title: Clinical presentation of eating disorders in young males at a tertiary setting.
abstract: BACKGROUND
  Young males with eating disorders are a neglected study population in eating disorders. The aim of this study was to provide knowledge about the clinical presentation of eating disorders in young males.
  
  
  METHODS
  The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project (N ~ 1000), a prospective, ongoing registry comprising consecutive paediatric (<18 years) tertiary eating disorder referrals. Young males with DSM-5 eating disorders (n = 53) were compared with young females with eating disorders (n = 704).
  
  
  RESULTS
  There was no significant difference in the prevalence of diagnosis of bulimia nervosa (2 % vs 11 %, p = 0.26) among sexes. Males had comparable duration of illness (9 months; p = 0.28) and a significantly earlier age of onset (M = 12 years; p <0.001). Shape concern (2.39 vs 3.57, p <0.001) and weight concern (1.97 vs 3.09, p <0.001) were lower in males, and body mass index z score (-1.61 vs -1.42, p = 0.29) and medical compromise (odds ratio [OR] = 0.64, 95 % CI: 0.36, 1.12) were comparable. Males had a two-folder higher odds of being diagnosed with unspecified feeding or eating disorders (40 % vs 22 % for females, p = 0.004). Driven exercise to control weight and shape was common and comparable in prevalence among males and females (51 % vs 47 %, p = 0.79) and males were less likely to present with self-induced vomiting (OR = 0.23, 95 % CI: 0.09, 0.59).
  
  
  CONCLUSIONS
  Boys with eating disorders are an understudied group with similarities and differences in clinical presentation from girls with eating disorders. Parents and physicians are encouraged to consider changes in weight, disturbed vital signs, and driven, frequent exercise for the purposes of controlling weight or shape, as possible signs of eating disorders among male children. Diagnostic classification, assessment instruments, conceptualisation, and treatment methods need to be refined to improve application to young males.
authors.affiliation: Eating Disorders Program located at Princess Margaret Hospital for Children, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia ; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Chloe Y
authors.initials: CY
authors.lastname: Shu
authors.affiliation: Eating Disorders Program located at Princess Margaret Hospital for Children, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia.
authors.forename: Karina
authors.initials: K
authors.lastname: Limburg
authors.affiliation: YouthFocus, Perth, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Harris
authors.affiliation: Eating Disorders Program located at Princess Margaret Hospital for Children, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: McCormack
authors.affiliation: Eating Disorders Program located at Princess Margaret Hospital for Children, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia ; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Kimberley J
authors.initials: KJ
authors.lastname: Hoiles
authors.affiliation: Eating Disorders Program located at Princess Margaret Hospital for Children, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hamilton
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Australia ; Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, USA ; School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
authors.forename: Hunna J
authors.initials: HJ
authors.lastname: Watson
keywords: Child; Clinical presentation; Eating disorders; HOPE Project; Males; Paediatric