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Childhood eating disorders: British national surveillance study

  • Dasha E. Nicholls (a1), Richard Lynn (a2) and Russell M. Viner (a3)



The incidence of eating disorders appears stable overall, but may be increasing in younger age groups. Data on incidence, clinical features and outcome of early-onset eating disorders are sparse.


To identify new cases of early-onset eating disorders (<13 years) presenting to secondary care over 1 year and to describe clinical features, management and 1-year outcomes.


Surveillance over 14 months through the established British Paediatric Surveillance System, and a novel child and adolescent psychiatry surveillance system set up for this purpose.


Overall incidence was 3.01/100 000 (208 individuals). In total, 37% met criteria for anorexia nervosa; 1.4% for bulimia nervosa; and 43% for eating disorder not otherwise specified. Nineteen per cent showed determined food avoidance and underweight without weight/shape concerns. Rates of comorbidity were 41%; family history of psychiatric disorder 44%; and early feeding difficulties 21%. Time to presentation was >8 months. A total of 50% were admitted to hospital, typically soon after diagnosis. Outcome data were available for 76% of individuals. At 1 year, 73% were reported improved, 6% worse and 10% unchanged (11% unknown). Most were still in treatment, and seven were hospital in-patients for most of the year.


Childhood eating disorders represent a significant clinical burden to paediatric and mental health services. Efforts to improve early detection are needed. These data provide a baseline to monitor changing trends in incidence.

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Corresponding author

Dasha E. Nicholls, Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH. Email:


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Parts of this paper were presented at the Annual Conference of the Royal College of Paediatrics and Child Health in York, April 2007, and at the Royal College of Psychiatrists' Child and Adolescent Psychiatry Annual residential conference in September 2008.

The study was funded by the Harold Hyam Wingate Foundation.

Declaration of interest




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Childhood eating disorders: British national surveillance study

  • Dasha E. Nicholls (a1), Richard Lynn (a2) and Russell M. Viner (a3)
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