title: Does Sex Matter in the Clinical Presentation of Eating Disorders in Youth?
abstract: OBJECTIVE
  Eating disorders (EDs) impact both males and females, but little is known about sex differences in ED psychopathology and overall clinical presentation. This study compared demographic and clinical characteristics of child and adolescent males and females who presented for ED treatment.
  
  
  METHODS
  Participants included 619 youth (59 males and 560 females) ages 6-18 years who presented for treatment between 1999 and 2011.
  
  
  RESULTS
  Males presented for ED treatment at a significantly younger age (p < .001), earlier age of onset (p = .004), and were more likely to be nonwhite (p = .023). Females showed more severe ED pathology across the Eating Disorder Examination subscales (weight concern: p < .001; eating concern: p < .001; restraint: p = .001; and shape concern: p = .019) and global score (p < .001). Males were more likely to present with an ED other than anorexia nervosa or bulimia nervosa (p = .002). Females presented with significantly higher rates of mood disorders (p = .027) and had a lower average percent of expected body weight (p = .020). Males and females did not differ in duration of illness, prior hospitalization or treatment, binging and purging episodes, anxiety disorders, behavioral disorders, or self-esteem. All analyses were controlled for age.
  
  
  CONCLUSIONS
  Results indicate that further exploration into why the sexes present differently may be warranted. Developing ED psychopathology assessments that better capture nuances particular to males and reevaluating criteria to better categorize male ED diagnoses may allow for more targeted treatment.
authors.affiliation: Pritzker School of Medicine, University of Chicago, Chicago, Illinois. Electronic address: kkinasz@uchicago.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Kinasz
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, California.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Accurso
authors.affiliation: Department of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Kass
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, California; Department of Pediatrics, University of California, San Francisco, San Francisco, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001008:Anxiety Disorders / Q000175:diagnosis; D001828:Body Image; D001835:Body Weight / Q000502:physiology*; D002648:Child; D003863:Depression / Q000175:diagnosis; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors
keywords: Anorexia nervosa; Bulimia nervosa; Comorbidity; Eating disorders; Sex distribution; Youth
references.citation: Int J Eat Disord. 2006 Nov;39(7):570-5
references.pmid: 16937384
references.citation: Int J Eat Disord. 2005 Sep;38(2):183-7
references.pmid: 16134106
references.citation: Biol Psychiatry. 2007 Feb 1;61(3):348-58
references.pmid: 16815322
references.citation: Arch Gen Psychiatry. 2007 Sep;64(9):1049-56
references.pmid: 17768270
references.citation: Annu Rev Clin Psychol. 2008;4:275-303
references.pmid: 18370618
references.citation: Eat Behav. 2010 Apr;11(2):119-21
references.pmid: 20188296
references.citation: J Clin Psychiatry. 2010 Mar;71(3):313-26
references.pmid: 20331933
references.citation: Arch Gen Psychiatry. 2011 Jul;68(7):714-23
references.pmid: 21383252
references.citation: Australas Psychiatry. 2011 Dec;19(6):526-30
references.pmid: 22077304
references.citation: Int J Eat Disord. 2012 Jan;45(1):110-4
references.pmid: 22170022
references.citation: Eur Eat Disord Rev. 2012 Jan;20(1):23-31
references.pmid: 21823213
references.citation: Int J Eat Disord. 2012 Apr;45(3):428-38
references.pmid: 21744375
references.citation: Eat Disord. 2012;20(5):346-55
references.pmid: 22985232
references.citation: Eat Disord. 2012;20(5):405-15
references.pmid: 22985237
references.citation: Eur Eat Disord Rev. 2013 Jan;21(1):1-7
references.pmid: 22847947
references.citation: Eur Eat Disord Rev. 2013 Sep;21(5):386-94
references.pmid: 23681932
references.citation: Int J Eat Disord. 2014 Sep;47(6):610-9
references.pmid: 24903034
references.citation: Pediatrics. 2014 Sep;134(3):582-92
references.pmid: 25157017
references.citation: Curr Opin Psychiatry. 2014 Nov;27(6):426-30
references.pmid: 25226158
references.citation: J Abnorm Psychol. 2000 Aug;109(3):488-503
references.pmid: 11016118
references.citation: Am J Psychiatry. 2001 Apr;158(4):570-4
references.pmid: 11282690
references.citation: Behav Res Ther. 2001 May;39(5):625-32
references.pmid: 11341255
references.citation: Int J Eat Disord. 2002 Dec;32(4):426-40
references.pmid: 12386907
references.citation: J Psychosom Res. 2002 Nov;53(5):963-74
references.pmid: 12445586
references.citation: Int J Eat Disord. 2003 Mar;33(2):205-12
references.pmid: 12616587
references.citation: Int J Eat Disord. 2003;34 Suppl:S19-29
references.pmid: 12900983
references.citation: Eat Behav. 2004 Jan;5(1):13-25
references.pmid: 15000950
references.citation: Br J Psychiatry. 1989 Jun;154:807-12
references.pmid: 2597887
references.citation: Am J Dis Child. 1992 Mar;146(3):323-5
references.pmid: 1543180
references.citation: Psychol Bull. 1994 May;115(3):424-43
references.pmid: 8016286
references.citation: Int J Eat Disord. 1996 May;19(4):391-7
references.pmid: 8859397
references.citation: J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):980-8
references.pmid: 9204677
references.citation: Can J Psychiatry. 1998 Jun;43(5):507-12
references.pmid: 9653536
references.citation: Can J Psychiatry. 1999 May;44(4):374-8
references.pmid: 10332579
references.citation: J Adolesc Health. 2006 Dec;39(6):800-5
references.pmid: 17116508