ORLANDO, Fla. ― Adolescents seen in epilepsy clinics are more likely to have eating disorders than those without epilepsy, suggests a first-of-its-kind study analyzing youth with both conditions, presented at the American Epilepsy Society Annual Meeting.
Researchers determined 8.4% of adolescents (ages 10-19) seen at an epilepsy clinic over a 10-year period had eating disorders. Comparatively, 2.7% of teens ages 13-18 have an eating disorder during their lifetime, according to the National Institute of Mental Health.
“This research is especially important because it highlights a psychiatric condition that may be associated with adolescents with epilepsy and can lead to a failure to meet nutritional needs and severe inability to carry out many daily life functions,” said Itay Tokatly Latzer, MD, lead author of the study and an epilepsy fellow at Boston Children’s Hospital affiliated with Harvard Medical School. “Disturbed eating behaviors may result from epilepsy as well as lead to seizures.”
Between 2013 and 2022, 1,740 adolescents who did not have an intellectual disability or autism were seen at least once at Boston Children’s Hospital Epilepsy Center clinics for any condition involving seizures, including epilepsy, provoked seizures or psychogenic nonepileptic seizures (PNES), also known as functional seizures. Of those, 146 (8.4%) were diagnosed with an eating disorder. Over the 10-year period, the number of adolescents seen at an epilepsy clinic who had eating disorders increased annually, from 12 in 2013 to 22 in 2022.
Researchers then analyzed the various characteristics of that group and compared them to 146 each from the following groups: those who had epilepsy but did not have eating disorders and those with eating disorders who did not have epilepsy. They determined having PNES or lower body mass index (BMI) were associated with an adolescent with epilepsy also having an eating disorder. In those with both conditions, anorexia nervosa (restricting food) was more common than bulimia nervosa (eating and vomiting) or binge eating disorder (inability to stop eating). Adolescents who had eating disorders began having seizures at a younger age than those who did not have eating disorders. In the epilepsy and eating disorder group, 24% were males whereas in the eating disorders-only group, only 10% were males.
They also determined that adolescents being treated at an epilepsy clinic who had eating disorders ― especially those with PNES ― were more likely to have depression, anxiety, suicidality and/or a history of sexual abuse than those from the other two groups.