Lifetime Prevalence of Psychiatric Disorders in Adolescents with Unexplained Weight Loss, Underweight, or Poor Appetite.
Micaela A Witte, Cynthia Harbeck Weber, Jocelyn Lebow and 6 others
PMID 37020320WHAT IT FOUND
Adolescents presenting with unexplained weight loss, underweight, or poor appetite had a 69.6% lifetime prevalence of any psychiatric disorder and a 21.3% prevalence of eating disorders.
These symptoms should trigger comprehensive mental health screening and close follow-up, not just nutritional intervention.
Key findings
01The lifetime prevalence of any psychiatric disorder was 69.6%, and the lifetime prevalence of any eating disorder was 21.3% in this cohort.
02Female patients were 4.27 times more likely to be diagnosed with an eating disorder than males over the five-year follow-up period.
03Patients with a greater decrease in BMI percentile were more likely to receive an eating disorder diagnosis, while those with a higher historical BMI were more likely to receive a non-eating disorder psychiatric diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on billing codes rather than structured clinical interviews, which may lead to misclassification of diagnoses. The sample was limited to adolescents whose symptoms were identified by a medical provider, potentially biasing the cohort toward more severe cases. There was no control group of adolescents without these symptoms for direct comparison. The findings are based on a single Midwestern US population, which may not generalize to other regions.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not interpret the association between higher historical BMI and psychiatric diagnosis as evidence that weight gain causes mental illness. The authors note this likely reflects diagnostic bias, where symptoms in heavier adolescents are attributed to general psychiatric disorders rather than eating disorders.