Background: Adolescence is a time of increased depression and eating disorder (ED) risk. The degree to which these symptoms are present in treatment-seeking adolescents with obesity is poorly understood, but should be considered in treatment programs. This study aimed to screen for ED risk and depression in adolescents with obesity prior to enrolment in a multi-site RCT, Fast Track to Health.
Methods: Eating Disorder Examination Questionnaire was used to screen for ED risk; defined as ≥2 episodes of binge eating, loss of control (LOC), or binge eating with LOC, or ≥1 episode of purging (self-induced vomiting or laxative use) within the last 28 days, or a global score ≥2.7. The Centre for Epidemiologic Studies Depression Scale-revised 10-item version for adolescents (CESDR-10) was used to screen for depression; defined as the presence of anhedonia, dysphoria or irritability plus two or more additional symptoms occurring 5-7 days or nearly every day in the past week.
Results: 65 adolescents have been screened. Adolescents most frequently reported binge eating (n=50), LOC (n=27) or both binge eating with LOC (n=28) ranging from twice in the last 28 days to daily engagement in the behaviour. Self-induced vomiting was reported by six adolescents, ranging from once to 15 times over the last 28 days; none reported laxative use. Almost half (n=31) had a global score ≥2.7. Adolescents met one (n=15), two (n=10), three (n=14), four (n=15) or five (n=1) of the six ED risk criteria. Eighteen adolescents met CESDR-10 criteria indicating possible (n=5), probable (n=3) or major depressive disorder (n=10).
Conclusion: A large proportion of adolescents with obesity presenting for treatment in a tertiary setting have a degree of ED risk and/or depression, often with more than one risk factor. Treatment providers should be aware of this risk and have mechanisms in place for identification and management.