In our past blogs we have voiced our clinical opinions regarding the need for increased screening for disordered eating. Who should be screening? Primary providers such as pediatricians, therapists and dietitians come to mind. In the news this past week it was reported that there is no clear evidence at this time to recommend specific guidelines for or against screening for eating disorders (HealthDay, 2022). This is frustrating for many of us who work in the field who want to help identify families and patients and get them support as early as possible.
This conclusion was found based on research done out of the University of North Carolina at Chapel Hill. Dr. Feltner and colleagues looked at the evidence on screening and eating disorders for both adolescents and adults. They reviewed 57 studies overall which included 10,773 participants in total. Three of the studies only evaluated adolescents. Despite the amount of studies and people included; none of the studies looked into the benefits or harms of screening (HealthDay, 2022). One reason for this might be that these aspects are hard to study and measure as well as challenges of following patients for periods of time either before and after. Harm may also be very subjective from both caregivers and clients.
Effectiveness of screening was looked at - the SCOFF questionnaire was the only one mentioned with shown useful outcomes. Sensitivity and specificity of 84% and 80% were reported in adult patients. Of the studies included, 40 randomized controlled trials looked at different treatments for eating disorders. However - none of them mentioned included patients by screening. This is interesting - we include patients based on diagnosis but how were they screened? Who was the first person to identify some body or food related struggles? What degrees of disordered eating were present, or when were they diagnosed? This information would be very helpful of course.
Interestingly enough - this month a new recommendation statement was released on screening in eating disorders. The USPSTF (the US Preventative Services Task Force) released recommendations on screening for eating disorders, including binge eating disorder, anorexia and bulimia both for adults and adolescents. Researchers looked at 17 studies and concluded there was not enough evidence to assess how screening should be done.
Point is - we need more information! These discussions with families need to be done in an effective and safe way, and it seems like there is a lot more work to be done in this area (Precopo, 2022). The statement and overall sentiment encourages providers to consider the harms, benefits and current practice guidelines when deciding how and if to screen patients.
Think about your interactions with your medical providers.
How do they discuss your weight trends or eating habits with you?
Do you feel they omit important questions or look over details?
What language or conversations would you like to hear?
References:
https://www.consultant360.com/uspstf-new-recommendations-screening-eating-disorders