Disordered eating in adolescent boys: Prevalence and long-term outcomes

Disordered eating includes behaviours and thoughts that are consistent with those of eating disorders but do not fully reach threshold for a full diagnosis. Adolescents’ disordered eating is a public concern: 20% of adolescents in the UK engage in disordered eating behaviours. Around a quarter of these are adolescent boys. Left untreated, adolescents are at higher risk of psychological distress, social difficulties, and later eating disorders. Early recognition and treatment of disordered eating is key for preventing long-term consequences. However, disordered eating in adolescent boys specifically is poorly understood and under-researched. Identifying the presentation of these problems as well as long-term outcomes is crucial. Although we know that disordered eating affects both boys and girls, there are key unanswered questions: How do disordered eating behaviours and cognitions co-occur in boys? Are these behaviours linked to both underweight and overweight? What are the long-term impacts on adult mental health and social functioning? Do men with a history of disordered eating present to healthcare services? And if so, which health services? To answer these important questions, our project has three parts. First, in the general population, we will look at patterns of disordered eating behaviours and cognitions in adolescent boys. These will include ‘traditional’ forms of disordered eating like dieting and body dissatisfaction, but also more male-centric concepts like excessive exercise and steroid-use to build muscle mass. We will also look at the relationship between disordered eating and body size. To do this, we will use information collected over many years from two population-based cohorts: ALSPAC in the UK and Young-HUNT in Norway. Second, we will look at long-term outcomes of disordered eating in men. Specifically, we will examine whether disordered eating in adolescence places men at greater risk of experiencing disordered eating, alcohol or substance use problems, and social difficulties in adulthood. To do this, we will use information collected through self-report questionnaires at age 30 in ALSPAC, and adolescence data with follow-up to adulthood using Young-HUNT with national linkage to health and welfare national registry data and self-report data from adult HUNT. Third, we will look at healthcare utilisation in men with disordered eating. We will examine whether men who engaged in disordered eating during adolescence use physical and psychological healthcare services, and if so whether there are certain services that they are more likely to use. To do this, we will use linked NHS data in ALSPAC, and Norwegian hospital data with Young-HUNT. Together, studying these questions will provide a thorough knowledge base of disordered eating in adolescent boys which can aid early detection and early intervention. We will share our findings with a range of stakeholders including parents, clinicians, and academics. Throughout the project we will seek to raise awareness of disordered eating in boys to counter the narrative that disordered eating is a “female problem”. Applicants: Nadia Micali (project lead), Kirsti Kvaløy (project co-lead - international), Trine Tetlie Eik-Nes (project co-lead - international), and Nora Trompeter (project co-lead - UK).