister for Children (2006). Source

• A systematic literature review found that the prevalence of eating disorders increased over the study period from 3.5% for the 2000–2006 period to 7.8% for the 2013–2018 period. Galmiche et al (2019). Source
• OSFED is the most prevalent eating disorder. Micali et al (2017). Source
• Lifetime prevalence estimates of anorexia nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and .3% .5%, and 2.0% among men. Hudson et al. (2007).  Source
• An estimated 20.8% of anorexia nervosa patients (Steinhausen, 2002) source and 23% of bulimia nervosa patients do not recover or improve, but develop a long term or chronic form of the eating disorder. Steinhausen & Weber (2009). Source

• An Austrian study with 715 middle-aged women found that 4.6% reported symptoms matching diagnostic criteria for an eating disorder. Mangweth-Matzek et al. (2014). Source

Media Influences

• The issue of thin media ideals, and whether the media contributes to body dissatisfaction and eating disorders has lacked a consistent, high quality evidence base – some of which has included systematic flaws. Ferguson (2018) Source
• A meta-analysis of 200 studies noted that, on balance, the available research evidence does not support the view that media effects on body dissatisfaction are widespread or strong for either males or females. Data from experimental studies show that media thin ideals may affect women with pre-existing body dissatisfaction issues. Ferguson (2013). Source

• The odds of using extreme weight-control behaviours (such as vomiting or using laxatives) are 3 times higher in the highest frequency readers of magazine articles about dieting and weight-loss compared with those who did not read such magazines. van den Berg et al. (2007). Source

• A study with 114 female college students found that those who were exposed to more fashion or beauty magazines were more dissatisfied with their overall appearance and exhibited a higher risk of eating disorder tendencies. The general frequency of television watching did not affect their self-esteem, body image, and eating disorder tendencies. Kim & Lennon (2007). Source

• Young girls aged 5-8 years who watched more appearance-focused television shows experienced lower appearance satisfaction. Dohnt & Tiggemann (2006). Source

Men

• 1 in 7 men will experience an eating disorder by age 40. Ward et al 2019
• Researchers in the United Kingdom (UK) found that EDNOS was the most common diagnosis in males, representing a 24% increase from 2000 to 2009. Micali et al. (2013). Source

• Previous estimates suggest that 10% of cases of anorexia nervosa and bulimia nervosa are male, though more recent studies suggest this figure could be as high as 25%. Hudson et al. (2007). Source

• Cases of binge eating disorder are much more equally divided, with up to 50% of cases occurring in men. Smith et al.(1998). Source

• Men and women who binge eat experience comparable levels of clinical impairment. Binge eating was also associated significantly with absence from work due to illness. Other effects included depression, stress, obesity and impaired health. Striegel et al. (2012). Source

• In a study with 111 males with eating disorders, the average age was 24 years old and 22.5% of the sample was aged 17 or younger. 62% of the sample had at least one mood disorder. Weltzin et al. (2012). Source

• A study with 10 male participants noted that it took the men months or years to recognise their experiences as being that of an eating disorder. For some, the realisation was precipitated by a crisis event or situation such as a marked deterioration in health. Some men experienced self-harm, increasing isolation and uncertainty about how to seek help. Räisänen & Hunt (2014). Source

• In terms of age of onset, it is unclear whether men and women differ in the development of eating disorders. Jones & Morgan (2010). Source There is however, a difference in terms of presentation for treatment. Men with bulimia may present at a later stage compared to females with bulimia. Men with anorexia nervosa may present earlier compared to females with anorexia nervosa. Calat et al. (1997). Source

Mortality

• In contrast to the general population, those affected by psychological disorders have increased all-cause mortality risks. Anorexia nervosa has one of the highest mortality ratios and also brings risk in terms of suicide mortality. Chesney et al. (2014). Source
• Of all eating disorders, anorexia nervosa has the highest mortality rate. Arcelus et al. (2011). Source
• Despite treatment advances, mortality rates of anorexia nervosa and bulimia nervosa remain very high: those who have received inpatient treatment for anorexia nervosa still have a more than five times increased mortality risk. van Hoeken and Hoek 2020.
• For those who’ve had inpatient treatment, men and women affected by anorexia nervosa, bulimia nervosa and OSFED have comparable mortality rates. However, males with anorexia nervosa may be at greater risk of premature death. Fichter et al, 2020.
• Factors which contribute to mortality in anorexia include cardiac abnormalities, low potassium (hypokalemia), and low blood sugar (hypoglycemia). Mehler et al, 2022.
• Patients with eating disorders diagnosed in hospital settings experience five to seven times higher mortality rates compared with the overall population. Iwajomo et al 2020.
• Women with a diagnosis of bulimia nervosa had a significantly increased risk of hospitalisation for cardiovascular disease and death up to 8 years after the index bulimia-related hospitalisation. Tith et al, 2020.

Self-harm

• A Dutch study involving 12 patients (women, 18-30) assessed the experiences of individuals dealing with anorexia and self-harm. Self-harm was often secretive, used to control emotions, as a form of personal punishment and as a reaction to feelings of self-hatred. Verschueren et al. (2014). Source

• In a study with 51 female patients with eating disorders, 33% of reported engaging in at least one non-suicidal self-injury (NSSI) behaviour during their life-time. Claes et al. (2014). Source

• A study involving 365 women with eating disorders (ED) and 170 obese women found that 19.1% of ED patients engaged in at least one act of NSSI during their life-time. Claes et al. (2013). Source

• In a study of 95 women eating with eating disorders admitted to a specialist inpatient unit, 38.9% reported at least one type of NSSI. Claes et al. (2012). Source

• In a study with male eating disorder patients, 21%, (27 patients), engaged in at least one type of NSSI. 67% (14 patients) reported that their NSSI had developed simultaneously with their eating disorder. Claes et al. (2012). Source

• In a retrospective review of charts of adolescents with an eating disorder aged 10-21 years, researchers found that self-injury was reported in 40.8% of individuals who were screened. Peebles, Wilson & Lock (2011). Source

Social media

• Social media and children’s mental health: A review of the evidence – Education Policy Institute
• Life in ‘Likes’: Children’s Commissioner report into social media usage among 8-12 year olds. Children’s Commissioner for England

Irish youth mental health

• What’s wrecking your head? A report on teenage mental health in Ireland. ReachOut.com
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